Glaucoma is an eye condition that builds up pressure inside the eye.
According to the Glaucoma Research Foundation, glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss.
Glaucoma is the second leading cause of blindness.
Hamed Bazargan Lari, MD, Summit Medical Group ophthalmologist, presents the facts about glaucoma to help those affected take care of their eyes and take charge of their health.
Selected Podcast
Your Eyes are Precious, Are You Worried About Glaucoma?
Featured Speaker:
Dr. Lari is the recipient of more than 20 honors and awards, including the prestigious Lions Eye Research Foundation Annual Research Award. He is a diplomate of the American Board of Ophthalmology and a member of the American Academy of Ophthalmology (AAO), American Glaucoma Society (AGS), American College of Surgeons, and American Medical Association.
Hamed Bazargan Lari, MD
In addition to his position at Summit Medical Group, Hamed B. Lari, MD, is an instructor in clinical ophthalmology at Columbia University Medical Center Edward S. Harkness Eye Institute in New York City.Dr. Lari is the recipient of more than 20 honors and awards, including the prestigious Lions Eye Research Foundation Annual Research Award. He is a diplomate of the American Board of Ophthalmology and a member of the American Academy of Ophthalmology (AAO), American Glaucoma Society (AGS), American College of Surgeons, and American Medical Association.
Transcription:
Your Eyes are Precious, Are You Worried About Glaucoma?
Melanie Cole (Host): Glaucoma is an eye condition that builds up pressure inside the eye. According to the Glaucoma Research Foundation, glaucoma is a complicated disease in which damage to the optic nerve can lead to progressive irreversible vision loss. And glaucoma is the second leading cause of blindness. My guest today is Dr. Hamed Lari. He’s an ophthalmologist at Summit Medical Group. Welcome to the show, Dr. Lari. Tell us a little bit about glaucoma. What is it, and who is at risk for it?
Dr. Hamed Lari (Guest): Hello, Melanie. Thank you for having me on your show and hello to your listeners. That is a great question. Glaucoma is really a term that is used for a group of ocular disorders that essentially what they all have in common is damage to the optic nerve. We like to think of glaucoma really as an optic neuropathy that is often associated with increased fluid pressure buildup inside the eye, causing the intraocular pressure to be elevated. As I said, there are about maybe 50 different types of glaucoma, but we like to roughly divide the disease into two groups of open angle glaucoma and closed angle glaucoma. That really refers to the drainage pathway of the eye, where the fluid leaves the eye. In the United States, the majority of glaucoma that we see, they’ve fallen in the first category of open angle, which is a chronic, slowly progressive glaucoma that causes damage to the optic nerve and eventually translates into peripheral vision loss. Now, to answer your second question of who is at risk, glaucoma tends to be the disease of elderly. So we have certain guidelines of how to screen people at what age. We recommend screening population age over 50, and if you have other risk factors such as a family history of glaucoma or if you come from certain ethnicities, like if you have African-American backgrounds, we’d like to screen those individuals a little bit earlier at age 40. However, anybody can get really glaucoma. We have juvenile-type glaucoma or even congenital infantile glaucoma. We have little babies born with glaucoma. In general, the majority of glaucomas are disease of elderly, and that’s when we recommend screening everybody with an annual eye exam at the age of 50, unless people have other risk factors to account for.
Melanie: Would we notice some symptoms that would actually send us to see an ophthalmologist such as yourself—pain, pressure? Or can it be more silent or just a little bit more subtle than that?
Dr. Lari: Sure. The early signs of the open angle glaucoma, they’re very subtle. Slowly, increased eye pressure can cause frontal type headaches. But by the time patients notice symptoms, it’s already too late. By the time patients notice peripheral vision loss, which is people more commonly refer to as tunnel vision, that’s a little bit late. However, in the acute type glaucoma, where we have a sudden increase in eye pressure, that can present with eye pain, decreased vision, nausea, vomiting, headaches, redness in the eye. Sometimes the surface of the eye looks a little bit hazy. Those are the signs to look for in a very acute type of elevation of eye pressure that can translate to optic nerve damage in glaucoma.
Melanie: Does it always lead to blindness, Dr. Lari?
Dr. Lari: Well, glaucoma, if left untreated is a blinding disease, unfortunately. However, with good treatment and early detection, the best of what we have with our technologies and with our medications, we can slow down the progression so that most of our patients now have good visual function during their lifetime. However, you are absolutely correct that glaucoma is a blinding disease if left untreated.
Melanie: Tell us about some of the treatments. If someone comes in, they get their eye exam and you’ve determined that you’ve detected glaucoma, what then do you do for them? Because that’s a very scary thing to hear from someone.
