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Like many vision problems, glaucoma rarely appears in younger people because the problems that cause it need time to develop. All people aged 60 or older are at risk for glaucoma, and individuals in high-risk groups could experience glaucoma as early as 40 years old.
What Is Glaucoma, Exactly?
Glaucoma isn’t just one problem – it’s actually a collection of problems that, ultimately, cause damage to the optic nerve and reduce the area in which people can see. The most common cause of this damage is an increase in the pressure of the fluid within the eyes, but it is possible for glaucoma to develop in other ways.
Other contributing factors include:
- Abnormal Anatomy of the Optic Nerve: Some people are born with unusual optic nerve systems, and in these cases, it’s almost always more likely that some damage will be caused to the optic nerve over time.
- Thin Cornea: The cornea – the clear front surface of the eye – tends to cause a lot of problems for the eye if it’s too thin. Among these issues is an increased risk of developing glaucoma.
- Previous Problems With The Eye: Individuals who have experienced retinal detachment, eye tumors, serious injury, or dislocated lens are at a higher risk of developing glaucoma. This, in fact, is a major contributing factor to the likelihood of glaucoma developing with age – as people continue to get older, it’s likely that some kind of damage will happen to the eye, and that in turn raises the risks of future problems.
- Ethnicity: Individuals of African descent are more likely to experience glaucoma as they age. This is believed to be genetic, but while the cause of this is not known, the statistics are clear.
Glaucoma is the second leading cause of blindness in the United States, with only cataracts contributing to a greater amount of blindness each year.
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Modern medicine has no cure for glaucoma – once the optic nerve is damaged, it stays damaged, and sight cannot be restored. However, while glaucoma cannot be cured, it can be treated by specialists, and it may be possible to prevent further loss of vision. Most patients will be asked to consider one or more of the following options:
- Eye Drops: Widely regarded as the least-invasive treatment plan, some cases of glaucoma can be treated by the regular application of medicinal drops. Most of these drops work by either relaxing the muscles in the eye (making it easier for liquid to flow out) or by decreasing the fluid production so the pressure doesn’t build up to begin with. It’s quite common for patients to be prescribed two or more types of drops, as clinical studies have found that they are often more effective when used together.
- In emergency cases, patients may be offered hyperosmotic drops. These actually decrease the level of fluid in the eye, and are generally a one-time-only treatment to get things under control before other treatment options are used.
- Laser Treatment: Patients may also be encouraged to go through a Selective Laser Trabeculoplasty (SLT) treatment. This process uses a special laser to help reduce the amount of fluid in the eye, and may be used in conjunction with medications in order to get glaucoma under control. However, patients should be aware that SLT treatments tend to be less effective if repeated, and results may take several months to appear – after they have appeared, though, the results typically last for 1-5 years.
- Tissue Removal: A more direct method of controlling glaucoma is actually removing some tissue from within the eye. This can be done to create new drainage channels (thus reducing pressure) or install special implants that can dispense medicine over time.
Which treatment is most effective will depend entirely on the individual involved – there are no universal treatment options, so it’s important to talk with your eye doctor about what technique will be best for you.
If an elder has undergone any kind of treatment beyond the application of eye drops, they may require professional in-home care while they heal – especially if they live alone. Be sure to ask about the normal recovery process for each treatment so you can plan ahead and make sure they get the care they need.
Is Treatment Always Effective?
Unfortunately, glaucoma treatments are not always perfectly effective. On average, about 10% of patients who receive treatment will still experience some kind of vision loss, and it may or may not be possible for alternate treatments to have an impact.
Living With Glaucoma
As we explained above, damage from glaucoma is permanent – lost vision cannot be restored because modern medicine has no way of repairing the optic nerves that link the eye to the brain. While mild loss of vision only has a minimal impact on daily living, advanced glaucoma can be frightening, especially for seniors who find themselves at a significantly increased risk of falling.
If glaucoma cannot be brought under control – and reasonable vision cannot be maintained – seniors will need to start making some serious changes in their lifestyle. The first step in this process is learning as much as they can about living while blind – what it means, how it will impact their daily life, and what they can do to prepare for it.
They’ll also need to adjust their living situation and start removing things that could cause falls – rugs are a major threat to seniors, as are slippery floors and uneven footing. This may not be easy, but over time, they’ll adjust to it – and even patients whose loss of vision cannot be stopped are likely to have several years to get used to these changes. Our society has a significant number of resources available to help the blind, so while they won’t be able to see, they certainly won’t be alone.
The Good News
There is one piece of good news here – glaucoma does not affect both eyes equally, and it’s quite common for one eye to function significantly better than the other. While most patients will ultimately develop glaucoma in both eyes, there could be a 5-10 year difference in when it starts, and chances are that at least some vision will be maintained even if one eye goes completely blind.
Some types of glaucoma – mostly those caused by injury and the like – have almost no chance of spreading naturally, but eye doctors will continue to carefully monitor both eyes just to be absolutely sure that it isn’t spreading.