glaucoma presentation - information, risk factors and detection

8/14/2019 Glaucoma Presentation - Information, Risk Factors And Detection

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January 2009

Glaucoma

Information, Risk Factors and Detection


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The healthy eye

Light rays enter the eye

through the cornea, pupil and

lens.

These light rays are focuseddirectly onto the retina, the

light-sensitive tissue lining the

back of the eye.

The retina converts light rays

into impulses; sent through the

optic nerve to your brain, where

they are recognized as images.


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What is glaucoma?

Disease of the optic nerve.

When damage to the optic nerve fibers

occurs, blind spots develop; blind spotsusually go undetected until optic nerve is

significantly damaged.

Leading cause of blindness in the United

States, especially for older people.

Early detection and treatment are keys to

preventing vision loss from glaucoma.

Normal vision

Vision as it might be

affected by glaucoma


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Anatomy of glaucoma

Clear liquid called aqueous humorcirculates inside the front

portion of the eye.

To maintain a healthy level of pressure within the eye, a small

amount of aqueous humor is produced constantly, while an equal

amount flows out of the eye through a microscopic drainage

systemthe trabecular meshwork.


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Anatomy of glaucoma

With glaucoma, aqueous humor does notflow through the trabecular meshworkproperly.

Over time, eye pressure IOP increases,damaging the optic nerve fibers.


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Types of glaucoma

Two main categories of glaucoma:

Open-angle glaucoma: the most common form of glaucoma - (the mostcommon form that affects approximately 95% of individuals)

Closed-angle glaucoma: a less common and more urgent form of

glaucoma.

Other Types of glaucoma:

Normal-Tension Glaucoma

Congenital glaucoma

Juvenile glaucoma

Secondary glaucoma


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Types of glaucoma Open-angle

Open-angle glaucoma

Trabecular meshwork becomes less

efficient at draining aqueous humor.

Intraocular pressure (IOP) builds up,

which leads to damage of the optic

nerve.

Damage to the optic nerve occurs at

different eye pressures amongdifferent patients.

Typically, glaucoma has no

symptoms in its early stages.

Open-angle glaucoma


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Types of glaucoma Open-angle

Open-angle glaucoma is the most common form of the disease, isprogressive and characterized by optic nerve damage. The most significant riskfactor for the development and advancement of this form is high eye pressure.

Initially, there are usually no symptoms, but as eye pressure gradually builds,at some point the optic nerve is impaired, and peripheral vision is lost. Withouttreatment, an individual can become totally blind.


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Glaucoma risk factors Open-angle

Strong risk factors for open-angle glaucoma include:

High eye pressure (IOP)

Family history of glaucoma Age 40 and older for African Americans

Age 60 and older for the general population, especially Mexican Americans

Thin cornea

Suspicious optic nerve appearance with increased cupping (size of cup,

the space at the center of optic nerve, is larger than normal)

Continued


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Glaucoma risk factors Open-angle (cont)

Additional risk factors for open-angle glaucoma include:

High myopia (severe nearsightedness)

Diabetes

Eye surgery or injury

High blood pressure

Use of corticosteroids (for example, eye drops, pills*, inhalers and creams)


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Types of glaucoma Closed-angle

Closed-angle (or narrow-angle) glaucoma:

The drainage angle of trabecular

meshwork becomes blocked by the iris.

IOP builds up very fast.

Symptoms include severe eye or

brow pain, redness of the eye,

decreased or blurred vision. Must be treated as a medical

emergencymust visit

ophthalmologist immediately.

Closed-angle glaucoma


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Types of glaucoma Closed-angle

Closed-angle glaucoma may be acute or chronic. In acute closed-angle glaucomathe normal flow of eye fluid (aqueous humor) between the iris and the lens issuddenly blocked. Symptoms may include severe pain, nausea, vomiting, blurred

vision and seeing a rainbow halo around lights. Acute closed-angle glaucoma is amedical emergency and must be treated immediately or blindness could result in oneor two days. Chronic closed-angle glaucoma progresses more slowly and candamage the eye without symptoms, similar to open-angle glaucoma.


