Glaucoma - Risk Factors

Diagnosis

A diagnosis of glaucoma does not rely solely on the presence of pressure within the eye. Optic nerve damage or a strong suggestion of damage must also be present. This damage can be clearly seen during a dilated eye examination of the optic nerve. In general, the hallmark sign of this condition is a loss of peripheral vision. With peripheral vision loss, a person can see in front but has lost the vision to the side.

Because chronic glaucoma has no warning symptoms, half of patients are unaware they have the condition. Early diagnosis is the key to successful treatment of glaucoma and prevention of blindness.

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Recommendations for Glaucoma Screening

There has been debate about the relative benefits and risks of routine glaucoma screening in adults. Glaucoma screening in adults can help identify signs of increased intraocular pressure (IOP) and the early stages of primary open-angle glaucoma (POAG). However, treatment of IOP and early POAG can potentially result in harmful effects, such as eye irritation and increased risk for cataracts. Because of this uncertainty, the United States Preventive Services Task Force has not found sufficient evidence to recommend for or against routine screening for glaucoma in adults.

In contrast, the American Academy of Ophthalmology strongly supports glaucoma screening, with the following specific recommendations:

• Everyone over age 65 and African-Americans over 40 years old should have periodic eye exams, including tests for glaucoma, every other year.
• African-Americans ages 20 - 39 should have eye examinations every 3 - 5 years.
• Other people at higher risk (people with diabetes, history of eye injuries, a family history of glaucoma, or those taking corticosteroid medications) should have eye examinations every year after age 35.
• People with known glaucoma should have frequent examinations to check peripheral vision and to be sure treatment is maintaining a safe eye pressure. After such examinations, the ophthalmologist will assess current treatment and make necessary adjustments.