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January is Glaucoma Awareness Month

All of my patients are aware of the dreaded “puff” test for glaucoma. No one likes it and no one really knows what it is for, they just know they have to have it when they get an eye exam.

Let’s start with the basics. First of all, glaucoma is not just one thing. Glaucoma is a group of conditions which is characterized by damage to the optic nerve and can cause loss of vision. Good vision can be preserved with early diagnosis and management. Often there are no or very few symptoms until the condition is advanced.

The “puff” measures the pressure of the eye. It continues to be one of the standards of care in testing for glaucoma. Traditionally, eye care professionals believed that high eye pressure alone caused glaucoma. Today research is showing it to be one of various risk factors for optic nerve damage.(see New Year~New You blog for more info on research)

High is a relative term, one pressure measurement may be too high and cause optic nerve damage in one person and not high enough to cause optic nerve damage in another person. The goal of glaucoma treatment is to get the pressure down to a point where it does not cause damage.

There are many types of glaucoma such as:– traumatic: from blunt force to the eye but this usually does not develop until many years after the incident.-inflammatory: from systemic diseases such as arthritis, sarcoids, etc.– neovascular: from complications of diabetes-open angle or closed angle: malfunction of the drainage system which regulates the fluid and thus the pressure in the eye-pigment dispersion: excess iris pigment blocking the drainage system-responsive: from steroid use

This is not an exhaustive list, the take-away is that glaucoma is a group of diseases affecting the optic nerve. Good vision is usually preserved with treatment. How it is managed depends on how it is caused but includes reducing the eye pressure.

The National Eye Institute has more information on glaucoma and other eye diseases. Go to www.nih.nei.gov