Glaucoma: The Silent Threat to Vision

A Rutgers Health expert emphasizes the importance of early detection

January is Glaucoma Awareness Month, prompting Rutgers Health experts to underscore the importance of early detection and public awareness.

Often progressing silently without noticeable symptoms, it has earned the reputation as the "silent thief of sight." While its progression may be gradual and silent, it can cause profound damage to the optic nerve. As one of the leading causes of blindness, glaucoma affects more than 3 million people in the United States, according to the Centers for Disease Control and Prevention.

Albert S. Khouri, a professor of ophthalmologyand director of the glaucoma service at Rutgers New Jersey Medical School, discusses what glaucoma is, the importance of early detection, risk factors and how Rutgers Health is advancing treatment.

What is glaucoma and why is it often referred to as the "silent thief of sight?"

Glaucoma is a blinding disease caused by damage to the optic nerve, leading to permanent vision loss. The main risk factor is high eye pressure, measured by a doctor, and it remains the only modifiable risk factor.

Glaucoma is painless, which is why it is described as the "silent thief of sight." Vision damage is typically peripheral at first and often goes unrecognized without an eye exam. By the time patients notice vision problems, significant nerve damage has usually occurred. This is why those with a family history of glaucoma should have routine eye examinations.

The American Academy of Ophthalmology recommends eye exams based on age and risk factors, including Black and Hispanic individuals and those with a family history of glaucoma. Adults over 40 should have exams every one to two years, with more frequent exams for those at higher risk.

Why is Glaucoma Awareness Month important and what should the public know about early detection?

Glaucoma Awareness Month sheds light on a blinding disease that is painless and sneaky. Early detection is the most powerful tool we have to treat glaucoma. Lowering eye pressure curtails nerve damage and helps preserve vision long-term. When diagnosed early, treatment with laser or medication can prevent further vision loss. Like other chronic diseases, such as diabetes or high blood pressure, controlling glaucoma can prevent damage.

Who is most at risk for developing glaucoma and what symptoms should people be on the lookout for?

High risk groups include Black and Latino patients, who have a genetic predisposition for more severe and rapidly progressive glaucoma. Older individuals, particularly those over 60, should have annual eye examinations to detect glaucoma and other vision-threatening diseases such as cataracts, diabetic retinopathy, and age-related macular degeneration. A family history of glaucoma and steroid use for other conditions also increase risk.

Unfortunately, glaucoma is typically painless and does not cause blurry or cloudy vision in its early stages, making it detectable only through an eye examination. This is why public awareness is so important.

What steps can people take to protect their vision and lower their risk of glaucoma?

Knowing one's risk of glaucoma is important. Risk factors include race, age and family history. Any family history of glaucoma warrants an eye exam. Elevated eye pressure requires follow-up with a physician to determine treatment needs. A comprehensive eye examination, including eye pressure measurement, nerve imaging, and peripheral visual testing, is essential for diagnosis.

Once diagnosed, early treatment and routine follow-ups help preserve vision. Additionally, maintaining a healthy lifestyle with exercise and a balanced diet supports general and ocular health.

How does Rutgers Health support communities in New Jersey that are disproportionately affected by glaucoma?

Rutgers Health offers many resources to support communities disproportionately affected by glaucoma. At New Jersey Medical School, the Institute of Ophthalmology and Visual Science in Newark provides state-of-the-art glaucoma care at University Hospital. Resources include a multidisciplinary approach and sophisticated diagnostics for early detection and follow-up. Advanced treatments, including laser and modern micro-incisional surgery, are available.

Rutgers also offers community outreach programs that provide glaucoma and vision screening across the state, particularly in higher-risk communities.

What advancements in glaucoma diagnosis, treatment and research are happening at Rutgers Health?

The Institute of Ophthalmology and Visual Science and full-time Rutgers faculty are dedicated to advancing glaucoma diagnosis and treatment. Recent efforts include clinical trials for medications targeting the trabecular meshwork, the diseased tissue in glaucoma. Other studies focus on implants that slowly release medication.

The telemedicine laboratory at Rutgers New Jersey Medical School has also published studies on modern diagnostic techniques, including digital imaging protocols and artificial intelligence tools for early detection.