Glaucoma refers to a group of progressive eye diseases that cause vision loss by damaging the optic nerve in the back of the eye. The optic nerve is a bundle of more than 1 million nerve fibers that carry messages from the retina, where light is converted into nerve impulses to the brain. The brain interprets the impulses as visual images.

January is National Glaucoma Awareness Month. Let’s learn more about glaucoma, which affects about 3 million Americans and 80 million people worldwide. It is the second leading cause of blindness in the world, behind cataracts.

One of the main risk factors for glaucoma is increased pressure in the eyes, or intraocular pressure (IOP). High IOP damages optic nerve fibers, leading to vision loss. IOP increases when the fluid that bathes and nourishes the front of the eye, called aqueous humor, cannot drain as fast as it is created and builds up.

Fluid drains through an area called the drainage angle, located where the colored part of the eye (iris) meets the white covering over the eye (sclera). One of the main structures of the drainage angle is the trabecular meshwork, which plays an important role in draining aqueous humor from the eye and maintaining a consistent IOP.

In addition to high IOP, other risk factors for glaucoma include being older (it is more common in people ages 60 and older), being African American or Latino, having a family history of glaucoma, having diabetes (people with diabetes are twice as likely to develop glaucoma), being very nearsighted or farsighted, using corticosteroids long-term and having a thin cornea.

Anyone with a risk factor should see an eye doctor for an annual exam.

There are two main types of glaucoma:

• Open-angle glaucoma is the most common, affecting up to 90 percent of Americans with glaucoma. It develops when tiny deposits build up in the eye’s drainage canals and slowly clogs them so fluid cannot drain efficiently. It typically has no symptoms early on. As the disease progresses, peripheral (side) vision may diminish. Because the disease can get to that point without symptoms, it is often called the “silent thief of sight.”

• Angle-closure glaucoma occurs when the iris is too close to the eye’s drainage angle. It can block the drainage angle so fluid cannot drain and IOP increases. If the angle gets completely blocked, IOP increases rapidly and causes symptoms. This is called acute angle-closure glaucoma. Signs of an attack include sudden blurry vision, severe eye pain, eye redness, headache, nausea, vomiting and rainbow-colored halos around lights.

Acute angle-closure glaucoma is a medical emergency. Anyone experiencing one of these symptoms should seek help immediately.

Because it causes no symptoms early on, it is possible to have glaucoma and not know it. So, routine eye exams are important to catch glaucoma before it can severely damage the optic nerve.

A doctor may perform one or more tests to check for glaucoma. These include a dilated eye exam to view the optic nerve, a gonioscopy to examine the drainage angle, tonometry to measure IOP, optical coherence tomography (OTC) to look for changes in the optic nerve that may indicate glaucoma, a visual acuity test (eye chart test) to check for vision loss and a visual field test to check peripheral vision.

If you have glaucoma, it is important to start treatment right away. A person cannot regain any vision already lost, but treatment can help slow the progression of the disease and reduce the risk of additional vision loss. To treat glaucoma, doctors typically use medications, laser procedures or surgery.

The most common medications for glaucoma are prescription eyedrops. These work by decreasing the production of aqueous humor or increasing its flow out of the eye. More than one eyedrop may be prescribed to control IOP.

The doctor may use a laser to help fluid drain from the eye. Lasers can be used to treat open-angle and angle-closure glaucoma. A laser can open the drainage angle, make a tiny hole in the iris to let the fluid flow more freely and treat areas in the eye’s middle layer to lower fluid production.

If eyedrops and laser treatments don’t lower IOP, the doctor may suggest surgery. There are several procedures that can help drain the fluid, including trabeculectomy microsurgery, in which the doctor creates a new drainage channel.

Minimally invasive glaucoma surgery (MIGS) makes tiny openings in the trabecular meshwork and places tiny devices, such as stents and microshunts, to help drain fluid. MIGS is most often performed as an add-on procedure after cataract surgery.

Now that you’ve had a glimpse at glaucoma, share what you’ve learned this National Glaucoma Awareness Month.

Patti DiPanfilo

Your baby’s vision at birth is limited but develops progressively during the growth process. While developing, your child’s vision is vulnerable to eye diseases. Untreated, vision disorders can interfere with your child’s ability to learn and play, and can lead to headaches, eyestrain and fatigue.

August is Children’s Eye Health and Safety Month, a time to concentrate on the well-being of our children’s eyes as they head back to school.

There are many conditions and diseases that can affect a child’s vision.

Refractive errors are among them. The most common are:

• Myopia, or nearsightedness, when closer objects are clear but faraway objects are not.
• Hyperopia, or farsightedness, which is difficulty seeing close-up objects but faraway objects are clear.
• Astigmatism, blurry vision due to an irregular shape of the cornea, the clear, outer layer at the front of the eye.

Eyeglasses are typically prescribed to treat these refractive errors and provide clear vision.

Amblyopia and strabismus are other common eye disorders in children.

• Amblyopia, or lazy eye, is characterized by reduced vision from lack of use in one otherwise healthy eye. Treatment typically consists of patching the stronger eye or blurring the vision in the stronger eye with eyedrops. These techniques make the weaker eye work harder and become stronger.

• Strabismus, or crossed eyes, is when the eyes are misaligned. One or both eyes may turn inward, outward, up or down. It can be caused by problems with the eye muscles, the nerves that transmit information to the muscles or the control center in the brain responsible for eye movement. Treatment includes glasses, eye patching, muscle surgery to straighten the eyes and eye exercises.

