Glaucoma: the eye disease that can steal sight without early symptoms

You may have heard the term “glaucoma” before, but what is it really, and how do you know if you have it? Glaucoma is an eye disease in which the optic nerve is damaged over time due to elevated pressure in the eye, resulting in vision loss. There are not many noticeable symptoms, so regular eye exams are the only way to identify if you have elevated eye pressure and to prevent blindness from glaucoma. Early detection is key, so getting a yearly comprehensive eye exam is your best bet in preventing vision loss!  

Causes and Risk Factors:

The main risk factor for glaucoma is elevated pressure within the eye. This is an imbalance between the rate at which the aqueous humor, the clear fluid filling the space in the front of the eyeball between the lens and the cornea, is produced and the rate it leaves the eye. Increased intraocular pressure over time causes damage to the optic nerve which connects the eye and the brain, causing irreversible vision loss.

There are several components and  risk factors that doctors look into. 

  • Age: Can begin as early as 40 years old
  • Race: African-Americans have a higher risk and are more likely to suffer permanent vision loss.
  • Family History: If someone in your family has a history of glaucoma it increases your risk.
  • Medical conditions: Diabetes and High Blood Pressure may increase your risk of developing glaucoma.

Diagnosis: 

You might be wondering how to know if you are suffering from glaucoma. At your annual comprehensive eye exam, your doctor will check your eye pressure in a couple of different ways:

  • Tonometer. After special numbing drops are put in your eye, your doctor gently holds this pencil-shaped device against the outside of your eyeball. The reading tells how well your cornea pushes back.
  • “Puff of air.” Your doctor could also use an instrument that blows a small puff of air at your eye while you look into a light.
    • Most people are familiar with the famous eye puff test. While it can still be used today as a screening method for checking eye pressure, it is slowly going by the wayside. Not only do patients dread the air puff, it is not as accurate as some of the newer methods of testing eye pressure or the gold standard tonometer.
  • Icare. No drops required. Single-use tips are used for measurement, which gently touches your eye quicker than a blink.

All of these methods are painless and only take a few seconds to complete. Your results will be available right away and your doctor will explain what they mean and the next steps if treatment is necessary. 

Treatments:

Luckily there are many treatments available to patients who are experiencing glaucoma. They range from drops to surgery depending on the need of the patient. 

  • Glaucoma medications are drops that can be used daily to decrease eye pressure by decreasing the amount of fluid made, increasing the outflow of fluid, or both.
  • SLT surgery is the use of Laser energy applied to the drainage tissue in the eye. This starts a chemical and biological change in the tissue that results in better drainage of fluid through the drain and out of the eye. This eventually results in lowering of the intraocular pressure or IOP. . It may take 1-3 months for the results to appear.
  • Minimally Invasive glaucoma surgery (MIGS) is a surgery using shunts that lower eye pressure.

These treatments may be combined for maximum pressure lowering.

What Should You Do?

No one should be afraid of glaucoma, but they should also not ignore it. Annual eye exams are the key to watch for this silent condition  

Early diagnosis and treatment of glaucoma is critical to ensure your vision remains healthy. The best thing to do to manage your eye health is to have an annual comprehensive eye exam. During your comprehensive eye exam you will be asked about your family history, medical conditions and have your eye pressure tested. If you are in need of an optometrist, click here to find a doctor near you! 

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Ask An Optometrist to Improve Your Eye-Q

If you have had a question about vision or eyesight but keep forgetting to ask while at your annual comprehensive eye exam, we may have a few answers for you! Below we have answered a few common questions or even misconceptions that we hear. 

Q: Will reading in the dark damage my eyes? 

A: Reading in the dark will not physically cause harm to the eyes. It might be harder to see clearly, and you may experience more fatigue reading in the dark, but it’s not causing any long-term damage. Because it can impact your comfort, turning on a light might be a good solution!  

Q: Can you tell if I have diabetes just by looking at my eyes? 

A: While we can’t formally diagnose diabetes just from what is seen during an eye exam (bloodwork is required for that), your optometrist can see signs of the disease when diabetes is present. In these cases, we may see specific types of bleeding, changes to the blood vessels or fluid in the retina. During your comprehensive eye exam, your optometrist can see signs of many different systemic conditions in the eyes including high blood pressure, high cholesterol, and anemia. 

Q: Will eating carrots improve my vision? 

A: Unfortunately, no matter how many carrots you eat, they will not improve your eyesight or change your prescription. Carrots are a great source of vitamins which are very important to keeping the different structures of your eye healthy long term. They contain beta-carotene which our body converts into Vitamin A. A few other veggies that contain vitamins important for our eye health are spinach, kale, collards, turnip greens, corn, peas, and broccoli. In addition to nutrition, don’t forget to wear sunglasses with both polarization and UV protection as well. 

