Glaucoma – The Insidious Thief of Your Sight
Almost every January I do a blog on Glaucoma since it is National Glaucoma Awareness Month. I do this because of the stealthy way glaucoma can rob older Americans of their sight. They use the word awareness in the title because the way that we combat this sight-robbing disease is by being aware of the danger and by getting tested. There’s no magic cure for glaucoma, but there are medicines, eye drops, and even surgery that can slow the progression of the disease and help you maintain your sight. As is almost always the case, early detection is paramount to controlling the effects of this disease.
For us older folks, we need to get checked at least once a year. This isn’t just a quick eye exam at the local strip mall, you need to see an optometrist for a comprehensive dilated eye exam. Usually, the optometrist will check for increased pressure in your eye, that’s the most common symptom of glaucoma. You all might remember the puff of air test, which is still used to check eye pressure. There is another test for pressure that involves some anesthetic eye drops and an instrument that applies a small pressure on the eye. The optometrist also will check the back of your eye and your peripheral vision. All of these tests are meant to detect the beginnings of glaucoma. Remember, there is often no indication you have glaucoma until it is advanced, and it is important to catch it before there are noticeable symptoms.
Although everyone is at risk of getting glaucoma, there are those who have a higher chance of getting this disease. They are people who:
Are over 60 years old
Are of African, Asian, or Hispanic descent
Have relatives with glaucoma
Are very nearsighted (myopic) or far-sighted (hyperopic)
Use steroid medications
Have high eye pressure
Have a thin central cornea
Have had an eye injury
If you fall into any of these risk groups and it’s been more than a year since your last eye exam, you need to get up off the couch and make an appointment right now. Medicare will pay for it, and it might be one of the best things you’ve done for a long time.
As we embark on a new presidential administration, there are two things that I feel I need to discuss. First, you have likely heard about efforts to deemphasize DEI (diversity, equity, and inclusion), and I think it’s important to clarify that DEI and personalized medicine have some important differences. Not including different races in clinical trials or withholding or discriminating care based on race, or other non-clinical reasons is wrong. Recognizing that differences in race or other personal categories affect how a person should be cared for is important and is key to ensuring the best clinical outcome for each patient. It is important that your primary care physician recognizes the special categories you might belong to and advises you accordingly. If you are of African, Asian, or Hispanic descent, it would be prudent that your doctor recognizes that you are at increased risk for glaucoma and ask you when the last time was that you had an eye exam. As scientists discover new differences that affect our risk for disease or ways we are more effectively cared for, we need to embrace and encourage the recognition of these differences and the increased effectiveness of the ensuing treatments.
Secondly, I think it’s important to reiterate how important innovation is to our future health. I said the following in last year’s glaucoma blog, and it is much more relevant now.
It amazes me that the regeneration of nerves is not science fiction anymore. While there certainly isn’t a timeline for this sight-restoring miracle, this has got to give some hope to those whose sight has been affected by glaucoma. It further magnifies the importance of innovation. Organizations like the Glaucoma Research Foundation are financed through grants and donations, and I’m sure their leaders are constantly searching for more funds to push their research forward. I’ve written often about how our government’s schemes for lowering healthcare costs have often had a negative effect on innovation. While I think there are absolutely ways to bring down the cost of our healthcare, any cost-saving approach should ensure that there isn’t a negative effect on research.
If we really want to Make America Healthy Again, we’ll quit finding short-term, short-sighted schemes to generate quick media hits and concentrate on personalizing our medicines and treatments and finding more ways to shift to value-based care. As I mentioned in my blog a few weeks ago, we have developed better and more accurate ways to measure the benefits of a treatment. This type of data hopefully will accelerate the transition to value-based solutions.
You might detect some of my frustration with the past direction of our healthcare. I will be watching the new administration as it begins its foray into our nation’s healthcare. I hope that there is a renewed focus on preventative care and that they make it easier to prevent sickness.
But just in case I might have diverted your attention for a minute, let me say again: If you haven’t been tested for glaucoma in the last year, make an appointment now.
Best, Thair