HJNO Jan/Feb 2020

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2020 55 Carrie A. Mercer Lambeth House T ypes of glaucoma There are two major types of glaucoma. Primary open-angle glaucoma This is the most common type of glau- coma. It happens gradually, where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first. Some people can have optic nerves that are sensitive to normal eye pressure. This means their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve. Angle-closure glaucoma (also called closed-angle glaucoma or narrow-angle glaucoma) This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute at- tack. It is a true eye emergency, and an oph- thalmologist must be consulted right away or blindness may occur. Here are the signs of an acute angle-clo- sure glaucoma attack: • Sudden blurry vision • Severe eye pain • Headache • Nausea and vomiting • Rainbow-colored rings or halos around lights P revention As a healthcare provider, it is important that you encourage your patients to not overlook eye health. Early detection is im- portant in preventing vision loss or slowing its progress. • Get regular dilated eye examinations. As a general rule, the American Academy of Ophthalmology recommends having a comprehensive eye exam every five to 10 years if you're under 40 years old; every two to four years if you're 40 to 54 years old; every one to three years if you're 55 to 64 years old; and every one to two years if you're older than 65. If you're at risk of glaucoma, you'll need more frequent screening. • Family eye health history. Glaucoma tends to run in families. If a patient has an in- creased risk, theymay needmore frequent screenings. • Exercise safely. Regular, moderate exercise may help prevent glaucoma by reducing eye pressure. Encourage patients tomain- tain an appropriate exercise program. • Take prescribed eyedrops regularly. Glau- coma eyedrops can significantly reduce the risk that high eye pressure will prog- ress to glaucoma. To be effective, eyedrops need to be used regularly, even if you have no symptoms. There is good news on the horizon for patients who suffer from glaucoma. New and evolving glaucoma treatment options are offering new alternatives for glauco- ma surgeons and their patients. In 2017, two new drug therapies were approved by the U.S. Food and Drug Administration (FDA).These are the first new classes of glau- coma drops to hit themarket in two decades. In addition to new drug advances, the con- tinued development of minimally invasive surgical procedures is providing additional options to lower IOP by enhancing part of the natural drainage pathways of the eye, withminimal tissue disruption. Micro-inva- sive glaucoma surgery (MIGS) uses micro- scopic-sized equipment and tiny incisions, offering a safer alternative than conven- tional glaucoma surgery, with the potential benefit of reducing the patient’s dependence on topical glaucoma medication. Glaucoma is a silent disease that can often go overlooked. Patients need to be reminded of the importance of good eye health and the impact it can have on overall total health. n