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Glaucoma risk factors Closed-angle

Closed-Angle Glaucoma

Age

Family history

Poor short-distance vision (farsightedness)

Eye injury or eye surgery

East Asian and Inuit ethnicity


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Types of glaucoma

Normal-Tension Glaucoma

Cardiovascular disease

Family history of glaucoma

Japanese ethnicity

Low eye pressure IOP

Normal-tension glaucoma occurs when eye pressure is normal, yet the optic nerve isdamaged and peripheral vision is lost. Lowering eye pressure through medicationsometimes slows the progress of the disease, but this type of glaucoma may worsendespite low pressure. Treatment is generally the same as for open-angle glaucoma withhigh eye pressure.


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Types of Glaucoma

Congenital glaucoma affects infants born with defects that preventthe normal drainage of fluid from the eye.

Juvenile glaucoma is open-angle glaucoma that affects children,adolescents and young adults.

Secondary glaucoma can be open-angle or closed-angle, and is theresult of some other medical condition in the eye or the body.

Examples of secondary glaucoma include:

Pigmentary glaucoma, a rare form, in which pigment granules from the iris flake off into the eye fluid(aqueous humor) and clog the eyes drainage system (trabecular meshwork).

Pseudoexfoliation Syndrome occurs when white material appears to flake off the lens of the eye andblock normal flow of the aqueous humor.

Neovascular glaucoma occurs when abnormal blood vessel growth blocks the eyes fluid drainagechannels and leads to increased eye pressure. This abnormal growth can be caused by low bloodsupply to the eye due to diabetes, insufficient blood flow to the head because of blocked neckarteries, or blood vessel blockage in the back of the eye.

Iridocorneal Endothelial Syndrome (ICE) has a number of features, including the breaking off of cellsfrom the cornea, which blocks the drainage channels in the eye and leads to increased eye pressure.Scars may also connect the iris to the cornea.


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Detecting Glaucoma

Regular glaucoma check-ups include two routine eye tests:

Tonometry eye pressure test IOP

Ophthalmoscopy is a test that allows a health professional to see inside the

back of the eye (called the fundus) and other structures using a magnifying instrument(ophthalmoscope) and a light source.

Additional tests:

Perimetry (the perimetry test is also called a visual field test)

Gonioscopy is a painless eye test that checks if the angle where the irismeets the cornea is open or closed, showing if either open angle or closedangle glaucoma is present.


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Detecting Glaucoma

Tonometry:

The tonometry eye test measures the inner pressure of the eye also known asIntraocular Pressure or IOP.

Tonometry is carried out by an instrument called a TONOMETER.


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Types of Tonometry:

Applanation tonometry measures intraocular pressure either by the force requiredto flatten a constant area of the cornea (e.g. Goldmann tonometry) or by the areaflattened by a constant force.

Goldmann tonometer: Stationary device requires anesthesia drops, requirescontact with cornea and is attached to a slit lamp usually is used by an

Ophthalmologist.


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Types of tonometry

non-contact tonometry or air-puff tonometry:

This type of tonometer uses a rapid air pulse to applanate the cornea. Intraocular pressure is estimatedby detecting the force of the air jet at the instance of applanation.

In most cases a stationary unit,Does not require anesthetic drops


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Types of tonometry

Tono-pen - is a portable electronic, digital pen-like instrument that determines IOPby making contact with the cornea, after use of topical anesthetic eye drops tipcovers are used between the patients.


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Types of tonometry

The newest Advancement in tonometry is DIATON TONOMETER It measures intraocular pressure (IOP) through the Eyelid.

Diaton Tonometeris intended for use by Inpatient & Outpatient Clinics such asHospitals, Emergency Rooms, Nursing & Elderly Homes,

General & Specialty Practitioners as well as Ophthalmologists and Optometrists.

DIATON Requires No Contact with Cornea No Anesthetic Drops, No Risk of Infecting
http://www.tonometerdiaton.com/http://www.tonometerdiaton.com/http://www.tonometerdiaton.com/http://www.tonometerdiaton.com/http://www.tonometerdiaton.com/http://www.tonometerdiaton.com/


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Diaton Tonometry

SafeQuickEfficientPainlessNoninvasive

Can be used onChildren and Adults


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Four Key Facts About Glaucoma

Glaucoma is a leading cause of blindnessGlaucoma can cause blindness if it is left untreated. And unfortunately approximately 10% of peoplewith glaucoma who receive proper treatment still experience loss of vision.