Dr. Lari: Sure. That’s a great question. As part of glaucoma evaluation, we look at a few different things as part of their exam. We look at their optic nerve, we look at the pressure, we look at their visual fields, the peripheral vision. Then once we determine that one needs to be treated, in general, we have three ways of treating glaucoma. One would be with medications—most of the time, in the form of eye drops that most of our patients are on chronically, on a daily basis. The second category would be laser treatment. Most of our laser treatments are geared towards lowering the eye pressure by targeting the drainage pathway of the eye so that there is more fluid leaving the eye or targeting certain parts of the eye that produce fluid and causing that part, specifically the ciliary bodies inside the eye, to make less fluids. Lastly, we have surgical options that we use. We usually reserve the surgical options as a last resort, and we try to manage glaucoma initially with laser treatments or medication.
Melanie: Is there anything that anyone can do for prevention of glaucoma?
Dr. Lari: That’s great. I think, really, the key here is screening. Unfortunately, if one is destined to get glaucoma, there is really not much we can do lifestyle wise or dietary wise. Really, the key to preserving good vision in people who have glaucoma is early detection. What we recommend is don’t forget your annual eye exam. If you have risk factors, you definitely need to be examined by an ophthalmologist. Really, monitoring is key and early detection is really key in preserving good vision.
Melanie: Now, if some of their vision has already been lost and they’re getting a little bit of a late diagnosis, what advice do you have for people that have lost some of their peripheral vision? Can they drive? Give us a little advice on resuming normal activities.
Dr. Lari: Sure. The best thing to do is—we have this in the Summit Medical Group—as soon as you detect glaucoma, we start treatment. And we try to really lower the pressure as much as possible. Then the next step is to really optimize their visual function with special types of glasses that we use and giving them help and low vision aids to really optimize their function, where there would be driving or being independent around the house. Unfortunately, in glaucoma, as you mentioned, the vision that you lose is irreversible. We can’t really bring back the vision that is lost. But with early and aggressive treatment, we can hold on to the central vision, which is really most of the functional vision that people use throughout the day.
Melanie: In just the last few minutes, Dr. Lari, what research is being done in the field of glaucoma, and why should listeners come to Summit Medical Group for their eye care?
Dr. Lari: Sure. Current research, there’s a lot of different research in different fronts. There’s a lot of research going on on the genetics of glaucoma, so we can detect glaucoma early and start treatment early. There’s a lot of research in the pharmaceuticals of glaucoma trying to come up with better medications to lower the pressure earlier. And also, as far as treatment, there are a lot of different microsurgical treatments that now we’re trying here at Summit Medical Group that help aggressively target the parts of the eye that is responsible for high pressure in the eye to achieve physiological eye pressure. In conclusion, what I really want to emphasize is glaucoma is treatable. However, it is a blinding condition if you don’t treat it. Early detection is really key, and one should really advocate for one’s eye health by really not forgetting those annual eye exams. And here at Summit Medical Group in New Jersey, we are lucky to have really the latest and the most advanced technology to screen, evaluate, and potentially treat glaucoma in its early stages.
Melanie: Thank you so much, Dr. Lari. It’s great information. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Your Eyes are Precious, Are You Worried About Glaucoma?
Melanie Cole (Host): Glaucoma is an eye condition that builds up pressure inside the eye. According to the Glaucoma Research Foundation, glaucoma is a complicated disease in which damage to the optic nerve can lead to progressive irreversible vision loss. And glaucoma is the second leading cause of blindness. My guest today is Dr. Hamed Lari. He’s an ophthalmologist at Summit Medical Group. Welcome to the show, Dr. Lari. Tell us a little bit about glaucoma. What is it, and who is at risk for it?
Dr. Hamed Lari (Guest): Hello, Melanie. Thank you for having me on your show and hello to your listeners. That is a great question. Glaucoma is really a term that is used for a group of ocular disorders that essentially what they all have in common is damage to the optic nerve. We like to think of glaucoma really as an optic neuropathy that is often associated with increased fluid pressure buildup inside the eye, causing the intraocular pressure to be elevated. As I said, there are about maybe 50 different types of glaucoma, but we like to roughly divide the disease into two groups of open angle glaucoma and closed angle glaucoma. That really refers to the drainage pathway of the eye, where the fluid leaves the eye. In the United States, the majority of glaucoma that we see, they’ve fallen in the first category of open angle, which is a chronic, slowly progressive glaucoma that causes damage to the optic nerve and eventually translates into peripheral vision loss. Now, to answer your second question of who is at risk, glaucoma tends to be the disease of elderly. So we have certain guidelines of how to screen people at what age. We recommend screening population age over 50, and if you have other risk factors such as a family history of glaucoma or if you come from certain ethnicities, like if you have African-American backgrounds, we’d like to screen those individuals a little bit earlier at age 40. However, anybody can get really glaucoma. We have juvenile-type glaucoma or even congenital infantile glaucoma. We have little babies born with glaucoma. In general, the majority of glaucomas are disease of elderly, and that’s when we recommend screening everybody with an annual eye exam at the age of 50, unless people have other risk factors to account for.
