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JANUARY IS GLAUCOMA AWARENESS MONTH
Early diagnosis and treatment are the keys to controlling this "sneak thief of sight."

Some 3 million Americans have glaucoma, but many are unaware they have the potentially blinding disease because they have no symptoms. The notion that people believe they can tell if they’re developing glaucoma is one dangerous myth about the disease. Here are some others.

Myth 1: Your vision will deteriorate or blur if you are developing the disease.

Most forms of glaucoma have no symptoms or cause no change in vision until later in the course of the disease. Once vision has been lost due to glaucoma, permanent damage has already been done to the optic nerve, and sight cannot be regained. Make an appointment today to get your eyes examined. 

Myth 2: Only old people get glaucoma.

Though frequency increases with age, glaucoma can strike at any time in a person's life. Approximately one in 10,000 babies is born with glaucoma and children between the ages of four and ten may develop a form of the disease called late congenital glaucoma. For those affected between ages ten and 35, the most common causes are hereditary disorders.

Myth 3: Glaucoma is always inherited.

Family history is a strong risk factor for glaucoma, but an absence of family history does not mean a person is risk-free. If there is a family history of glaucoma, everyone in the family -- from children on up -- should be tested.

Myth 4: Ethnicity has nothing to do with glaucoma risk.

Blacks and Asians are at particularly high risk for developing glaucoma. Researchers have also recently discovered that glaucoma is far more common among U.S. Hispanics than originally thought. African Americans, who are six times as likely to suffer from glaucoma as Caucasian Americans, develop glaucoma 10 years earlier and are fourteen to seventeen times more likely to go blind than their Caucasian counterparts.

Myth 5: All people with glaucoma have elevated intraocular pressure (IOP).

Elevated IOP is a risk factor for glaucoma and is not the disease itself. There are more than forty different types of glaucoma, and not all of them are associated with elevated IOP. Glaucoma specialists believe that some forms of glaucoma are strongly related to vascular changes and impaired “nutrition” (poor blood flow) to the optic nerve. The common thread among all glaucoma is damage to the optic nerve rather than elevated IOP.

Myth 6: If you don't have high blood pressure, you cannot have high eye pressure.

Blood pressure and eye pressure vary independently. Controlling blood pressure does not mean IOP is controlled. However, high blood pressure is often - but not always - associated with elevated intraocular pressure. Interestingly, low blood pressure is strongly associated with some forms of glaucoma, such as normal-tension glaucoma.

Myth 7:  Glaucoma always leads to blindness.

This is one of the most dangerous myths of all. Some 90 percent of all glaucoma-related blindness could have been prevented with proper treatment. In fact, glaucoma is the leading cause of preventable blindness. But you can’t get treatment unless you know you have a problem!

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GLAUCOMA TREATMENT NEWS

In 2017, new strides were made in the treatment of glaucoma. Recent issues of this newsletter have reported on several newly-approved minimally invasive glaucoma surgery (MIGS) devices and procedures. The advent of microinvasive glaucoma surgery, often performed in conjunction with cataract surgery, opens up new avenues for controlling IOP.

There has also been news on the medication front. In November, as we reported here, the FDA approved Bausch + Lomb’s new glaucoma medication, Vyzulta (latanoprostene bunod ophthalmic solution, 0.024%), for the reduction of IOP in patients with open-angle glaucoma or ocular hypertension. Vyzulta is an eyedrop for once-daily usage but has a dual mechanism of action. It is now available in pharmacies. 

Vyzulta provides a new treatment option that works to reduce IOP by increasing the outflow through both the trabecular meshwork and the uveoscleral pathways. While the prostaglandin component increases uveoscleral outflow, the nitric oxide component releases nitric acid to increase aqueous outflow through the trabecular meshwork.
 
Closing out the year, this December the FDA approved Aerie Pharmaceuticals’ Rhopressa (netarsudil ophthalmic solution 0.02%) -- a once-daily eye drop designed to lower IOP in patients with open-angle glaucoma or ocular hypertension. The therapy is believed to reduce IOP by increasing outflow of aqueous humor through the trabecular meshwork. While approved by the FDA, the drug is not yet available.