There is no cure (yet) for glaucoma

Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it ispossible to halt further loss of vision. Since glaucoma is a chronic condition, it must be monitored forlife.

Screening, detection and prevention is the first step to preserving your vision.

Everyone is at risk for glaucoma

Everyone is at risk for glaucoma from babies to senior citizens. Yes, older people are at a higher riskfor glaucoma but babies can be born with glaucoma (approximately 1 out of every 10,000 babies bornin the United States).

Young adults can get glaucoma, too. African-Americans in particular are susceptible at a younger age.

There may be no symptoms to warn youWith open angle glaucoma, the most common form, there are virtually no symptoms. Usually, no painis associated with increased eye pressure.

Vision loss begins with peripheral or side vision. You may compensate for this unconsciously byturning your head to the side, and may not notice anything until significant vision is lost. The best wayto protect your sight from glaucoma is to get tested. If you have glaucoma, treatment can beginimmediately.


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Statistics About Glaucoma

It is estimated that over 4 million Americans have glaucoma but only half of those know they have it. (1)

Approximately 120,000 are blind from glaucoma, accounting for 9% to 12% of all cases of blindness inthe U.S. (2)

About 2% of the population ages 40-50 and 8% over 70 have elevated IOP.

Glaucoma is the second leading cause of blindness in the world, according to the World HealthOrganization.

Glaucoma is the leading cause of blindness among African-Americans. (2)

Glaucoma is 6 to 8 times more common in African-Americans than Caucasians. (3)

African-Americans ages 45-65 are 14 to 17 times more likely to go blind from glaucoma than Caucasianswith glaucoma in the same age group.

The most common form, Open Angle Glaucoma, accounts for 19% of all blindness among African-

Americans compared to 6% in Caucasians. (4)Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics,and people who are severely nearsighted.

Estimates put the total number of suspected cases of glaucoma at around 65 million worldwide. (5)


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Statistics About Glaucoma cont

Prevent Blindness America Survey found that:

Blindness ranked third (after cancer and heart disease) as peoples majorfear.

20% of people knew that glaucoma was related to elevated pressure

within the eye. Most of them mistakenly thought people could tell if theyhad glaucoma due to symptoms, or that it was easily cured, or that it didnot lead to blindness.

50% had heard of glaucoma, but werent sure what it was.

30% had never heard of glaucoma.


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Economic Impact:

Glaucoma accounts for over 7 million visits to physicians each year. (1)

In terms of Social Security benefits, lost income tax revenues, and healthcare expenditures, the cost to the U.S. government is estimated to be over

$2.5 billion annually. (6)

Sources: (1) Prevent Blindness America; (2) National Eye Health Program/National Institutes of Health; (3)

merican Academy of Ophthalmology; (4) Racial differences in the cause-specific prevalence of blindness

in east Baltimore. N Engl J Med. 1991 Nov 14;325(20):1412-7; (5) Quigley, Number of people with glaucoma

worldwide, 1996; (6) NEI, Report of the Glaucoma Panel, Fall 1998


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as per University of Washington Department of Ophthalmology.

In U.S. - there are ONLY:

17,000 Ophthalmologists & 30,000 Optometrists

There is a great NEED for ADDITIONAL screening locations

60 million Americans are at RISK for developing Glaucoma,


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FLORIDA AGE DEMOGRAPHICS:

Florida National % National

Households

All 6337929 1054801016%

Age 65+ 1943478 24672708 7.9%

Alone 710025 9722857 7.3%

Not Alone 1233453 14949851 8.3%

45 to 54 years 2069479 37677952 5.5%

55 to 59 years 821517 13469237 6.1%

60 to 64 years 737496 10805447 6.8%

65 to 74 years 1452176 18390986 7.9%

75 to 84 years 1024134 12361180 8.3%

85 years and over 331287 4239587 7.8%

TOTAL AT RISK (45 years and older) 6,436,089

As population ages the impact of the disease will increase


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Glaucoma Prevention Initiative

Thank you for your attention

and your openness to challenge the silent thief of sight!

glaucoma presentation - information, risk factors and detection

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