AARP Hearing Center
If you've been diagnosed with the early stage of an eye disease, count yourself lucky.
Why? Because there are several million Americans out there who don't know they have one of the leading causes of blindness — glaucoma, age-related macular degeneration and diabetic eye disease. Our brains are so deft that they readily compensate for creeping loss of vision, masking early symptoms and putting us at risk of future blindness. By getting yearly dilated-eye exams, you allow your doctor to catch an eye disease early enough to begin effective treatment. You may be able to save your sight, and even reverse some of the damage.
But what if you're too busy to be bothered with annual dilated exams, or convinced your eyes are still performing at the top of their game? In that case, your future path might look very different. Many of us won't even see symptoms of an eye disease until it has progressed significantly. So if you want to see your grandchildren graduate high school one day, it makes sense to dedicate an hour or so every year to a dilated exam. The power is totally in your hands, and the difference is dramatic. Here's how four common eye diseases play out when you take action — and when you don't.
Glaucoma
"Glaucoma has been called the silent thief of sight,” says Yvonne Ou, associate professor in ophthalmology at the University of California, San Francisco. More than 3 million Americans have glaucoma, but only half know it. The disease is marked by damage to the eye's optic nerve, which collects visual information from the retina and transmits it to the brain. At the beginning, one eye may lose more of its peripheral vision. “The other eye will compensate to cover up the problem,” says Ou, so with both eyes open you may not notice the vision loss.
If you take action: A comprehensive, dilated-eye exam is the best way to detect glaucoma. Every adult over age 50 should get this test every year, but if you have a family history of glaucoma, you may need one sooner or more often. “If we catch glaucoma early, it's a very treatable disease,” says Ou. “We tell patients with confidence that we can usually prevent vision loss that affects quality of life.”
The treatment goal is to reduce eye pressure, and that can be done via medicated eye drops or a laser procedure called selective laser trabeculoplasty (SLT). New research in The Lancet has found that, compared to eye drops, SLT is better at controlling pressure and can be more cost-effective, and fewer patients eventually require surgery. SLT is not a cure for glaucoma, but many patients find it far more convenient than drops.
If you don't: Glaucoma is extremely aggressive when it's diagnosed late or not at all. “When glaucoma is diagnosed late, the optic nerve is already damaged, and a damaged nerve is more vulnerable, so later-stage disease can be more difficult to control,” says Ou. With moderate to advanced glaucoma, you may find that important tasks involving the peripheral vision, like the ability to change lanes safely while driving, become challenging. The late stage of the disease affects your interior vision, so it can be tough to navigate stairs or curbs. Later stage glaucoma attacks central vision, and when left untreated, glaucoma can cause irreversible blindness.
Risk of sight impairment from glaucoma: 10 percent. Risk of blindness: 5 percent.
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