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Glaucoma can strike at any age

Karen Miller | 1/28/2014, 6 a.m.
Glaucoma often runs in families and, although it is more common in older people, it can strike at any age.
(From left to right): Demetri Flaherty, grandmother, Nancy Beckford, mother, Shelley Flaherty and twin brother, Chance Flaherty. Demetri, Nancy and Chance have been diagnosed with glaucoma, which tends to run in families. Photo by Ernesto Arroyo

Glaucoma is not one disease. Rather, it is a family of several different types. Congenital glaucoma is rare and develops in infants and young children. Secondary glaucoma results from another cause, such as an eye injury or long-term use of corticosteroids.

In low tension glaucoma, which affects up to one third of people with the disease, eye pressure remains within the average range, but still results in optic nerve damage.

A more severe form is acute closed-angle glaucoma. It results from a sudden and complete blockage causing severe eye pain, blurred vision, headaches and nausea. This form of glaucoma is a medical emergency and requires immediate treatment.

The most common form of glaucoma — primary open-angle glaucoma — is frequently referred to as the silent thief of sight. In Demetri’s case, even the doctor was surprised. “The doctor didn’t want to believe it,” Demetri said. “You’re too young.” A second opinion, however, confirmed the initial diagnosis.

Demetri’s reaction was one of disbelief as well. “I was surprised,” he said. “I didn’t know it existed.”

Demetri had a long haul ahead of him. The eye drops he was prescribed worked — but not well enough. He said that his pressure dropped but not to the levels that doctors were hoping. A few years ago he had laser surgery to open up the drainage in his right eye.

Video

The correct technique for putting in eye drops

Dr. A. Sydney Williams demonstrates how to instill medication eye drops for treating glaucoma.

Dr. A. Sydney Williams demonstrates how to instill medication eye drops for treating glaucoma.

He admitted it took some doing to master the eye drops. “You have to be careful that the nozzle does not touch the eye,” he explained. And you have to tilt your head back just right. Air bubbles, he said, can be deceiving. They feel wet, but contain air instead of medicine.

Demetri perfected his technique by practicing with his grandmother. She also has glaucoma and was caught by surprise as well. Nancy Beckford, 56, was playing around with a friend some years back. They were singing along with the Hall and Oates song “Private Eyes.” As she sang “we’re watching you,” Beckford playfully closed her left eye to simulate a watchful eye.

“It was blurry around the edges of my vision,” she said, describing impaired peripheral vision. “It wasn’t clear.” An eye exam confirmed the diagnosis.

Though it is not possible to prevent glaucoma, the disease can be detected early before it causes serious damage. A comprehensive eye exam does the trick. The American Academy of Ophthalmology recommends that at age 40 adults with no signs or risk factors for eye disease should have a comprehensive baseline screening. But Rhee is quick to point out that people of high risk — especially blacks and those with a family history — should start earlier. Intervals for follow-up examinations will be based on the findings. Usually exams are recommended every one or two years.

Timing is the key. Vision lost from glaucoma cannot be regained.

Demetri has not escaped the disease unscathed. He has lost some peripheral as well as central vision in his right eye, but his left eye compensates. He lapsed a bit on taking his medications but is back on track now.

According to Demetri, his condition hasn’t slowed him down. Nor has it forced him to change his study of interest. Despite his impaired vision, he’s a junior at Massachusetts College of Arts and Design with an interest in industrial design.

“You get used to it,” he said.