Glaucoma can be a serious setback to healthy and independent senior living. It is one of the leading causes of blindness in the United States. At least 2 million Americans have been diagnosed with glaucoma, but many others live with the condition without even realizing it.

At ERH, we take senior healthcare seriously, and our wellness professionals can help you understand how glaucoma affects senior living, recognize symptoms of the different conditions, and know what questions to ask your eye care professional.

What is Glaucoma?

Glaucoma is not a single disease, but rather a collection of diseases that affect the optic nerve—the bundle of over a million fibers that transmit light and images from the retina to the brain.

In a healthy eye, the drainage system in the anterior chamber at the front of the eye steadily bathes and nourishes the surrounding tissues. This drainage system works too slowly in the eye of an individual with glaucoma. Fluid builds up causing the internal pressure of the eye to rise and, potentially, damage the optic nerve or other parts of the eye.

While anyone can develop glaucoma, the condition is most common among older adults—older Americans are more than 6 times more likely to develop glaucoma than their younger counterparts— and seniors of African American, Hispanic and Japanese heritage are especially at risk.

If glaucoma is a collection of diseases, what types should I be concerned about?

There are two types of glaucoma that are most common in senior living communities.

1. 1.       Open-angle glaucoma which represents 90% of all diagnoses.

In this form of glaucoma, the clear hydrating fluid leaves the anterior chamber and flows as it should until it reaches the drainage canal where the cornea and iris meet. Although the angle is wide and open as it should be, over time eye pressure slowly builds as fluid is slowed down when it passes through the spongy framework of the canal.

1. 2.       Angle-Closure Glaucoma which is the second most common form of the condition.

This form of glaucoma develops rapidly and can be much more severe. In angle-closure glaucoma, fluid is obstructed by a narrowing or other blockage in the drainage canal at the angle of the iris and cornea. This causes a sharp rise in eye pressure.

What symptoms should I be looking for in my day-to-day senior living?

Open-Angle and Angle-Closure Glaucoma are two very different conditions with separate causes and symptoms.

Because Open-Angle Glaucoma develops slowly, the condition has few warning signs until loss of vision begins to occur. Symptoms appear gradually as a slow encroachment on peripheral vision that progresses from mild tunneling to complete blindness.

The rapid onset of angle-closure glaucoma, however, comes with a list of possible symptoms:

• Eye pain that can cause nausea and vomiting
• Impaired night vision
• Blurred vision or other distortions such as halos around lights
• Reddening of the eye

How do I talk to my senior healthcare team about glaucoma?

If you’re over the age of 60, especially if others in your family have developed glaucoma or you’re part of an at risk group, ask your eye care profession to schedule a comprehensive eye exam that includes a visual acuity test, visual field test, dilated eye exam, tonometry, and pachymetry.

If your senior living is already affected by glaucoma, have a frank conversation with your healthcare provider about your concerns and ask how you can take steps to prevent the disease from progressing.

The National Eye Institute has a number of steps you can take to be proactive about your eye care

• If you don’t understand your eye care professional’s responses, ask questions until you do understand.
• Take notes or bring a tape recorder to document the discussion for later reference.
• Have your eye care professional write down any instructions for testing and treatment.
• Ask for available literature on the disease and find out where you can go for more information
• Enlist your whole senior healthcare team. Talk to your primary care provider, attending nurses, and regular pharmacist about how they can help you manage your glaucoma.

Image Credit: Omer Wazir