Q: Am I a LASIK candidate? 

A: Many criterion are considered before undergoing LASIK surgery to correct vision. These include age, stability of prescription, amount of prescription, and any eye conditions that could put you at risk of a poor outcome. These factors are best discussed with your optometrist. Many LASIK surgery centers offer free consultations to answer these question but will also need information from your most recent comprehensive eye exam. There are additional measurements that are taken at these consultations to verify that your cornea can safely undergo the procedure. Speak with your optometrist to learn more about your next step in determining if you are a good candidate.  

Q: If I wear my glasses, will my eyes become weaker? 

A: No! The research shows that full correction does not cause a worsening of your prescription. Sometimes what people notice is that the poor vision they have just been dealing with looks particularly bad when compared directly with how clear it can be through their new glasses. The brain doesn’t like blur but will tolerate it if it hasn’t seen any better. Actually, wearing the appropriate correction can help alleviate underlying eye strain, headache and fatigue induced by trying to compensate for an underperforming visual system. 

Q: Do cataracts run in the family? 

A: Typically, cataracts are a normal age-related change. Every person on the planet will have cataract changes eventually, usually becoming visually significant in our 60s or 70s – although this may happen earlier or later in life as well. Very early cataract formation can run in the family due to underlying genetic conditions. That is why early eye exams at ages 1, 3 and 5, are so important. Some medications and systemic diseases can also induce early cataract formation. It is also why your eye doctor always takes a thorough systemic history and wants to know all the medications and supplements you are taking.

Q: Do blue light glasses work? 

A: Blue light filters on glasses block blue wavelengths of light which are emitted from devices. The reality is that the amount of blue light you are exposed to from device screens will not physically harm your retina. However, blue light does impact your circadian rhythm and an excess during the day can disrupt your ability to get restful sleep, which can make you feel more fatigued than normal. Rather than simply buying a pair of blue light glasses over the counter, if you are experiencing eye strain or fatigue from computer work, please visit your optometrist! You are likely experiencing symptoms of Computer Vision Syndrome (CVS) and there are many things in addition to blue light filters that can be done to help your eyes stay healthy and comfortable. 

Q: Does smoking marijuana really treat glaucoma? 

A: There is a very small intraocular pressure lowering effect from smoking marijuana. It is not sufficient to treat glaucoma! We use eye drops and/or surgeries when appropriate to lower the intraocular pressure safely and in a consistent, reliable way. 

When in doubt, schedule an appointment with your optometrist to discuss any concerns about your vision or eye health. We love to answer your questions! Comprehensive eye exams are also important to detect any eye health and vision concerns before they become a problem. If you don’t have an optometrist, find one here!

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4 Steps to Improve Independence When Living With Visual Impairment

Visual impairment (low vision) may be defined as insufficient vision to do the things a person wants and needs to do.  The loss of vision cannot be corrected by regular glasses, medical treatment, or surgery and can be congenital or the result of disease, and injury. 

Common eye diseases that cause low vision may include macular degeneration, glaucoma, diabetic retinopathy and inherited retinal disease.  These conditions can cause a permanent loss of central (detailed) vision, as well as a loss of peripheral (side) vision.  People may have difficulty reading the newspaper, paying bills (even with reading glasses), recognizing faces, crossing streets, and seeing small print on their television.

Low vision care (also referred to as Vision Rehabilitation) helps people with low vision function as fully and independently as possible by providing devices, information, and technology. 

Step 1: Get an Eye Exam With an Eye Care Professional

A thorough eye examination is imperative to diagnose the reason for your decrease in vision.  The eye doctor will ensure you:

  • are evaluated for ocular and systemic disease
  • receive proper medical treatment for your eye disease
  • have the best eye glass prescription possible

Due to the underlying eye disease, new glasses cannot restore vision to a level that allows you see detail (small & fine print, faces, etc.) like you did before.  Your eye care professional may refer you to an optometrist specializing in low vision care.  You can also request a referral for low vision rehabilitation, if you are having difficulty performing your daily activities.

Step 2: Discuss With Your Eye Doctor the Need for a Low Vision Evaluation

A low vision exam with an optometrist specializing in low vision care, takes about one to two hours and is different than a typical eye exam. The low vision evaluation will focus on how you function with your remaining vision and find strategies to maximize your remaining vision.

Use the time during your low vision exam to discuss and understand your vision goals and challenges.  For example, improving facial recognition, writing, reading, color identification, and more.  Bring any current glasses, magnifiers, or other low vision devices you use, whether they are helpful or not.

Step 3: Discuss How to Make Reading Easier

A conversation about how to make reading with low vision easier can produce great results. Your low vision specialist can make suggestions on how to improve reading for your specific needs and uses. For instance, a student might require a way to read notes on a whiteboard while in class and you can troubleshoot the challenges around this together.

