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Often referred to as the “silent thief of sight,” glaucoma in elderly is a condition that, if left unchecked, can steal away vision subtly and gradually. But fear not! With understanding, care, and timely action, we can guard against this thief and protect the precious gift of sight of our loved ones.

Before your elderly loved one realizes there is something wrong, they could lose about ½ or more of their vision. Glaucoma often doesn’t present with any symptoms until permanent loss accumulates slowly. Millions of United States citizens have this condition and about ½ of them don’t even know they have it. There is not a cure for glaucoma, but treatments are possible to help slow the progression of this condition. If your elderly loved one has a higher risk of getting this condition, it is important to detect it early on to help stop it from progressing too quickly.  

What Is Glaucoma?

In simple terms, glaucoma is a group of eye conditions that damage the optic nerve, the vital cable that carries visual information from the eye to the brain. This damage is often linked to an increased pressure in the eye, known as intraocular pressure, which can arise from a buildup of fluid. The tricky part? Glaucoma often shows no symptoms until significant vision loss has occurred, making it a stealthy adversary.

So what causes glaucoma in elderly? The eyes are producing certain types of fluid constantly. This fluid helps send nutrients to the eyes and body. Glaucoma happens when the tunnels for draining the nutrients get narrowed or even blocked. When fluid can’t get out of the eye, more and more pressure is building up. Over time, the pressure that is built up will start damaging the optic nerve. This can lead to vision loss that is permanent.  

Why the Elderly?

As we embrace our golden years, our bodies undergo various changes, and our eyes are no exception. The risk of developing glaucoma increases with age, particularlyin those over 60. This means that our beloved elders are at a higher risk of facing this condition, making awareness and regular eye check-ups more crucial than ever.

Apart from age, other risk factors for glaucoma include a family history of the condition, certain medical conditions like diabetes, and extreme nearsightedness or farsightedness. Knowing these risks can help tailor prevention strategies and screening schedules.

The Many Faces of Glaucoma

Glaucoma isn’t a one-size-fits-all condition. It comes in several types, with the two main ones being open-angle glaucoma, which progresses slowly, and angle-closureImage about Glaucoma In Elderly: Information For Our Loved Ones glaucoma, which can advance rapidly and is considered a medical emergency. Understanding these differences is key to recognizing and addressing the condition effectively.

Imagine your eye is a sink, with a faucet (producing eye fluid) and a drain (removing it). Glaucoma generally happens when the drain gets a bit clogged, causing water (or in your eye’s case, fluid) to build up and increase pressure. This can damage the optic nerve, which is like the cable sending visual info from your eye to your brain. If too much pressure builds up, it can start to wear down this cable, affecting your vision.

It is important to know that this is a chronic condition. Anyone who has glaucoma will need management for the rest of their life. They might need medications or surgery. Both of these things can help to slow the progression of this disease. The quicker your elderly loved one gets treatment, the less vision damage they will have at the moment. 

Those who are nearsighted, diabetic, have family members who have glaucoma, and who are 60 or older have a higher risk of glaucoma. Those who have a Japanese ancestry or who are African American have a higher risk of getting this condition, as well. If your elderly loved one falls into any of these categories, every other year they should get a dilated eye exam once they are 40 years of age. However, anyone who is diabetic should get a dilated eye exam every year after they reach 40 years of age. 

Now, there are several types of glaucoma, but today we’re focusing on the three main characters in our story: Primary Open-Angle Glaucoma (POAG), Angle-Closure Glaucoma, and Normal-Tension Glaucoma.

Primary Open-Angle Glaucoma (POAG)

POAG is kind of like a slow-moving river. It’s the most common form of glaucoma and progresses very gradually. Here, the eye’s drainage canals become clogged over time, leading to increased eye pressure that can damage the optic nerve.

Risk Factors: Age is a biggie here, especially if you’re over 60. Family history plays a role, as does ethnicity, with African Americans at higher risk.

