Prevent Glaucoma Damage by Early Detection: How to Catch the "Thief of Sight" Early
Glaucoma steals your vision slowly over time.
Nobody likes a thief, but one that takes your vision is the kind we want to catch before they ever break in and get away with our most valuable sense: vision.
We call glaucoma the “thief in the night” because it starts by stealing the part of our vision that we use the least: peripheral vision. When compared to our central vision, we just do not use our side vision as actively so it takes a very severe change to become obvious. Eventually glaucoma even steals central vision, which rapidly progresses to entirely losing the perception of light. Unfortunately, once that vision is lost it is gone forever - many very smart scientists are working to figure out how to get the vision back, but we do not have many leads in that department yet.
While we hope and pray for these miracles of science, our only weapon right now is prevention by detection. We have to use all of our tools to catch glaucoma that is sneaky and subtle.
In order to determine if a person is high risk for glaucoma, an eye doctor screens for glaucoma. They will check for (1) high intraocular pressures (high eye pressure), (2) look at the health of the nerve with pictures and visual examination, (3) use visual field testing, and (4) assess the thickness of your cornea (read more detail on testing here on one of our blog posts). A family history of glaucoma from immediate relatives can also raise the risk of developing glaucoma over a lifetime. If any of these factors are present and outside of the normal range then an eye doctor will often run more tests and check pressures a little bit more often throughout the average year of a patient's life. These "pre-glaucoma" patients are given a diagnosis of “glaucoma suspect.” Glaucoma has not yet been diagnosed, but suspicion of developing glaucoma at some point is higher than the average person so additional testing is extremely important.
If a patient is at higher risk of developing glaucoma but not yet exhibiting loss of vision, a doctor will recheck the patient with the previously mentioned tests at least two times per year. Some tests will be scattered to balance the importance of testing with the reality that patients don't want to have to move next door to their eye doctor for all the trips they might make coming in more often than that. This is a great screening technique to minimize the general population’s loss of vision, but it still may not be as often as one would like for a disease that causes irreversible vision loss.
In terms of the testing there are two main categories outside of the physical exam and the questions a patient answers in the office:
1. The structure and shape of the nerve can give us information about the health of the eye and changes slowly over time, therefore it would make sense to check this over a slower time period: every six months to every year is typical
2. The pressure is a different story. Eye pressure goes high and low throughout the day, and the further apart the high and low are the more vision you lose. In fact this is considered an early warning sign that your eye is losing vision. One study found it to be 6x more likely to lose vision if your eye pressure highs and lows are very far apart. https://glaucomatoday.com/articles/2003-oct/1003_06.html). We call this wave of highs and lows during the day a “diurnal curve.” You would think that this scientific discovery would result in more frequent measuring, or at least establish the range of pressures throughout a typical day in your life.* And in some ways you are right: we check back higher pressure patients and patients with worsening vision more often. But to get to be one of those people you have to be getting worse - meaning you are already losing enough vision for it to be obvious on one or multiple tests before a doctor will start treatment. What if we caught glaucoma earlier by checking pressures more often? Could you save more vision? Absolutely we could! But only if we look - prevention by detection requires using tools that can detect changes early.
That is why we founded digital glaucoma.
Our mission is to empower patients to have control over their eye care in order to partner with their eye doctor to prevent vision loss from glaucoma.
No single technology is more important than the doctor patient relationship, even home tonometry. That is why we help every patient to discuss home tonometry with their doctor by providing helpful materials and a custom prescription form that helps the doctor understand the new iCare Home2 tonometer device allows patients to take pressures at home just like a blood pressure monitor for high blood pressure. It is easy, safe, and accurate as determined and approved by the FDA.
If you would like to help your doctor prevent glaucoma damage through early detection of eye pressure changes, please do not hesitate to reach out to us via email at firstname.lastname@example.org for a custom packet to share with your local clinic.
If you are new to eye care and need a screening, we can match you up with a local Digital Glaucoma doctor and, if they determine it is helpful, we can ship a device to you the same day we receive a prescription for a home tonometer like the iCare Home2.
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*A note on why diurnal curves are rarely performed in doctors offices:
Unfortunately, it is for the practical and simple reason that patients don’t want to spend the day in a doctors office and doctors do not have enough space in their offices to do this for the 3 million patients in the US that have glaucoma. Some highly dedicated ophthalmologists have used this technique in academic institutions where resources are abundant. Even then it is limited to only the most severe or unusual patient, rather than as a tool to screen more patients and prevent unnecessary vision loss in a greater number of people.