Basic Modifications for Reading:

  • Increase lighting.
  • Use of increased magnification such as stronger reading glasses, hand-held and stand magnifiers, hand-held and spectacle mounted telescopes, and electronic video magnifiers.
  • Use of auditory and large print accessibility features on your smartphone, tablet and desk-top computers.
  • Use of audiobooks through the National Library of Congress Talking Book program.

Step 4: Discuss How to Improve Quality of Life at Home/Work

Your eye doctor may refer you to a:

  • Certified Vision Rehabilitation Teacher
  • Occupational Therapist who specializes in working with the visually impaired
  • Certified Orientation and Mobility Specialist

These professionals work with you in your home, community, and workplace to ensure safety and independence.

Obtaining additional strategies and modifications are critical for maintaining independence. Adjustments and organizational practices can make a huge difference. The following techniques are commonly offered, but this is also your chance to troubleshoot any current issues arising at home or work:

  • Improve over-head and task lighting. Consistent lighting at home can reduce the risk of falls and disorganization.
  • Use contrasting colors to help identity steps, railings, knobs, switches, and anything else that is difficult to detect visually.
  • Remove hazards like rugs, cords, bulky furniture, or anything that could cause a fall or injury.
  • Use large print labels and tactile dots to help identify objects, numbers on the oven or microwave, telephone, remote control, and computer keyboard.
  • Create an organizational system to keep track of personal items.
  • Label medications or use a color code system for identifying prescription and over the counter medications.
  • Troubleshoot any challenges that prevent access to a healthy diet high in nutrient dense foods like leafy greens, berries, fish, nuts, and more.

Colorado Resources and Support Services Specific to Blindness/Visual Impairment

National Resources

Scholarship Information

Colorado Low Vision Specialists

Aurora

Kara Hanson, OD, FAAO

720-848-2020

UCH-Sue Anschutz Rodgers Eye Center 1675 Aurora Ct
Aurora, CO 80045

Aurora

David Lewerenz, OD, FAAO

Clinical Diplomate in Low Vision,

American Academy of Optometry

720-848-2020

UCH-Sue Anschutz Rodgers Eye Center 1675 Aurora Ct
Aurora, CO 80045

Aurora

Dr. David Simpson

720-848-2020

UCH-Sue Anschutz Rodgers Eye Center 1675 Aurora Ct
Aurora, CO 80045

Aurora

Shannon Kessler, OD, FAAO

303-283-5386

VA Eastern CO Healthcare System
14400 E Jewell Ave
Denver, CO 80012

Bayfield

Brian Meier, OD

970-884-2020

49 W. Mill Street
Bayfield, CO 81122

Brush

George Hertneky, OD

970-842-5166

212 Cameron St
Brush, CO 80723

Centennial

Eddy Najjar, OD

720-389-8023

7500 South University Blvd., Unit 104
Centennial, CO 80122

Craig

Craig Eckroth, OD

970-824-3488

450 Pershing St., Suite 100
Craig, CO  81625

Colorado Springs

Dr. Gregg Pusateri

719-471-3200

5614 N Union Blvd
Colorado Springs, CO 80918

Colorado Springs

Margaret “Molly” Dixon, OD, FAAO

719-599-2020

320 E. Fontanero, #201
Colorado Springs, CO  80907

Fort Collins

Deanna Alexander, OD, FAAO

970-221-4811

702 W Drake Rd, Bldg B
Ft. Collins, CO 80526

Glenwood Springs

Jennifer Zwelling, OD, FAAO

970-945-2020

Valley Vision  904 Pitkin Ave, Glenwood Springs, CO 81601

Lakewood

Dale Lervick, OD, FAAO

303-233-7575

7586 W Jewell Ave # 104
Lakewood, CO 80232

Lakewood

Kirk Matoba, OD

303-988-2777

200 N. Union Blvd
Lakewood, CO 80228

Lakewood

Neuro-Sight Vision Care – Drs. Jarvis, Politzer, and Chonka

303-989-2020

333 S Allison Pkwy # 120, Lakewood, CO 802226

Lakewood

Meredith Schneider, OD

720-793-0487

Denver Vision Inc1535 S Kipling Pkwy Unit CLakewood, CO 80232-6258

Lakewood

Dr. Alex Zemke

303-238-9900

2290 Kipling St Unit 1
Lakewood, CO 80215

Steamboat Springs

Craig Eckroth, OD

970-879-2020

365 Anglers Dr Suite A
Steamboat Springs, CO 80487

Tips for Dry Eye Relief


Tips for Dry Eye Relief

Did you know that between 16 million and 49 million Americans have dry eyes? This is between 5-15% of the population!¹ Dry eye symptoms are


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