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Glaucoma affects more than 2.7 million Americans aged 40 and older and has no symptoms in early stages. In most cases, blindness caused by glaucoma is preventable if it is detected early through an eye exam. Still, a diagnosis of glaucoma can be overwhelming, even when caught early. OCB glaucoma specialist Theodor Sauer, MD, MPH answers common questions patients have upon learning that they have glaucoma.
Q: A glaucoma diagnosis may feel daunting in the beginning. What is the first thing patients should do to feel more at ease and move forward successfully?
A: Glaucoma is a chronic disease so there may be years or decades of follow-up and treatment. So the first step is to establish a collegial relationship with your eye doctor. Having a trusting relationship with your glaucoma specialist or eye care provider will help ensure that you feel comfortable, that you are on the right treatment, and that you are kept abreast of changes in the field, such as new treatments that may be appropriate for you. This will also ensure that you are monitored closely enough to detect any changes before they become significant and impact vision.
Q: Studies show that more than half of glaucoma patients struggle to adhere to their treatment schedule. Why is it so important to strictly adhere to the glaucoma drop schedule?
A: It is so important for people to recognize that even though they don’t feel symptoms or notice vision changes day to day, taking eye drops as prescribed is critical to preventing vision loss.
Q: How can patients ensure that they stick to the schedule and apply their glaucoma drops correctly?
A: Anyone who has used eye drops or needs to take a medication multiple times a day, knows that it is easier said than done. But I want to assure you that as with most new routines, the beginning is the hardest. After a few weeks of applying drops correctly, it will become a habit. Using reminders, such as a daily cell phone alarm or an app like EyeDropAlarm.com (iPhone and Android) are great ways to keep consistent.
Q: Is there a recommended technique?
A: Yes. I would suggest laying back in a chair or bed, pulling down the lower lid and bracing your hand against your cheek. Sometimes having someone else place the drops for you is most effective. Lastly, after drop application, close your eyes and pinch the upper nose to block the nasal lacrimal duct for at least 1 minute. This will help increase the effect of the drops on the eye and decrease drainage into the nose and systemic absorption. See Prevent Blindness handout
Placing eye drops is not always easy and some people may struggle with squeezing the bottle, holding it still, or avoiding contact with the lids and lashes. Fortunately, there are drop free treatments such as laser and implants that provide long term efficacy as well.
Q: How effective are glaucoma treatments?
A: Glaucoma treatment is very effective and the majority of patients who follow through with their eye doctor’s recommendations retain good vision. Glaucoma is most dangerous when undiagnosed, so it is important to have a regular eye exam. That is the only way to detect this disease before you lose vision. Depending on several factors, your eye doctor can tell you how often you should be examined. Consistent follow-up (usually 2-4 times per year) and being adherent with eye drops or other treatments are the keys to success.
Q: Why do I need to have a visual field test?
A: With open-angle glaucoma, there are no warning signs or obvious symptoms in the early stages. As the disease progresses, blind spots develop in your peripheral (side) vision. The visual field test with the lights that you click in response to seeing is a way for your doctor to measure changes in your peripheral vision. In addition to visual field testing, your doctor will also take photos of your optic nerves to monitor changes.
Q: Is there anything else I can do outside of recommended treatment to help keep my glaucoma under control?
A: I’m asked this question often. A healthy lifestyle that includes regular exercise, avoiding smoking, stress reduction/meditation, and healthy eating can help to support your overall health and the effectiveness of your glaucoma treatment.