Melanie: Would we notice some symptoms that would actually send us to see an ophthalmologist such as yourself—pain, pressure? Or can it be more silent or just a little bit more subtle than that?
Dr. Lari: Sure. The early signs of the open angle glaucoma, they’re very subtle. Slowly, increased eye pressure can cause frontal type headaches. But by the time patients notice symptoms, it’s already too late. By the time patients notice peripheral vision loss, which is people more commonly refer to as tunnel vision, that’s a little bit late. However, in the acute type glaucoma, where we have a sudden increase in eye pressure, that can present with eye pain, decreased vision, nausea, vomiting, headaches, redness in the eye. Sometimes the surface of the eye looks a little bit hazy. Those are the signs to look for in a very acute type of elevation of eye pressure that can translate to optic nerve damage in glaucoma.
Melanie: Does it always lead to blindness, Dr. Lari?
Dr. Lari: Well, glaucoma, if left untreated is a blinding disease, unfortunately. However, with good treatment and early detection, the best of what we have with our technologies and with our medications, we can slow down the progression so that most of our patients now have good visual function during their lifetime. However, you are absolutely correct that glaucoma is a blinding disease if left untreated.
Melanie: Tell us about some of the treatments. If someone comes in, they get their eye exam and you’ve determined that you’ve detected glaucoma, what then do you do for them? Because that’s a very scary thing to hear from someone.
Dr. Lari: Sure. That’s a great question. As part of glaucoma evaluation, we look at a few different things as part of their exam. We look at their optic nerve, we look at the pressure, we look at their visual fields, the peripheral vision. Then once we determine that one needs to be treated, in general, we have three ways of treating glaucoma. One would be with medications—most of the time, in the form of eye drops that most of our patients are on chronically, on a daily basis. The second category would be laser treatment. Most of our laser treatments are geared towards lowering the eye pressure by targeting the drainage pathway of the eye so that there is more fluid leaving the eye or targeting certain parts of the eye that produce fluid and causing that part, specifically the ciliary bodies inside the eye, to make less fluids. Lastly, we have surgical options that we use. We usually reserve the surgical options as a last resort, and we try to manage glaucoma initially with laser treatments or medication.
Melanie: Is there anything that anyone can do for prevention of glaucoma?
Dr. Lari: That’s great. I think, really, the key here is screening. Unfortunately, if one is destined to get glaucoma, there is really not much we can do lifestyle wise or dietary wise. Really, the key to preserving good vision in people who have glaucoma is early detection. What we recommend is don’t forget your annual eye exam. If you have risk factors, you definitely need to be examined by an ophthalmologist. Really, monitoring is key and early detection is really key in preserving good vision.
Melanie: Now, if some of their vision has already been lost and they’re getting a little bit of a late diagnosis, what advice do you have for people that have lost some of their peripheral vision? Can they drive? Give us a little advice on resuming normal activities.
Dr. Lari: Sure. The best thing to do is—we have this in the Summit Medical Group—as soon as you detect glaucoma, we start treatment. And we try to really lower the pressure as much as possible. Then the next step is to really optimize their visual function with special types of glasses that we use and giving them help and low vision aids to really optimize their function, where there would be driving or being independent around the house. Unfortunately, in glaucoma, as you mentioned, the vision that you lose is irreversible. We can’t really bring back the vision that is lost. But with early and aggressive treatment, we can hold on to the central vision, which is really most of the functional vision that people use throughout the day.
Melanie: In just the last few minutes, Dr. Lari, what research is being done in the field of glaucoma, and why should listeners come to Summit Medical Group for their eye care?
Dr. Lari: Sure. Current research, there’s a lot of different research in different fronts. There’s a lot of research going on on the genetics of glaucoma, so we can detect glaucoma early and start treatment early. There’s a lot of research in the pharmaceuticals of glaucoma trying to come up with better medications to lower the pressure earlier. And also, as far as treatment, there are a lot of different microsurgical treatments that now we’re trying here at Summit Medical Group that help aggressively target the parts of the eye that is responsible for high pressure in the eye to achieve physiological eye pressure. In conclusion, what I really want to emphasize is glaucoma is treatable. However, it is a blinding condition if you don’t treat it. Early detection is really key, and one should really advocate for one’s eye health by really not forgetting those annual eye exams. And here at Summit Medical Group in New Jersey, we are lucky to have really the latest and the most advanced technology to screen, evaluate, and potentially treat glaucoma in its early stages.
Melanie: Thank you so much, Dr. Lari. It’s great information. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.