Look Out for These Early Signs of Glaucoma

21 October 2019 Assisted Living

The early signs of glaucoma are sometimes so subtle that they go unnoticed. Since the damage from glaucoma occurs gradually over time, it often affects seniors over the age of 60. Glaucoma is a leading cause of blindness for aging adults and there is no cure. Early diagnosis and treatment are the only options for slowing or preventing vision loss.

What Is Glaucoma?

“Glaucoma” refers to a group of eye conditions, each with its own characteristics. It often occurs because of high pressure in the eye that damages the optic nerve. The optic nerve carries impulses formed by the retina to the brain, which interprets them as images. Once damage occurs to the optic nerve, it isn’t reversible. When caught early, there are treatments that stop or slow vision loss.

Some Common Types of Glaucoma in Seniors

Isopen-Angle – This is the most common form of glaucoma. It causes a slow loss of peripheral vision that doesn’t cause any pain.

Withopen-Angle – This type of glaucoma causes a slow narrowing of your field of vision that is imperceptible. It results in tunnel vision once the damage has already occurred. Without experiencing any early signs of glaucoma, it’s easy to miss withopen-angle glaucoma without regular eye exams.

Low-Tensionornormal Tension– This type of glaucoma is harder to detect because it doesn’t cause the same high eye pressure that other types do. Some experts believe it is connected to impaired blood flow to the optic nerve.

Fromangle-Closure –  When the eye pressure becomes too high, it forces the iris against part of the eye, blocking drainage. Once the drainage is completely blocked, it results in an acute glaucoma attack. If you experience a Fromangle-closure glaucoma attack, you will probably lose your vision very quickly.

Some types of glaucoma are less common, but they can also affect seniors. They include:

Trauma-Related – This type of glaucoma stems from a serious blow to the eye, a penetrating injury, or a chemical burn.

Pigmentary– This type of glaucoma is more common in men and in nearsighted people. It sometimes starts in early adulthood, making it more of a threat to your vision if you’re a senior.

Causes of Glaucoma

A fluid called “aqueous humor” flows throughout the inside of your eye and drains out a tissue called the “trabecular meshwork.” When your eye produces too much fluid or the drainage system doesn’t work properly, it causes a buildup in the eye that leads to high eye pressure. Experts don’t fully understand how the pressure leads to damage of the optic nerve.

There are some risk factors for glaucoma that make you more likely to develop it. These include:

  • Being over 60 years of age
  • Having a family history of glaucoma
  • Having high internal eye pressure
  • Being extremely farsighted or nearsighted
  • Having certain medical conditions including high blood pressure, diabetes, heart disease, and sickle cell anemia
  • Being black, Hispanic, or Asian
  • Taking corticosteroid medications, particularly eye drops, for an extended period
  • A history of eye injury or some types of eye surgery
  • Having corneas that are thin in the center

You might know some of your risk factors, but an eye doctor might recognize physical risk factors during an eye exam. For example, a large central cup of the optic nerve head is a significant risk factor. An optometrist or ophthalmologist can identify risk factors and monitor your eyes.

Symptoms of Glaucoma

Some forms of glaucoma don’t have any signs or symptoms while those for others vary. The variety of forms makes it even more difficult to recognize the symptoms without an eye exam. The sign that usually occurs first is a loss of peripheral vision. Peripheral vision is your ability to see objects around you without moving your head or eyes.

Losing your peripheral vision creates “tunnel vision,” which makes you feel like you are looking at the world through a narrow tube. Peripheral vision loss also makes it difficult to see in dim light and decreases your ability to navigate while walking. Other conditions such as eye strokes, brain damage from strokes, or concussions can also cause peripheral vision loss.

Other signs and symptoms of glaucoma include:

  • Seeing halos (rainbow-colored circles) around lights or sensitivity to light
  • Loss of vision, especially when it happens suddenly
  • Redness in the eye that is sometimes accompanied by pain
  • A hazy looking eye
  • Nausea or vomiting

Glaucoma is most common in people over the age of 60, but those of any age can develop glaucoma, including infants and children. Anyone with a high risk should get a complete eye exam every one to two years. Seniors should have an eye exam every year, regardless of whether they have any additional risks.

Other Reasons Regular Eye Exams Are Important for Seniors

We all know that aging brings about a lot of changes to your body. You move a little slower, forget things easier, and have a much higher risk of developing many health conditions. Too often, we accept a loss in hearing or vision as a result of aging. Seniors who don’t have access to medical care or who can’t afford a hearing aid or glasses might not bother to see a doctor. Others don’t realize the enormity of the problem.

It turns out that there’s another reason to keep your eyes and ears in top shape. A loss of hearing or vision has been linked to dementia. Seniors who have both hearing and vision loss are at an even greater risk of developing both dementia and Alzheimer’s.

Most people know if they have some hearing loss. Since there aren’t always early signs of glaucoma, they might not realize the problem with their vision in time. Having access to medical care should be a priority for any senior living independently as well as those confined to a nursing home. Access to medical care should always be a priority when choosing a living facility for your aging loved one.

