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Don’t let glaucoma sneak up on your vision

Glaucoma is often referred to as the “sneak thief of sight.” It has earned this nickname because in many cases, vision is damaged gradually. January is Glaucoma Awareness Month and if you are older than 40, it is a good time to have an eye exam to screen for this sneaky disease.

Vision loss from glaucoma is usually so gradual that you will not notice changes until the disease is advanced. Currently, glaucoma is not curable, there are no treatments to restore vision and there is no way to know if you are in the early stages without an examination, so it is important to be checked for glaucoma periodically by an optometrist or ophthalmologist.

If you are younger than 40 with no known risk factors for glaucoma, you should usually have a complete eye exam, which includes checking for glaucoma, once every 5 to 10 years. Risk factors for glaucoma include the following:

• Being older than 40

• High eye pressure (intraocular pressure)

• Family history of glaucoma

• Descent from African, East-Asian or certain Native Alaskan groups

• Farsightedness

• Eye injury or surgery

• Diabetes

• High blood pressure

• Taking steroids of any kind

Glaucoma is a group of eye conditions that damage your optic nerve, and therefore your vision, usually from abnormally high intraocular pressure. Open angle glaucoma, which starts slowly, is the most common type, affecting about 2 million people in the United States. Acute closed-angle glaucoma, which is less common, causes increased intraocular pressure suddenly and is associated with pain, nausea, a red eye, vision changes and a change in the shape or function of the pupil (the center of the eye). It is an emergency and immediate treatment is needed to preserve vision. You can also be born with congenital glaucoma, but this is rare.

No matter which type you have, the aim of treatment is to minimize or prevent optic nerve damage and stop or slow vision loss.

Treatments to lower intraocular pressure include eye drops, oral medication and surgery. Daily eye drops increase outflow of liquid from the eye, reduce production of fluid in the eye, or do both. Some eye drops or oral medications prescribed for glaucoma can affect other medical conditions or interact with other medications, so be sure to tell your eye care professional about all your health conditions, and about all medications and supplements you are taking.

There are many medications for treating glaucoma. If you have intolerable side effects from the medication prescribed, tell the person who prescribed your treatment so that you can work together to find an effective medication without those side effects. Many natural compounds and plants have been investigated for treatment of glaucoma, but none have been shown to be as effective long term as prescription and surgical options.

Surgery to treat glaucoma is usually reserved for situations where you cannot tolerate medication; medication is not effective for acute emergencies.

Since diabetes and high blood pressure increase your risk of developing glaucoma, I recommend eating a healthy low-sodium diet, exercising and maintaining a healthy body weight to reduce the risk of developing those diseases. Eye injuries can lead to glaucoma too, so wear eye protection when doing things like using power tools or playing sports.

Glaucoma should be taken very seriously. Untreated it can end in blindness. Follow up with eye exams regularly, take the recommended treatment and take care of your overall health to help preserve your vision. Hopefully in the future we will have a way to restore vision the “sneak thief” has stolen, but for now, once it is gone, it is gone forever.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears the second and fourth Tuesday of the month in the Today section. Send your comments and column suggestions to

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