Dr. Grossman’s Blog

This week I’m going to start a series on glaucoma – I’ll cover these points in my next posts:

1. What is it? How does it manifest? Why is it caused? Symptoms?

2. What are the conventional treatment options? Do they work?

3. Are there any alternatives? Do they work? Is there research to back them up?

So – what is glaucoma!

Glaucoma is a truly insidious disease that can be difficult to detect until a significant amount of vision is lost. We are especially concerned about glaucoma because heavy computer users (ie 8 hours a day) have been found to have a higher risk for glaucoma, especially if they are nearsighted.

Glaucoma is often referred to as the “silent thief”, because most individuals with undiagnosed glaucoma do not suffer from any symptoms until they begin to notice a reduction in their peripheral vision.
Technically, glaucoma is due to damage to the optic nerve, sometimes as a result of increased pressure of the aqueous humor, the clear, watery fluid that circulates in the chamber of the eye between the cornea and the lens. But the term glaucoma is now defined as a collection of diseases that causes optic nerve damage. As a result, the diagnosis is no longer solely based on whether a person’s Intraocular Pressure (IOL) is elevated or not.

There are several types of glaucoma:

Open angle or Chronic Glaucoma

Narrow Angle Glaucoma – an ocular emergency

Low Tension Glaucoma

Secondary Glaucoma

Glaucoma Suspects

Congenital Glaucoma

Symptoms

• Reduced peripheral vision
• Intraocular pressure (IOP) greater than 21, or where there is a large discrepancy in IOP’s between the two eyes.
• Optic cup asymmetry

In short, nothing you would readily notice until the disease had significantly developed. This is why it is so important that you have your vision checked periodically – annually. One of the tests that your eye doctor will do is one for glaucoma.

Causes

• High level of stress – has been implicated as a major cause of chronic glaucoma. For example, stress causes us to breath shallowly, which reduces the amount of oxygen in the bloodstream, causing venous backflow in the head. This effects the eye’s ability to revolve eye fluids, which results in increased pressure. Although we do not know exactly how the optic nerve is damaged in glaucoma, one common factor in all cases of glaucoma is a lack of bloodflow to the retina and optic nerve. This results in retinal nerve cell death, enlargement of the optic cup, and loss of vision.
• Nutritional Deficiencies and Poor Digestion – Often sufferers of glaucoma are deficient in some or many of the important nutrients including essential fatty acids, lutein, zeaxanthin, taurine, antioxidants, bioflavenoids, zinc, selenium, vitamin B-complex.
• Poor digestion often results from a lack of hydrochloric acid in the stomach needed to breakdown food, which becomes more common as we age. Use of excessive antibiotics is also a prime culprit in poor digestion due to the killing of important stomach flora.
• Family History of Glaucoma
• Other chronic diseases that can raise IOP’s include obesity, diabetes, cardiovascular disease (insufficient blood flow to the eyes), thyroid disease (hyperthyroidism) which due to prominent eyes, the eyes are exposed to increased pressure from intraorbital swelling.
• Being African-American (glaucoma is the leading cause of blindness among this population)
• Extreme nearsightedness or farsightedness (higher level and a risk of angle closure)
• Steroid use, often in the form of eyedrops, nosedrops or inhalants (elevates IOL pressure mildly in approximately 16% of people on steroids).
• Heavy computer use – it is thought that heavy computer use can contribute to glaucoma, especially in those who are short-sighted.

Take Care!
Marc Grossman