Some frequently asked questions about glaucoma

• Q: What is childhood glaucoma and how can I prevent the disease from progressing?

A: Childhood glaucoma, also known as infantile or congenital glaucoma, is a disease of infants and is sometimes inherited. It involves a developmental abnormality of the trabecular meshwork, which is the drainage tissue of the eye. Treatment options include medications to lower intraocular pressure and/or anterior chamber angle surgery. Some patients may also need other types of glaucoma surgery. The goal of treatment is to lower the intraocular pressure to prevent permanent visual loss. It is also important to monitor the visual function and to treat any delay in the affected eye’s visual development.

• Q: I have been given a variety of eye drops in a failed attempt to control elevated eye pressure that was apparently caused by retinal vein occlusion in my left eye. I had many problems with the eye drops, including a terribly upset stomach, nausea, indigestion, heartburn and gas. My doctor changed my prescription to Xalatan and Timolol. I have noticed that the pupil in my left eye has become significantly larger than the pupil in my right eye, which is not being treated. Can Timolol cause this symptom and is it safe to continue to use it?

A: Timolol is a topical beta-blocker that acts to reduce intraocular pressure and is very commonly prescribed for the treatment of glaucoma. Timolol has not been shown to cause pupillary dilation. The size of your left pupil may be related to the prior retinal vein occlusion. Other causes of pupillary dilation include topical medications, iris neovascularization, prior intraocular surgery, and others. Your eye doctor should be able to determine the cause of your pupillary asymmetry.

• Q: Is it true that glaucoma patients cannot take medications like Actifed or Sudafed for relief of cold symptoms because they can cause a dangerous increase in eye pressure?

A: Cold medicines such as Actifed and Sudafed can cause mild pupil dilation, which can affect eye pressure. Patients with very narrow angles or untreated angle-closure should not take cold medications. Patients who have been treated for narrow-angle glaucoma or open-angle glaucoma can take cold medicines safely. Your eye care provider should be able to advise you as to the safety of this medication class in your particular case.

• Q: My husband is 36 years old and was just diagnosed with early-stage glaucoma in his left eye. There is no history in his family. Why did he develop this condition and will he be OK? He is now being treated with eye drops. Can you help me?

A: Primary open-angle glaucoma is a multifactorial disease that can affect patients in their 30s. Some patients have no family history of the disease. Glaucoma that affects only one eye may be related to other conditions such as trauma and pseudoexfoliation. Glaucoma that is detected in the early stages carries a better prognosis than glaucoma that is diagnosed at an advanced stage. Treatment involves reduction of the intraocular pressure and monitoring of the optic nerve function. With diligent treatment and follow-up, your husband should maintain vision throughout his lifetime.

Fast Facts About Glaucoma

1. Glaucoma is the leading cause of blindness in the world.
   
2. More than 1,000,000 people are totally blind from glaucoma in China.
   
3. Several million more people have elevated intraocular pressure.
   
4. About 2% of the population age 40-50 and 8% over 70 have elevated intraocular pressure.
   
5. Glaucoma affects people of all ages and all races.
   
6. Most blindness from glaucoma is needless and could have been prevented if detected and treated in time.
   
7. Most patients have no symptoms from glaucoma.
   
8. Blindness from glaucoma usually begins with loss of peripheral vision. Central vision is usually maintained until the late stages. By the time the patient notices visual loss, damage is advanced.
   
9. Factors which predispose to glaucoma include myopia, black race, and a family history of glaucoma. Thyroid disease, diabetes, and high blood pressure may be associated to some degree.
   
10. Intraocular pressure can be measured by a simple office test called tonometry. This test is the only reliable method of detecting elevated intraocular pressure.
    
11. Signs of disorders within the eye which could lead eventually to elevated intraocular pressure can be determined by a thorough eye examination by an ophthalmologist.
    
12. Fully half of all persons with damage from glaucoma are unaware of it.
    
13. In a nationwide phone survey conducted a few years ago by Prevent Blindness America, blindness ranked third after cancer and heart disease as people's major fear.
    
14. However, only 20% of people knew that glaucoma was related to elevated pressure within the eye. Another 50% had heard of glaucoma, but weren't sure what it was, while 30% had never heard of it.
    
15. Of the 20% who knew about glaucoma, most thought either that people affected could tell because they would have symptoms, that it was easily cured, or that it did not lead to blindness.
    
16. Despite that fact that glaucoma is roughly as common as high blood pressure and diabetes, the widespread public lack of familiarity with glaucoma results in thousands of blindness annually, most of which could have been prevented.