Other nonrefractive conditions include:

• Glaucoma, a condition associated with a higher-than-normal fluid pressure inside the eyes.
• Cataracts, a clouding of the lens.
• Retinoblastoma, a rare cancer of the retina, the light-sensitive layer of nerve tissue lining the back wall of the eye.

Catching and treating eye disorders early will help a child develop healthy vision and avoid learning difficulties at home and in school. Eye care for children begins at birth. A pediatrician will perform a screening eye exam on a baby after birth. This exam can detect abnormalities in the light reflex from the pupil and eye alignment, as well as in external features of the eye.

The pediatrician will continue to check the eyes and vision during routine well-baby visits. There’s disagreement among eye specialists as to when a child should begin seeing an eye doctor for eye exams and how often a child should be examined. Follow doctor’s recommendations, which are based on your child’s specific circumstances.

Here are some things a parent can do to help protect a child’s eyes and developing vision:

• Encourage healthy eating. Healthy vision is influenced by the food we eat. Try to incorporate many fruits and vegetables into the child’s diet. Fruits and vegetables contain many of the vitamins and minerals necessary for maintaining healthy eyes and vision.
• Spend time outdoors. Playing outside for at least an hour a day, or even just taking a walk outdoors, will help eye muscles relax. It can also help lower the risk of certain eye conditions, including myopia.
• Wear sunglasses outdoors. Wearing sunglasses protects eyes from the sun’s harmful ultraviolet rays. Excessive exposure to UV radiation over time has been linked to serious eye diseases later in life.
• Wear protective eyewear while playing sports. Avoid serious eye injuries by wearing protective eyewear with shatterproof plastic. Different sports have different eyewear recommendations.
• Limit screen time. Prolonged time staring at computer and television screens may cause blurry vision, focusing problems and possibly even increase your the risk for developing myopia. Limit the amount of time on digital devices each day and ensure the child takes frequent breaks to the eyes a rest.

Set a good example for your child. Incorporate these tips into your own life as well.

If you suspect a problem with your child’s eyes or vision, contact a qualified eye doctor who can diagnose and treat the problem.

Patti DiPanfilo

For people who have to wear glasses all the time, contact lenses can be a blessing. But if you wear contacts, like I do, you know they require some tender loving care. If you don’t do it and you continue to wear contaminated lenses, you could be in for some serious eye problems later on.

There are a number of complications that can occur from wearing contacts that haven’t been properly disinfected or used as directed by your doctor. Let’s take a look at a few of them, then learn some tips for caring for your lenses. August 21 though 25, 2017, is Contact Lens Health Week, but it’s important to practice good lens hygiene all year long.

Eye problems can happen in anyone who wears contact lenses, but the risk for complications, such as infection, varies based on the type of lens worn.

According to the American Academy of Ophthalmology, single-use, daily disposable lenses are the safest soft contacts for lowering the risk for eye infections. In addition, rigid, gas-permeable lenses are less likely to lead to infection than regular soft contacts. Extended-wear contacts that you sleep in pose the highest threat of infection and other contact lens-related problems.

One type of infection that can occur is keratitis. Keratitis is inflammation of the cornea, the transparent layer forming the front of the eye. The cornea is especially susceptible to this type of infection due to its proximity to the contact. Keratitis is the most serious complication of wearing contacts. If untreated, it can lead to blindness.

Bacteria most often cause keratitis, but in rare cases, it can result from viral or fungal infection. A germ sometimes found in tap water leads to a form of keratitis that is becoming increasingly more common in those who wear soft contact lenses. If you have bacterial keratitis, treatment is generally antibiotic eye drops.

Another disorder linked to extended-wear contact lenses in blepharitis, inflammation of the eyelids that leads to dryness, burning and itching. Blepharitis can occur on it’s own, but it often coincides with dry eye syndrome. With dry eye, which affects healthy tear production, you might feel burning, irritation and itching, a foreign body sensation and general discomfort. Dry eye is one of the most common reasons people stop wearing their contacts.

Eye drops are generally the first line of treatment for blepharitis and dry eye syndrome, but there are other options for treating these disorders as well. They include specialized eye scrubs, a mechanical eyelid cleaning device called BlephEx® for blepharitis and the LipiFlow® Thermal Pulsation System for dry eye.

In addition to keratitis, there are other problems affecting the cornea that are possible, including corneal hypoxia, abrasions and ulcers. With hypoxia, extended contact wear can interfere with oxygen getting through to nourish the cornea. Corneal abrasions are scratches, and ulcers can form when there is erosion of the superficial surface of the cornea. Ulcers are usually related to keratitis and hypoxia.

You can reduce your risk of these complications with routine eye exams with your doctor and proper lens hygiene. The theme of this year’s Contact Lens Health Week is “healthy habits mean healthy eyes.” Here are a few healthy habits to incorporate into your regular contact lens care, courtesy of WebMD:

• Always follow your doctor’s recommendations as well as the cleaning instructions for your lenses.
• Keep your lenses and supplies clean. Don’t forget to wash your hands before inserting or removing contacts.
• Use the lens rinse recommended by your doctor. Never use tap water to clean your contacts, and don’t put them in your mouth to moisten them. Do not wear your contacts when you swim.
• Thoroughly rinse your lens case and let it air dry.
• Insert your contacts before you apply makeup, and be sure not to any on your lenses. Replace eye makeup every three to six months to avoid contamination.

Most eye doctors also recommend removing your contacts at the end of each day. Some doctors even recommend removing extended wear lenses daily.

Take the time to take care of your contacts.. Remember, “healthy habits mean healthy eyes.”