Raising Awareness About the Second Leading Cause of Blindness
A Q&A with UT Health Austin’s fellowship-trained glaucoma specialist, Eileen Bowden, MD
Reviewed by: Eileen Bowden, MD
Written by: Ashley Lawrence
January has been designated National Glaucoma Awareness Month in hopes of increasing awareness about glaucoma, the second leading cause of blindness worldwide. Glaucoma encompasses a spectrum of diseases that damage the optic nerve, which is responsible for transmitting visual information to your brain. Damage to the optic nerve is often a result of increased ocular pressure (but can also occur when eye pressure is normal) and can lead to irreversible vision loss and blindness.
“There currently is no cure for glaucoma,” explains UT Health Austin ophthalmologist Eileen Bowden, MD. “However, early diagnosis and treatment by a glaucoma specialist, such as myself, can help preserve your vision and prevent permanent vision loss.” Dr. Bowden is a fellowship-trained glaucoma specialist practicing in UT Health Austin’s Mitchel and Shannon Wong Eye Institute. She completed her fellowship training at Bascom Palmer Eye Institute, which has been ranked “Best in Ophthalmology” by U.S. News & World Report for the last 17 consecutive years.
Is glaucoma preventable?
“Some types of glaucoma are certainly avoidable,” says Dr. Bowden. “For example, you should always wear eye protection when participating in activities that put you at risk of experiencing trauma to the eye. Injuries to the eye can generate trauma that may develop into glaucoma. Of course, if you have a family history of glaucoma or if you are genetically predisposed to developing glaucoma, there may not be much we can do to avoid the condition completely. This is why it’s important to see an ophthalmologist yearly, particularly if you have a family history of glaucoma—we can detect the signs that glaucoma may be developing and begin treatment to prevent further damage.”
Common risk factors for glaucoma include:
- A thin cornea
- Diabetes or high blood pressure
- Family history of glaucoma
- Low or high eye pressure
- Older age, usually over the age of 60, though it can occur at any age
- Past eye surgery or injury
- Poor long-distance vision (severe nearsightedness)
- Poor short-distance vision (severe farsightedness)
- Use of corticosteroids, such as eye drops, pills, inhalers, and creams
<br>Is it possible to have glaucoma and not be aware of it?
“While there are several types of glaucoma,” says Dr. Bowden, “these can be organized into two categories. The first category is open-angle glaucoma in which the eye’s drainage canals become clogged overtime, causing an increase in eye pressure that damages the optic nerve. Patients with this type of glaucoma typically do not exhibit any symptoms until the glaucoma has advanced to the point of affecting the center of their vision, which means they may have already permanently lost a significant amount of their peripheral vision.
“The second category is angle-closure glaucoma in which the iris bulges forward to narrow or block the eye’s drainage canals, which restricts fluid circulation, causing an increase in eye pressure that damages the optic nerve. Patients with this type of glaucoma often experience significant pain associated with the rapid rising of their ocular pressure.”
Common symptoms of glaucoma include:
- Appearance of “halos” around bright lights
- Eye pain
- Eye redness
- Loss of peripheral vision or tunnel vision
- Nausea or vomiting
- Severe headache
What does glaucoma screening entail?
“Glaucoma screening involves a full eye exam in which we check if the eye pressure is elevated, examine the drainage canals to see if they are open or closed, and assess the optic nerve for any signs of damage,” explains Dr. Bowden. “If needed, further testing can be done, such as a visual fields test, where we check subjectively to find out if the patient has suffered any damage to their vision. Scans can also be taken of the optic nerve to see if there are any objective signs of damage to the optic nerve, such as signs of thinning or focal damage, which we can actually pick up on a very microscopic level using the technology available to us in our clinic.”
If I am diagnosed with glaucoma, what does treatment look like moving forward?
“Treatment depends on the stage at which we detect the glaucoma,” says Dr. Bowden. “Early on, we may just be suspicious of glaucoma developing in the future, but there is no diagnosis yet. In this case, I would encourage the patient to come see me once per year so that we can perform annual testing and closely monitor the situation. If a patient has a glaucoma diagnosis and damage to the ocular nerve has occurred or their ocular pressure is high, I would suggest the patient check in with me once every three months or so.
“When treating glaucoma, we typically begin with less invasive treatment options, such as topical eyedrops or even oral pills that can help lower eye pressure. An in-office laser procedure can also be done, which is minimally invasive and can take place in the same chair that you have your eye exam in. The entire procedure only takes about five to 10 minutes. If we need to consider surgical intervention, this can also include minimally invasive procedures. All of these surgeries take place down the hall from our office in UT Health Austin’s Ambulatory Surgery Center and are performed as outpatient surgeries, so patients will be discharged the same day their surgery takes place.”
Have there been any recent breakthroughs in terms of reversing damage caused by glaucoma?
“We still don’t know everything about glaucoma and why it occurs, and there’s a lot of room for research,” shares Dr. Bowden. “Just this past December, Harvard published a study conducted on mice, where they were able to regenerate dead nerve cells that are important for vision. I’m excited about the potential for further research and hope that maybe in the next few years we can shift away from focusing on preventing further damage caused by glaucoma, and instead, there will be certain treatments available that can reverse the damaging effects of glaucoma and restore vision that has been lost. In the meantime, continue eating a wide variety of healthy foods, such as fruits, vegetables, and leafy greens, try to find time to exercise to help reduce stress hormones in your body, and be sure to schedule your annual eye exams.”