The Diseases That Affect Mostly Aged People, Essay Example

This paper examines one of the diseases that affect mostly aged people – glaucoma which is one of the three main causes of acquired blindness in the Western world. Glaucoma is associated with elevated intraocular pressure, optic disk cupping and atrophy, and loss of vision. Intraocular pressure is a function of aqueous humor drainage from the eye. Aqueous humor formed by the ciliary body slightly behind and lateral to the lens flows between the iris and lens, through the pupil into the anterior chamber and drains out via the trabecular network and canal of Schlemm into the extraocular veins at the rate of 2 to3 ?l/min. If intraocular pressure rises above 22 mmHg, there is a serious risk of developing glaucoma. In case proper treatment is not received, glaucoma results in permanent damage of the optic nerve and resultant visual field loss potentially progressing to blindness. Glaucoma has been dubbed the “sneak thief of sight” as the loss of visual field usually occurs gradually over a long period and can only be recognized at the advanced stage. The lost visual field can never be recovered.

Alternative classifications of glaucoma include primary versus secondary glaucoma and open-angle versus closed-angle glaucoma. While primary glaucomas develop without primary ocular or systematic disease, secondary glaucomas are usually the result of ocular inflammation, trauma, diabetic neovascular formation, corticosteroids, and sometimes tumors. People suffering from secondary glaucoma are often already ophthalmology patients by the time they develop it and present less problems in diagnostics than patients with primary glaucoma.

Primary glaucomas are subdivided into open-angle and closed-angle types depending on the angle that the iris assumes in relation to the cornea and trabecular network. Primary open-angle glaucoma is mostly a hereditary disease which develops due to degenerative changes in the trabecular network that reduce the flow of aqueous humor from the eye. Closed-angle glaucomas are quite rare but surgically curable.

The risk group is quite extensive as glaucoma affects one in two hundred people aged fifty and younger, and one in ten over the age of eighty. There is a danger of developing glaucoma for people with a family history of the disease, for myopic patients, people using ocular or systematic corticosteroids, and diabetics. African Americans have been proved by many studies to be at greater risk of developing glaucoma than other races (in fact, they are three times more likely to develop glaucoma). Some Asian groups including Mongolian, Chinese, Japanese, and Vietnamese are susceptible to angle closure glaucoma due to their shallower anterior chamber depth. An ocular trauma increases the risk of glaucoma.

Unfortunately, the risk of developing glaucoma is quite high for me as my grandmother suffers from it. It means my mother and I have a 6% chance of having glaucoma in older age. Moreover, I often have high blood pressure which is associated with glaucoma, although it has not been proved that it causes the disease directly.

The symptoms that should warn a person about possible glaucoma include eye pain, red eye, corneal cloudiness, loss of vision, headaches and sensitivity to pressure. However, glaucoma can be asymptomatic at the early stages, which means that people in the risk group have to undergo regular eye checks to diagnose the disease. The eye checks should include an obligatory contrast sensitivity test. Another method of diagnosing the disease is tonometry – the indirect estimation of intraocular pressure by measuring resistance of the eye to indentation by an applied force. Ophthalmologists also should estimate changes in size or shape of the eye, examine anterior chamber angle (perform gonioscopy) and check the optic nerve for the signs of visible damage to it. Change in the cup-to-disc ratio and rim appearance should be identified as well as vascular change.

In fact, regular screening is the main prevention measure for people with high risk of developing glaucoma and early diagnosis allows effective treatment to stop the disease. Other recommendations include avoiding ocular trauma by wearing protective devices like goggles when working or going in for sports (this is a life-long recommendation which is to be followed irrespective of the age).

The study of 2004 conducted by the team headed by Paul Weber, the chairperson of The Ohio State University Medical Center’s Department of Ophthalmology, showed that a regular application of eye drops that reduce intraocular pressure make the chances of developing primary open-angle glaucoma in African Americans, the high-risk group, 50% lower. Paul Weber emphasized the importance for African Americans especially to have regular eye checks as they turn 40. If increased intraocular pressure is discovered, it does not necessarily mean that glaucoma is near. While it certainly shows high risk of it, individual eyes vary considerably in their ability to tolerate elevated intraocular pressure. Consequently, increased intraocular pressure is not the only reason of prescribing daily eye drops. Other factors like the extent of eye damage and the patient’s general health should be considered.

In conclusion, it is should be said that people over 40 should undergo regular screening for glaucoma as the disease has no symptoms at the early stage, but the loss of visual fields is irrevocable. Special attention to the prevention of the disease should be paid by people who fall into the high-risk group described above.

References

Alguire, P.C., Tonometry. Clinical Methods. The History, Physical, and Laboratory Examinations. Retrieved March 19, 2009, from http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&partid=222#A3607

Osborne, N.N., et al. Ganglion Cell Death in Glaucoma: What Do We Really Know? British Journal of Ophthalmology. Retrieved March 19, 2009, from http://bjo.bmj.com/cgi/content/full/83/8/980

Science Daily. Daily Eye Drops Hold Key To Glaucoma Prevention. Retrieved March 19, 2009, from http://www.sciencedaily.com/releases/2004/06/040617080658.htm