Symptoms: Sneaky is its middle name because POAG often doesn’t show symptoms until it’s advanced. Regular eye exams are crucial for early detection.

Angle-Closure Glaucoma

This type is more like a sudden storm. It happens when the eye’s iris bulges, narrowing or completely blocking the drainage angle, causing a rapid increase in eye pressure. It can be acute (sudden) or chronic (gradual).

Risk Factors: Being farsighted, older age, and a family history of this type can up your chances. It’s also more common in women and Asians.

Symptoms: Symptoms can hit suddenly and may include severe eye pain, nausea, red eyes, blurred vision, and seeing halos around lights. Acute angle-closure glaucoma is a medical emergency, so if these symptoms appear, seek help right away.

Normal-Tension Glaucoma

Imagine this as a silent mystery. Here, optic nerve damage occurs even though the eye pressure isn’t above the normal range. Why? The jury’s still out, but it might be due to a less hearty optic nerve that’s more susceptible to damage.

Risk Factors: Risk factors include a family history of this condition, Japanese ancestry, and a history of systemic heart disease like irregular heart rhythm.

Symptoms: Similar to POAG, normal-tension glaucoma is a master of disguise, often showing no clear symptoms until significant vision loss has occurred.

Since glaucoma can be a bit of a sneak, it’s vital to keep an eye out for any signs, especially in its more aggressive forms. Symptoms can include blurred vision, severe eye pain, headache, and seeing halos around lights. However, because the most common form of glaucoma (open-angle glaucoma) progresses slowly, regular eye exams are essential for early detection.

How the Elderly with Glaucoma Actually Feel

Your elderly loved one might not feel that they have this condition. Most of the time, there aren’t signs that help someone to realize they have glaucoma until some permanent damage is already done. However, your elderly loved one might start to notice they have blurry or distorted vision. They might have nausea or pain in their eye. They may also lose their vision suddenly. If this happens, they need to get immediate emergency medical attention.  

Navigating Testing and Treatment Glaucoma in Elderly

There are numerous tests that can check for and diagnose this condition. The main tests for diagnosing this condition are gonioscopy, perimetry, and pachymetry. For the most part, your elderly loved one should not experience pain with these tests.  

While glaucoma’s effects are currently irreversible, there’s hope in management and treatment options that can halt or slow down its progression. These include prescription eye drops, oral medications, laser treatments, and surgery, depending on the type and severity of the condition. Early detection through regular eye exams plays a pivotal role in effective management.

Many glaucoma patients can be prescribed medication to help slow the progression of this condition. Eye drops are often prescribed for these patients. However, if your elderly loved one’s condition is more severe, their doctor might need to do procedures to drain their eye. Surgery is the last option for those who can’t be helped with the drainage procedure.  

Prevention: The Best Medicine

Adopting a lifestyle that supports eye health can also play a part in preventing glaucoma. Regular exercise, maintaining a healthy weight, eating a nutrient-rich diet, and avoiding smoking can all contribute to lower eye pressure and reduced risk. And let’s not forget the power of protective eyewear when engaging in activities that could harm the eyes.

Understanding glaucoma in elderly especially its various forms is the first step on the road to protecting your vision. If you suspect you’re experiencing any related symptoms or if glaucoma runs in your family, don’t hesitate to reach out to an eye doctor. For our elders, regular eye check-ups are not just appointments—they’re a crucial line of defense against conditions like glaucoma.

By staying informed, embracing a healthy lifestyle, and prioritizing eye health, we can help safeguard our vision and continue to enjoy the beauty of the world around us, even in our golden years. Remember, in the battle against glaucoma, knowledge is your shield, and action is your sword. Together, let’s protect our sight and the sight of those we love.

If you or an aging loved-one is considering Elderly Care in Villanova, PA please contact the caring staff at Correct Choice Home Care today at (267) 323-1700. 



Joshua Walker, MBA