Common eye diseases

Of all the potential maladies that could affect the human body, none scares me as much as eye diseases do. The mere thought of a patient losing their ability to see, frightens me terribly. This probably explains why my chosen specialty is Family Medicine and not Ophthalmology. With January being dedicated to glaucoma awareness month, I thought having a little discussion about not only glaucoma but also other serious eye complications would be beneficial to us all. 

First of all, glaucoma is the leading cause of blindness in the United States. Approximately 2.2 million people are affected by glaucoma. It is estimated by 2050, that number will swell to over 7 million people. Glaucoma is the result of fluid pressure building up in the eye, which in turn, damages the optic nerve. Initially there may be no symptoms at all but gradually loss of peripheral vision occurs (people describe this as tunnel vision) and if left untreated eventual blindness.   

African Americans over the age of 40, people over the age of 60 and people with a family history of glaucoma are all considered high risk. A thorough exam by an eye professional can determine if you are at risk. People at increased risk should at least be checked every two years. Glaucoma can be controlled but there is no cure. To prevent vision loss, early treatment is the key. Treatment consists of eye drops and sometimes surgery. 

Another just as frightening eye disorder is diabetic retinopathy. Basically, this is eye damage that resulted because of poorly controlled diabetes. In 2011, 20.8 million adults were diagnosed with diabetes, the greatest majority being African American. Diabetes is a disease in which blood sugar levels are above normal in the body. The body is either not making enough insulin or the body is not responding properly to the insulin that is present. As a result, serious complications can develop such as heart disease, kidney failure, lower extremity amputations and blindness.   

People with diabetes should receive at least quarterly a test called hemoglobin A1c. This result will alert the doctor to how well your blood sugars have been controlled.  The expected standard is less than 7.  In addition, it is imperative that diabetics have yearly dilated eye exams to assess for early damage in the light sensitive portions of the eye, the retina. Similarly to glaucoma, early stages of diabetic retinopathy can be present but not necessarily causing symptoms. A sustained history of high blood sugars and the amount of time you have had the disease contribute to the likelihood of developing this particular eye manifestation, which can also result in blindness. 

A leading cause of vision loss in adults over the age of 60 is AMD, age-related macular degeneration. AMD destroys central vision, which is important in reading and driving. The macula, the part of the eye that is important in seeing fine detail, is what is affected by AMD.   

There are two different types of AMD, wet and dry. Wet AMD occurs when abnormal vessels grow under the macula and start to leak blood and fluid. Patients generally describe their vision as blurry. When the light sensitive cells start to slowly break down, this is called dry AMD. An early symptom of dry AMD happens when straight lines start to look crooked. Although treatable with vitamins, vision aids, medications and laser therapy, macular degeneration has no cure. 

Probably the most familiar eye disease is as a cataract. It results from clouding of the lens and diminishes vision acuity. Approximately 50 percent of all Americans over the age of 80 either have a cataract or have had surgery to remove a cataract. It can affect one or both eyes but does not spread from one eye to the other. 

The lens is the clear part of the eye that helps to focus light on the retina. The lens must be clear in order for the retina to receive a sharp image. Thus, if the lens is cloudy, this will cause the image that you see to appear blurry.   

The lens is made up of mostly protein and water. However, as you age, the protein starts to clump together and form a film over the lens causing the image to look hazy or fuzzy. Age, diseases such as diabetes, and smoking increases your risk of developing a cataract. 

As you can see with the majority of these conditions, prevention and early treatment are essential in preventing vision loss. Your health should be more than just a focus on longevity but also on the quality of the life you live. Therefore, eye care should be taken seriously.  

Yours in Service,

Denise Hooks-Anderson, M.D.

Assistant Professor

SLUCare Family Medicine

yourhealthmatters@stlamerican.com