Glaucoma Awareness Vital for this Blinding Eye Disease
January is Glaucoma Awareness Month, and March 12-17 will be World Glaucoma Week (WGW) with events held around the globe, including an Alliance for Eye and Vision Research (AEVR) Congressional Briefing on March 9 at noon in House Rayburn Office Building 2040 in Washington, D.C.
Americans fear vision loss more than most other conditions, as reported in a 2014 Research!America survey conducted for AEVR.1 So sustained education about glaucoma is vital since it is the second leading cause of preventable vision loss in the United States. A neurological disease affecting the optic nerve, it causes loss of peripheral vision and ultimately blindness. It affects more than 2.7 million Americans over age 40, with that number estimated to more than double by the year 2050. It includes both diagnosed and undiagnosed cases, as often individuals are unaware they have the disease until vision is lost. In its 2014 report on the prevalence and cost of vision disorders, Prevent Blindness2 estimated that glaucoma is a driving factor − along with cataract and diabetic retinopathy − in the annual cost of vision impairment reaching $373.2 billion by the year 2050, or $717 billion when adjusted for inflation.
Certain characteristics such as age, ethnicity, high blood pressure, high intraocular pressure (IOP), and optic nerve appearance are associated with disease development. Groups at highest risk include African Americans over age 40, individuals over age 60 – especially Mexican Americans – and those with a family history of the disease.
In its most common form − primary open angle glaucoma (POAG) − nerve damage can result from high IOP, which occurs when the fluid that circulates in and out of the front part of the eye drains too slowly. Research funded by the National Eye Institute (NEI) within the National Institutes of Health (NIH) has resulted in pressure-reducing drug regimens, and NEI’s Ocular Hypertension Treatment Study (OHTS) found that pressure-reducing eye drops delayed disease onset. Since the average glaucoma patient is treated for 14 years, a patient’s compliance with their IOP-reducing drug regimen is important in disease management, especially since NEI has also shown that patient adherence to their drug therapy may be poor due to improper use or not using the medication at designated times.
In addition to drug regimens, glaucoma is also treated through conventional surgery – which makes a new opening for fluid to leave the eye – and laser trabeculoplasty, where the laser burns a drainage hole in the spongy meshwork near where the fluid leaves the eye.
Recently, NEI reported the discovery of three more genes – making a total of 15 – that contribute to POAG. NEI’s Glaucoma Human Genetics Collaboration (NEIGHBOR) Consortium has joined with the National Human Genome Research Institute (NHGRI) in engaging clinicians and geneticists at multiple institutions throughout the U.S in identifying genetic variants associated with POAG. Characterizing the genes and environmental exposures will help define the molecular abnormalities responsible for the disease, which is the first step toward developing novel therapies targeted to the disease-causing events.
1JAMA Ophthalmology, August 2016 Online First, based on AEVR’s survey The Public’s Attitudes about the Health and Economic Impact of Vision Loss and Eye Disease, September 2014 (conducted by Zogby Analytics for Research!America through a grant from Research to Prevent Blindness).
2The Future of Vision: Forecasting the Prevalence and Costs of Vision Problems, Prevent Blindness, June 2014.
James F. Jorkasky is Executive Director at the Alliance for Eye and Vision Research.