St. Johns UCC - Parish Nursing

June 2003 - Glaucoma

This week: Screening

Screening for glaucoma is problematic and medical groups do not agree on the frequency or techniques to use. First, your health care provider should be looking at the nerve in the back of the eye during routine physical exams. If the nerve looks as though there is excess pressure in the eye you should be referred to an eye care specialist.

The American Academy of Ophthalmology recommends a complete eye exam every two years for all persons older than 60 and all African Americans over 40 years of age. Screening for glaucoma is a problem because eye pressure measurements can be misleading. It is estimated that only 10% of individuals with mildly high eye pressures will develop glaucoma. Conversely, 50% of people with glaucoma will have normal eye pressure measurements.

Testing visual fields is another way to evaluate for the end product of glaucoma - loss of peripheral vision. Testing involves looking into a bowl-like structure with lights imbedded in the bowl and pushing a button when you see the light flash. The down side to using visual fields as a screening tool is that it only identifies damage from glaucoma after it occurs. It would not help prevent glaucoma damage. In addition, the testing is somewhat cumbersome and time consuming.

Screening for glaucoma is probably best when it includes aspects of all the above testing measures. Your health care provider should be looking at the eye nerve at every routine physical. He or she should recommend referral if the nerve looks suspicious or if you have a family history of glaucoma. You also should be referred if you have other risk factors including diabetes, high blood pressure, migraine or near-sightedness. Your eye care specialist can then do a more detailed evaluation of the nerve and any additional testing needed.

NEXT WEEK: Look for information regarding treatment for glaucoma