Living with glaucoma: It's all in the family

With today's improved treatments, glaucoma patients no longer face inevitable blindness, but preserving vision depends on seeing an Eye M.D. (ophthalmologist) at the right time and carefully following a prescribed plan. Glaucoma remains a leading cause of preventable blindness because it often goes undetected -- about half of the three million Americans who have the disease are unaware of it. This January during Glaucoma Awareness Month, the EyeSmart campaign of the American Academy of Ophthalmology, and Eye Care America, a public service program of the Foundation of the American Academy of Ophthalmology, want to remind people that knowing your risks for glaucoma can save your sight.

Glaucoma can quietly damage the eye and optic nerve even before a person notices vision problems. Such damage cannot be reversed once it occurs. As is true for other chronic illnesses, family support from the first diagnosis onward makes a vital difference in a patient's course of treatment, says Louis B. Cantor, MD, the Jay C. and Lucile L. Kahn Professor of Glaucoma Research and Education at Indiana University, and an Academy clinical correspondent.

"When a patient comes alone to appointments, I know from experience that he or she will probably have a harder time staying on course," says Dr. Cantor. "If at least one family member is involved, the patient will be much less likely to forget their eye drops or have other lapses that increase the risk of blindness." Family members can help an elder set up a medication schedule that fits his or her daily routine and learn to self-administer eye drops. Empathic listening and companionship are also important, as studies show depressed or isolated patients are less likely to adhere to treatment. Sometimes an elder may just need a ride to a doctor's appointment or help filling a prescription.

When you help a family member with glaucoma, it reminds you to pay attention to your own increased risk for the disease. Every adult who has a family history of glaucoma should have a comprehensive eye examination to be screened for glaucoma. John Ryan, president emeritus of Indiana University and a patient of Dr. Cantor's, began getting check-ups years ago when his sister was diagnosed with an early glaucoma. A few years ago Dr. Ryan's intraocular pressure (IOP), a key glaucoma indicator, was deemed too high. Dr. Cantor performed combined glaucoma and cataract surgery, and Dr. Ryan now controls his glaucoma with a single medication.

In the rare instances when glaucoma strikes children, family support is essential. Dr. Cantor's patient, Brianna, was diagnosed at age 11. Now 16, Brianna has had several surgeries, uses medication daily, and faces a lifetime of managing the illness and dealing with reduced vision. In addition to her parents and close cousins, with whom she can share "anything," Brianna relies on an online group where young patients and their parents can find information and understanding. Glaucoma support groups and resources for older patients and their families can also be found online.

As part of the EyeSmart campaign, the Academy and EyeCare America recommend that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40 - the time when early signs of disease and changes in vision may start to occur. Based on the results of the initial screening, an ophthalmologist will prescribe the necessary intervals for follow-up exams. For individuals at any age with symptoms of or at risk for eye disease, such as those with a family history of eye disease, the Academy recommends that individuals see their ophthalmologist to determine how frequently their eyes should be examined.

(Source: American Academy of Ophthalmology: December 2008)