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Fighting Glaucoma May Be Easier Than You Think

Early detection is the key to saving your vision

En español | If you’re like most people, you think you’re taking reasonably good care of your eyes. You don goggles when operating power tools and usually wear sunglasses on the slopes or beach.

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But at least 2 million Americans are on a path to losing their vision and are doing little about it. Why? Fully half of the 4 million Americans with glaucoma — a leading cause of blindness — are unaware that their vision is at risk.

"With glaucoma, if you wait until there is a symptom related to loss of vision or reduced vision, then you're in the later stages," says Dr. Eve J. Higginbotham, senior vice president and executive dean for health sciences at Howard University in Washington, D.C.

Don't wait until there is a problem. Especially if you are at added risk (see below), collar this thief before it robs you of your sight. Here are the things you need to know.

Q: What exactly is glaucoma?
A: Glaucoma is a condition that damages the eye's optic nerve, a bundle of tissue carrying information about your visual world from your eyes to your brain. This damage is usually — but not always — caused by the buildup of naturally occurring fluid within the eye. When fluid cannot escape through the eye's clogged drainage system, the resulting pressure causes the optic nerve to deteriorate, resulting in vision loss and blindness.

Q: What's my risk?
A: Anyone can develop glaucoma, but some people are at higher risk, including people 60 and older; those with a family member, especially a parent or grandparent, who have or have had the disease; and Latinos and African Americans. Indeed, African Americans are five times more likely than whites to be diagnosed with the disease and four times more likely to lose their vision because of it, according to Lighthouse International. Also, having severe nearsightedness, hypertension or diabetes puts you at higher risk because these conditions can contribute to increased eye pressure that damages the optic nerve.

Q: What symptoms should I watch out for?
A: There are two main types of glaucoma, each with different symptoms. In open-angle glaucoma, the most common type, the eyes' drainage system becomes blocked slowly over time, so symptoms are not always pronounced. Gradual loss of peripheral vision is the primary symptom (click on the photo, above, to see what that's like). But often individuals who have the disease experience no symptoms at all. In closed-angle glaucoma, the eye's drainage system becomes blocked suddenly, causing acute, severe pain in one eye. Other symptoms: Nausea, decreased vision, halos around lights and a swollen eye. Closed-angle glaucoma is an emergency and can lead to complete vision loss within 24 to 48 hours, so it's important to see a doctor right away.

Next: How to protect your vision.

Q: What can I do to protect my vision?
A: Get an eye exam. "The biggest misconception is that there is no real treatment for it, that it just comes with aging," says Higginbotham. "Glaucoma — at least blindness related to glaucoma — can be prevented with early detection." While there is no way to prevent glaucoma or reverse vision loss caused by the disease, regular eye exams are critical to diagnosing and controlling the condition.

Q: What's the exam like?
A: During the exam, your doctor will place drops in your eyes to dilate, or widen, your pupils. This will allow him or her to look inside your eye for signs of damage to the optic nerve. In addition, your doctor will gauge the fluid pressure inside your eyes with an instrument called a tonometer, which either rests against your eye's (numbed) surface or sends a puff of air onto your cornea. The puff can be startling, and you may feel a slight pressure on your eye, but it doesn't hurt. Also part of the exam: Tests that measure your peripheral vision and visual acuity at various distances.

Q: Can I get help paying for the exam?
A: Medicare will cover an annual dilated eye exam for some people at higher risk for glaucoma, including African Americans 50 and older, Hispanics 65 and older, people with diabetes and those with a family history of glaucoma. (Learn more about free eye screenings.)

Q: If it turns out I have it, what are my treatment options?
A: Patients may be given medication, have surgery or get a combination of both. Laser and conventional surgical procedures help fluid drain out of the eye by widening the eye's drainage system or creating a new opening through which fluid can flow. Medication, usually in the form of eye drops, reduces fluid production or increases the exit of fluid from the eye. Ask your doctor questions if any of the information you receive about treatments is unclear, and be sure to stick to your regimen, Higginbotham says. Careful management of the condition can save your vision.

You may also like: 7 tips for choosing the right sunglasses.

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