Optometrists turn eyes on glaucoma

Saturday, Jan. 1, 2005 | 9:07 a.m.

Glaucoma can attack anyone's eyes at any age without warning. People can develop the disease without symptoms.

Possible symptoms include:

People more prone to develop glaucoma include:

Source: Glaucoma

Research Foundation

As a diabetic, Eva Nielsen of Las Vegas knew she was at a greater risk for glaucoma. When she started having trouble with her eyes she sought medical help.

Nielsen, 42, was at a Vision Source clinic in Green Valley on Tuesday for a series of noninvasive yet comprehensive eye tests.

Like many optometrists' patients, Nielsen said she hated the thought of dilated eyes, blurry vision and air being puffed into her eyes. But she said she wanted to make sure that her vision problems weren't being caused by something as serious as glaucoma.

After macular degeneration, glaucoma is the second leading cause of blindness in the United States. It affects 2.2 million people ages 40 years or older, including between 1.5 million and 2 million who do not know they have it.

Glaucoma is caused by a buildup of fluid in the eye from too much aqueous humor being produced or not enough clear liquid being drained. There is rarely any pain, and other warning signs are often missed or ignored.

That's one reason that optometrists hope to educate people this month about glaucoma. January is glaucoma awareness month.

While most people usually think of glaucoma as a disease that threatens grandma and grandpa, it's not limited to older people. Optometrist Thomas Kroll of Vision Source said that in his 30 years of practice he has diagnosed two Las Vegas children with glaucoma.

Glaucoma progresses slowly, which tends to work against people who have it.

"It's the tortoise, not the hare" of eye diseases, Kroll said.

Optometrist Mark Lee said people in the early stages of glaucoma don't notice their vision change.

"You lose half your vision before you notice," Lee said.

That means that half the nerves between the brain and the eye have been damaged or destroyed.

"Although there is no cure for glaucoma, vision loss can be prevented or slowed if we can detect the disease early," said Lee, who also works at Vision Source.

That's why high-risk candidates should have a comprehensive eye exam each year.

It had been two years since Nielsen had an eye exam. After her visit, the 38-year Las Vegas resident and former construction site administrator said she was "amazed at the technology they used."

The latest diagnostic tools are worthy of a sci-fi film set. People no longer have to endure discomfort from puffs of air aimed at the eyeball or blurry vision afterward.

With computerized machinery such as the Heidelberg Retina Tomograph, which maps the blood vessels connecting the eye to the brain, the exam is noninvasive and takes little time.

Nielsen began her hourlong exam with technician Erika Olguin who mapped an eye by capturing images within the eyeball that appeared like constellations in a satellite photo.

On a Orbscan monitor, Olguin measured the thickness of Nielsen's cornea or the clear lens in each eye.

Nielsen's peripheral vision was checked on a machine that had Nielsen zapping points of light on a screen before her, one eye at a time.

"I tell children it's a video game," Olguin said with a smile.

About five years ago, likely glaucoma sufferers would simply be checked for pressure inside the eyeball, Kroll said.

About two years ago doctors discovered that a thicker cornea can increase pressure without glaucoma present.

"A thicker lens, like Eva's, gave false pressure readings," Kroll said.

But thicker corneas mean there is a slimmer chance for developing glaucoma.

Next Kroll checked the drainage in each of Nielsen's eye, since glaucoma can occur with normal or low pressure within the eyeball.

Her drainage was "beautiful," Kroll said.

Since glaucoma develops gradually, patients are prescribed simple treatments first, such as once- or twice-a-day eyedrops.

"The biggest problem we have is getting people to use the drops," Kroll said.

The last resort is laser surgery to repair damaged tissue.

As Kroll checked the hole in the back of Nielsen's eye where the nerves thread in and out, her right eye's opening appeared larger than the left.

If it doesn't grow larger in a year, "then I'm just paranoid," Kroll said. "Right now I'm leaning toward I'm paranoid and you don't have glaucoma ... So far you don't have glaucoma."

Nielsen smiled. She said she had errands to run and her eyes felt fine.

There were no wraparound dark glasses to wear, no blurry vision to overcome, and best of all, a sense of relief. But she said she planned getting her eyes checked every year.