Around 300,000 Australian adults have glaucoma, but it is thought that half these people don’t even realise they have it. If you know you have an elevated glaucoma risk through a family history of glaucoma or other factors identified by your eye health professional, questions on how to prevent glaucoma may have already crossed your mind.

When it comes to discussing how to prevent glaucoma, while the straight answer may not be what you’re hoping for, there are still steps you can take to combat this blinding eye disease.

What is Glaucoma?

Glaucoma is a type of eye disease known as an optic neuropathy. This is a descriptive term referring to disease and damage to the optic nerve. As the optic nerve is responsible for transmitting signals from the eyeball to the brain, if it becomes damaged, your sight will subsequently be affected. After cataracts, glaucoma is the leading cause of blindness around the world. However, unlike cataracts, this blindness can’t be cured.

In most cases, the development of glaucoma is associated with elevated pressure inside the eye; this is known as intraocular pressure (IOP). Intraocular pressure is determined by the balance of aqueous fluid production to its drainage through a structure known as the anterior angle inside the eyeball. If this fluid is unable to be drained out at a sufficient rate, the IOP can rise. This can put the optic nerve at glaucoma risk. However, as we’ll see, elevated intraocular pressures don’t explain all cases of glaucoma. 

Your eye surgeon and other eye health professionals will divide glaucoma into three broad subtypes:

• Open-angle glaucoma. This is a type of glaucoma where the drainage structures of the eye appear open, but for some reason (not always understood), fluid is unable to drain out properly.
• Closed-angle glaucoma. As the name suggests, the drainage angle is narrowed or closed, physically impeding the drainage of aqueous fluid and causing the IOP to rise.
• Normotension or low-tension glaucoma. In this type of glaucoma, the intraocular pressure is still within a normal range, yet optic nerve damage is occurring. There are likely other underlying causes, such as compromised blood flow to the optic nerve.

How to Prevent Glaucoma – Is it Possible?

 Glaucoma, in all its forms, is a complex disease. The eye health community doesn’t fully understand what causes it, why some people with all the glaucoma risk factors never develop it, and why some people with no risk factors do. So, when it comes to discussing how to prevent glaucoma, unfortunately, the blunt answer is that you can’t. However, there are ways you can reduce your glaucoma risk. 

Manage Your Glaucoma Risk

There are a number of known glaucoma risk factors. Some of these can be controlled, while others can’t. It’s due to these uncontrollable risk factors (both those that are currently known and those that are yet to be discovered) that your eye surgeon will tell you that we cannot prevent this disease.

As far as we know so far, unmodifiable risk factors include:

• Genetics. Mutations in certain genes are known to be associated with glaucoma. Family history can dramatically increase your risk of developing this eye disease yourself. If you have a parent or sibling with glaucoma, your likelihood increases up to 10-times.
• Ethnicity. Although all ethnic backgrounds have the potential to develop glaucoma, Asians and Africans are known to be at the highest risk.
• Age. Being older than 50 years is considered to be a factor for glaucoma. The older you get, the higher your risk. Older adults are at a higher likelihood of developing other eye health problems and general health issues, which can indirectly increase your glaucoma risk too. 
• Eye anatomy. If your anterior angle is naturally narrow, this will automatically elevate your risk of glaucoma. However, unlike the other unmodifiable risk factors, your eye surgeon can proactively treat this through a laser procedure if necessary. 
• Very high myopia (short-sightedness) or hyperopia (long-sightedness). Structural changes to the eyeball from these high prescriptions can be a risk factor for glaucoma. 

Although you cannot eliminate your risk of glaucoma entirely, there are some risk factors that you do have some control over. Above all, maintaining regular visits with your optometrist or eye surgeon to check your eye health is crucial. The vision loss from glaucoma cannot be reversed, so the best course of action is to try and prevent it from progressing in the first place. There are a number of effective treatments that can help to slow or stop the progression of glaucomatous damage, but the first step is to be diagnosed. 

Here are some risk factors you can control:

• Stop smoking. 
• Treat any obstructive sleep apnoea. 
• Wear protective gear if you’re doing an activity with a risk of eye injury.
• Manage any diabetes well. 
• Avoid taking corticosteroid medications, or keep a close watch on your intraocular pressures if it’s unavoidable. 
• Keep your blood pressure within a healthy range. 

It is also important to manage your intraocular pressures if they’re elevated, as high pressures increase your likelihood of glaucomatous vision loss. It is possible to have pressures above the normal range without developing glaucoma – this is often termed ocular hypertension. Your eye surgeon will make a decision through experience and your glaucoma test results about whether it’s recommended to proactively treat your IOP, even if there’s not yet any evidence of glaucoma. Treatment is always aimed at lowering the intraocular pressures, although there is some evidence that vitamin B3 supplementation may also be useful for protecting the optic nerve in glaucoma. Pressure-lowering treatments include laser procedures, eyedrop medications, or surgery.

Call us now on (03) 9070 5753 for a consultation.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Glaucoma
https://www.cera.org.au/conditions/glaucoma/

Epidemiology of Glaucoma: The Past, Present, and Predictions for the Future.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769798/

Risk Factors for Glaucoma.
https://glaucoma.org.au/what-is-glaucoma/risk-factors-for-glaucoma

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