Glaucoma isn’t the only risk to a senior’s vision, either. Other causes of vision loss in the elderly include age-related macular degeneration, cataracts, and diabetic retinopathy. When eye disease is related to other health conditions, your doctor might recommend eye exams more frequently following your diagnosis. For example, a diagnosis of diabetes puts you at a higher risk for glaucoma and diabetic retinopathy.

How Do Eye Doctors Detect Glaucoma in Seniors?

Schedule a full eye exam with your eye doctor. Tell them your age and your concerns about developing glaucoma. The doctor’s office may tell you to arrive early to complete the paperwork. It is important to provide all the information the doctor needs. It provides clues about your risk for glaucoma and any other eye disease.

Have someone drive you to the eye appointment. The doctor will need to dilate your eyes and you might not be able to see clearly after the appointment. Take a list of all your current medications with you.

The doctor will ask about your current health, problems with your vision, and any symptoms you are having. They will ask about your family’s medical history including any family members who had glaucoma.

The doctor, or a member of the staff, will give you a visual acuity test. This is the part of the eye exam where you read from an eye chart with one eye covered. This test tells the doctor how well you see at various distances.

An eye doctor uses a machine called a “phoropter” with different lenses to determine the best prescription for you. You will look through the machine and tell the doctor whether you can see better or worse with each lens change.

Some other things the eye doctor will check include:

  • Your Pupils – The black circle in the middle of your eyes shrinks in response to light and opens larger when it gets darker. The doctor might shine a light in your eyes to see if your pupils respond appropriately.
  • Eye Movement– An ocular motility test tells the doctor if your eyes are properly aligned and working in unison. It also determines if the eye muscles controlling the movement of your eyes are working correctly.
  • Peripheral Vision– This test determines if you have lost any of your peripheral (side) vision. Loss of peripheral vision is one of the early signs of glaucoma, but you don’t always realize it when you’ve lost your side vision.
  • Front of Eye– This test allows the eye doctor to light up the front of your eye and examine the cornea, iris, lens, and the eyelids. It detects cataracts, scars, or scratches on your cornea that might affect your vision.
  • Eye Pressure – Tonometry is a test that measures the intraocular eye pressure or IOP. The test might use a puff of air or gentle pressure near or against your eyes. Your doctor might give you numbing eye drops before this test to ensure your comfort.
  • Inside Your Eye– Dilating drops open up the pupils so the doctor can view the retina and optic nerve. This part of the exam is especially important in detecting glaucoma. Your doctor might take an image of your optic nerve to show you any signs of damage.
  • Field of Vision– Your doctor might give you a simple test involving holding up fingers to the side of your face during your exam. A more formal test using a field of vision test might be given at the same time or scheduled for a later date. The test measures how far to the side you can see while focusing on a point in front of you. It detects blind spots in your vision and determines your loss of peripheral vision from glaucoma.

Glaucoma Treatment

If you get a positive diagnosis of glaucoma, your eye doctor will discuss your condition and the recommended treatment with you. The damage isn’t reversible, so the goal of treatment is to reduce the pressure in your eyes and prevent future damage from occurring.

Most treatments are given in the form of eye drops, but oral medicines are sometime used. The most common medications prescribed include:

  • Rho Kinase Inhibitor – Suppresses the enzymes that cause an increase in fluid production in the eye.
  • Prostaglandins- Reduce eye pressure and improve the outflow of the fluid in your eye.
  • Beta Blockers – Reduce the production of fluid in your eye and lower eye pressure.
  • Alpha-Adrenergic Agonists – Reduce the production of fluid in your eye and improve the outflow of fluid.

These drugs all work to decrease eye pressure and improve the drainage of fluid from your eye. Each type of medication has some potential side effects. Those that enter the bloodstream can cause side effects unrelated to your eyes. Tell your eye doctor if you experience any side effects regardless of what they are.

Take all of your medications exactly as prescribed. If your doctor prescribes multiple types of eye drops, wait at least five minutes between drops. Don’t use any over-the-counter eye drops without asking your doctor.

Make and keep annual appointments and tell your eye doctor about any problems, new symptoms, or changes to your other medications. Some of these drugs lose their effectiveness over time or they interact with other drugs. It’s important for your eye doctor to know about any changes.

Like many other things that become more difficult for seniors, putting eye drops in their eyes is often difficult. If they are unable to administer the drops regularly, they might require a caregiver to help. There are also special devices available to help those with tremors and other issues apply the drops more easily. Of course, those with memory problems require help remembering their dosage times.

In some cases, doctors might recommend some types of surgery or therapy.

Glaucoma is a complicated condition that isn’t affected by diet, alternative treatments, or vitamin supplements. There are often no early signs of glaucoma to alert you to the risk. The only way to prevent further damage from occurring is with regular eye exams that include dilating the pupils. The eye doctor must view the optic nerve to detect any damage that you can’t see.

If you experience any of the early signs of glaucoma or have any of the risk factors associated with the disease, schedule a full eye exam right away. If you are concerned about an aging parent or other loved one, persuade them to get the medical care they need. Failing to take preventive measures will lead to more damage and eventual blindness.

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