Glaucoma is one of most misunderstood eye diseases that eye doctors treat. Most people have heard of glaucoma and know they don’t want to have it, but I’ve found that most of my patients aren’t really sure how it damages vision or how it gets treated. 2.7 million people in the United States have glaucoma and it is the second leading cause of blindness.
Certain types of glaucoma are painless, which gives the disease the dubious distinction of being called “the sneak thief of vision”. It is a disease that damages the optic nerve in the eye causing progressive loss of peripheral vision, and by the time someone notices that they have lost portions of their visual field it is too late, and that visual loss is irreversible. One of the variables that causes the optic nerve to sustain damage is elevated intraocular pressure. If the pressure in the eye is extremely high, the eye will be painful, but the majority of patients only have moderately elevated pressure and will not know it is high until it is detected on a routine eye exam. Factors that increase the risk of developing glaucoma include being African American, having a family history, hypothyroidism, being over 60, and previous eye trauma. Typically, the initial treatment modality is using eye drops that lower the intraocular pressure, but more advanced or complicated cases may need laser or surgery.
A disease such as glaucoma is a perfect example of why everyone needs routine eye care, even if they have 20/20 vision, since evaluation of the optic nerve, peripheral vision, and eye pressure measurements in the office are key to preventing devastating and permanent vision loss.
Can too much coffee cause glaucoma? Yes, no, and maybe. A recent study published in the June edition of Ophthalmology determined that consuming large amounts of caffeine daily increased the risk of glaucoma by more than three fold for those with a genetic predisposition for higher eye pressure. Glaucoma is the leading cause of blindness in the United States and often goes undetected for years since it’s first impact is on peripheral vision. Although many factors contribute to glaucoma, high intraocular pressure is an important risk factor in the disease as well as being the primary target of glaucoma drops whose goal is to decrease elevated eye pressure. Researchers studied the relationship between caffeine, eye pressure and patients who had glaucoma, and concluded that caffeine intake was not associated with causing glaucoma or high eye pressure overall, BUT, in patients with a high genetic predisposition to elevated eye pressure, greater caffeine consumption was associated with higher eye pressure and higher prevalence of glaucoma. So how much caffeine are we talking about? The study determined that patients who consumed more than 321 mg of caffeine (about 3 cups) were at risk for high eye pressure and glaucoma, but again, only if they were in that high genetic risk category.
As a dry eye patient myself I empathize with my fellow dry eye sufferers. For many of us, dry eye is a chronic condition that waxes and wanes for myriads of reasons. Dry eye sounds innocuous but anyone who has experienced it knows it can severely affect the ability to see both clearly and comfortably. Dry eye is a condition in which a person does not have enough “quality” tears to lubricate and nourish the eye. I give the example of driving with a dirty windshield – in order to see clearly to drive you need the wipers and the washer fluid in tandem to make the window clear and allow you to see well. So too if the tears and the eyelids are not working well together the vision will be impaired – like driving with a filthy windshield.
For many allergy sufferers mere avoidance of the offending allergens is not enough to prevent symptoms. The first line of treatment is to use high quality over the counter artificial tears which help to lubricate irritated eyes as well as to wash out and dilute the pollen that reaches the eye. Cool compresses are another natural way to relieve symptoms. Although there are a myriad of over the counter topical allergy drops on the market, it is hard to figure out which ones might be right for you, don’t hesitate to make an appointment so we can figure it out. Prescription antihistamine and mast cell inhibitor drops are very effective, and if these are still not enough we can prescribe a pulsed dose of topical steroids to get things under control. In some instances a consult with an allergist may be necessary if there are other systemic symptoms such as asthma, coughing and rashes that are not being addressed. Oral medications or immunotherapy (allergy shots) may be helpful as a more long term solution.
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