Early Glaucoma Screening Essential for Eye Health

As with many eye conditions, early detection and treatment is key to glaucoma. The disease is devastating with no symptoms until vision is lost. Ophthalmologist Karen Rudo, MD, shares insight on glaucoma and how it can be addressed early for the best outcome.

There are a few types of glaucoma but the term often applies to the most common form, accounting for 90 percent of cases and affecting more than three million Americans. “Primary open-angle glaucoma is when the fluid in the eye has a pressure that is too high for the eye to tolerate. The specific pressure is different for every individual,” said Dr. Rudo. The optic nerve, described as the cable connecting the eye to the brain, becomes damaged by the high pressure gradually over time, and peripheral vision is typically impacted first.

“Eye pressure cannot be felt and doesn’t cause pain,” explained Dr. Rudo. “Until the end stages, glaucoma has no symptoms. Once optic nerve damage occurs, it is not repairable.” This is why early detection is so critical to preventing vision loss. Those most at risk of developing glaucoma are people who are older, have African or Hispanic heritage, use corticosteroids, have diabetes, or have prior eye injuries or family history of the condition.

Angle-closure glaucoma is an entirely different disease where the drain in the eye suddenly closes or is blocked, she said. It’s more common among people of East Asian descent and females. With this type, the pupil doesn’t change size in response to light, and symptoms—hazy vision, a red and painful eye, and a severe headache that can lead to nausea—develop within minutes. If treated the same day, vision may recover. Congenital and juvenile glaucoma are two other rare kinds of the disease.

Because increasing age is a significant glaucoma risk factor, Dr. Rudo recommends baseline screening by age 40. A complete eye exam assessing intraocular pressure and appearance of the optic nerve is the only way to detect glaucoma. “If anything looks suspicious, we do a computerized test of the peripheral vision, look at the health of the optic nerve and monitor for changes over time, and make sure the drain of the eye is open,” she said.

If identified early, glaucoma is highly treatable, particularly with advanced testing technology and new medications now available, said Dr. Rudo.“The goal is to lower the pressure in the eye, accomplished with prescription eye drops or a simple laser procedure. Many people elect for the laser treatment to avoid the difficulty of remembering to take drops. If the first line treatment isn't successful, sometimes surgery is required.”

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