A Drop a Day Can Keep Glaucoma at Bay

January is traditionally a time for New Year’s resolutions relating to diet, exercise and smoking.  Here’s one I would like to add to the top of your list: Schedule your annual eye exam.  There is a more pressing reason for this timely recommendation: Glaucoma.

January is National Glaucoma Awareness Month, a time to remind the public about this eye disease which affects more than three million people in the United States and is one of the leading causes of blindness. Even more urgent is the prediction by the National Eye Institute that this number will reach 4.2 million by 2030, a 58 percent increase.  The problem with Glaucoma is there are often no physical symptoms. Often called “the sneak thief of the night,” the loss of vision is often irreversible.  So an eye exam is a sight saver. Without it, there is no way to detect or treat it. And treatment is the only way to prevent further loss of sight.

My favorite approach when seeing patients is to explain what I am doing, why I am doing it and how things work. When it comes to Glaucoma, I like to use the analogy of a sink. Like a sink, the eye produces fluid called aqueous humor, and drains the fluid at the same rate. This balanced process provides a healthy internal pressure called Intraocular Pressure or IOP.

Unfortunately, like a sink, the drain in your eye can clog; but the damage to your eye is permanent, unlike the sink which can be unclogged by your plumber. In the eye, the blockage causes damage to the optic nerve, resulting in loss of vision.

There are two types of Glaucoma, open angle glaucoma (COAG) and angle-closure glaucoma  The most common form of Glaucoma is open-angle glaucoma. Also called primary or chronic glaucoma, this type of Glaucoma is symptomless.  A far less common type of glaucoma is angle-closure glaucoma, resulting in an abrupt, significant elevation of your eye pressure. Patients experiencing this type of Glaucoma are very symptomatic with eye pain, headaches, blurred vision, and often nausea.  This is a true emergency and requires immediate eyesight saving laser surgery to reduce the pressure.

There are three distinct treatment options to treat chronic open angle glaucoma (COAG):

Medications such as eye drops which lower your intraocular pressure (IOP), laser procedures, and surgery in the operating room.

All glaucoma patients use prescription eye drops which maintain your eye sight and keep the disease from progressing. There are five different types of drops with each one having a different therapeutic effect and of course side effects. Most patients need to take more than one medication. About 50% of glaucoma patients need two or more different medications.

Here is the problem. The more prescriptions prescribed, the less the likelihood of compliance. And non-compliance leads to blindness.  Additionally, the one-a-day eye drops do not always lower your eye pressure sufficiently.  But there is good news for the New Year. The FDA has recently approved Vyzulta, the first glaucoma drug in 20 years. The advantage is you only take it once a day though it is replaces two different eye drops. I personally have prescribed this new medication to my patients in my Fort Lauderdale practice, Eye Surgeons & Consultants and seen firsthand the excellent results in reducing eye pressure.


Annual eye exams prevent blindness. Why not add it to your 2018 New Year’s resolution list?


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