What is Glaucoma?

But what is glaucoma anyway? Glaucoma is an eye condition that causes damage to the optic nerve due to high pressure in one or both eyes. High pressure like this overtime can lead to irreversible vision loss. You need your optic nerve to see clearly, in fact it’s the very thing that sends signals to your brain that describe what you’re seeing. But, how do you know if you’re developing glaucoma? It can be hard to tell sometimes.

Glaucoma progresses slowly, sometimes without early symptoms, so it can be hard to notice without a comprehensive eye exam. In fact, you can lose up to 40% of your vision without really noticing (Glaucoma Research Foundation). When patients come into the Center for Eye Care, they aren’t always aware of any potential issues, but both our faculty and students are prepared to check for any hidden signs. 

“Treating glaucoma doesn’t have to be a difficult process, nor does it mean you will lose vision,” shares Dr. Emily Humphreys, NECO Associate Professor or Clinical Optometry and Attending Optometrist at Lynn Community Health Center. “With regular eye exams, glaucoma can be easily detectable and treatable. Now that Massachusetts has updated the scope of practice, I have been able to continue treatment and support my patients better throughout their journey.” 

Types of Glaucoma

There are many forms of glaucoma. Open-angle is the most common and won’t typically present with noticeable symptoms. If progressing, a patient may slowly lose their peripheral vision. However, this vision loss isn’t typically detectable by the patient until later, severe stages.  Another form of glaucoma is acute angle-closure glaucoma. It is a rare medical emergency and patients will present with severe symptomatology including severe headaches, eye pain, redness, and halos around lights. NECO Optometrists are familiar with detecting and treating all forms of glaucoma at any stage.

For many of our clinicians, including NECO Associate Professor of Clinical Optometry and Attending Optometrist at South Boston Community Health Center Dr. Amy Sickinger, detecting glaucoma and treating the condition has become a great teaching moment for both patients and students in the clinic. 

“I frequently have student interns who present to me that they have suspicions of glaucoma in a patient,” shares Dr. Sickinger. “It could be elevated intraocular pressure, optic nerve appearance, or presence of pseudoexfoliation material, but whatever symptom they find, it is always impactful when a student detects a new risk factor.” 

“On the other hand, it is equally rewarding when a student can come to the conclusion that a patient may not need treatment and can avoid a life-long diagnosis.” She continues, “I remember a specific student last semester who was so excited to bring their classroom lessons into clinical care when we started treatment for a patient with early glaucoma and the student was able to make a direct impact on a patient.”

Treating Glaucoma in Massachusetts

In NECO’s home state of Massachusetts, Optometrists have only had treating glaucoma under their scope of practice since 2021. As the last state in the nation to update this scope, NECO clinicians at our health centers and clinics have now been treating this condition for several years, despite having been diagnosing it for much longer. Although clinical faculty have only been treating since 2021, NECO’s curriculum has always included detection and treatment of glaucoma for students. 

“Since optometrists in Massachusetts have been able to prescribe glaucoma medication, I have seen an increase in access to greater glaucoma care,” shares Dr. Sickinger. “When I was a NECO student, MA Optometrists could not prescribe these medications despite seeing the same patients in their practice. I was fortunate that the bill passed while I was a resident and today my patients have fewer barriers to receive the care they need. It is also advantageous for students to have a direct role in glaucoma management and treatment during their clinical experiences.”

Indeed, treating glaucoma is based on a series of tests performed during your regular eye exam. Standard tests for glaucoma include a visual field test for peripheral vision loss, optical coherence tomography (OCT) imaging to assess retinal damage, and frequent eye pressure checks. Based on the findings, optometrists will develop a personalized treatment plan that may involve prescription eye drops to regulate eye fluid in order to reduce overall eye pressure.

Risk Factors

“Recently we had a patient whose sister had severe glaucoma,” recalls Dr. Humphreys. “She was very nervous to come for an eye exam given her family history. She was asymptomatic, but knowing about her sister led us to run additional testing. We were able to detect early signs of damage to the optic nerve and initiate treatment to hopefully prevent further damage and noticeable vision loss for the patient.”

Knowing your health history and any additional risk factors is important information to share with your eye doctor. Risk factors that may increase your risk of optic nerve damage include having African, Asian, or Hispanic lineage, being over the age of 60, having family members with glaucoma (especially siblings), a diagnosis of diabetes, or severe nearsightedness. 

Like many conditions, early detection is key in treating glaucoma and preventing any unnecessary vision loss. If you are curious to learn more about treatment options or early detection, make an appointment at the NECO Center for Eye Care.