Blinding eye disease: Why routine exams and early treatment are important

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Glaucoma, the second leading cause of blindness in the world behind cataracts, is often referred to as “the silent thief of sight” because it can so easily go undetected.

“You can have a very severe case of glaucoma and be completely unaware of it, especially if it isn’t affecting your central vision or causing blurry vision,” says Lauren Dhar, M.D., a board-certified Krieger Eye Institute (KEI) ophthalmologist.

It’s also usually painless.

“It’s not the same, but you can think of it like high blood pressure. Many people have high blood pressure, and it’s not something where you walked into your doctor’s office and you said, ‘I think I have high blood pressure.’

You went into the doctor’s office feeling fine, and they took your blood pressure and the blood pressure was high,” Dhar says. “And that’s doing silent damage to your body.”

Similarly, glaucoma can imperceptibly damage your vision, which is why routine exams are so important.

A family of diseases that causes vision loss by damaging the optic nerve, glaucoma is often caused by abnormally high eye pressure.

It affects your peripheral vision before it affects the clarity of your vision, which is how it can go unnoticed before causing serious damage.

Being over age 60, your family history (especially if a first-degree relative has been diagnosed), a history of high eye pressure and being very nearsighted are among the main risk factors for glaucoma.

In general, African Americans have the greatest risk for vision loss from glaucoma. There are other factors that may be discovered only through routine exams.

Vision loss caused by glaucoma is permanent, so early treatment is critical. Currently, the only way to treat glaucoma is to modify or lower eye pressure.

Medicated eye drops (for use once daily or multiple times a day in some cases), laser procedures and surgery are possible treatment options.

Glaucoma is treated in a stepwise fashion, starting with the least invasive treatment and moving to invasive procedures when necessary. Surgeries are usually done to build a new drain for the eye.

“At the root, that’s basically what we’re doing with glaucoma surgery, trying to lower the pressure in the eye by improving the drainage of fluid inside the eye,” Dhar says.

“Now is a really exciting time to be a glaucoma surgeon because there are a lot of different procedures that are being developed, including minimally invasive procedures that can be done at the time of cataract surgery.”

Your ophthalmologist can help you determine which treatment is right for you if you’re diagnosed. Just remember, routine eye exams can allow your ophthalmologist to monitor for signs of glaucoma that you may not be aware of.