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Glaucoma News Archive (2011)

...continued from Current Glaucoma News

Glaucoma Causes Higher Risk of Falls Among Older Adults

BRISBANE, Queensland, Australia, November 2011 — Glaucoma can affect a person's downward field of view, and this seems to be causing a higher risk of falls resulting in injury among older people with the eye disease.

During a year-long study of 71 glaucoma patients with an average age of 74, about 44 percent fell at least once, with 31 percent of the falls resulting in injury. (Fortunately, none of the injuries were severe.)

Those with less visual function were more likely to fall, and those with extensive visual loss toward the feet (called inferior visual field loss) had a 57 percent higher risk of falls overall and an 80 percent higher risk of falls with injury.

The researchers concluded that doctors could identify these high-risk groups with an inferior visual field loss assessment and then help them take fall-prevention measures.

A report of the study appeared in the November issue of Optometry and Vision Science.

Cocaine and Other Illegal Drug Use Linked to
Open-Angle Glaucoma

INDIANAPOLIS, October 2011 — Researchers have found that cocaine use is predictive of open-angle glaucoma (OAG), and cocaine users have a 45 percent increased risk for the eye disease.

The study was of 5.3 million veterans, 91 percent of whom were male, who used outpatient clinics of the Department of Veterans Affairs during fiscal year 2009. About 83,000 (1.5 percent) had glaucoma, and about 178,000 (3.3 percent) had a diagnosis of cocaine abuse or dependency.

The men with OAG showed significant exposure to amphetamines and marijuana as well.

The glaucoma patients with a history of illegal drug use averaged 54 years of age, vs. 73 years for those patients without drug exposure.

The researchers did not discover a reason for the increased risk of glaucoma among the drug users and said the issue requires more investigation. A report of the study appeared in the September issue of Journal of Glaucoma.

Diabetes and Hypertension Increase Glaucoma Risk

ANN ARBOR, Mich., August 2011 — People with diabetes and/or hypertension are more likely to develop open-angle glaucoma (OAG) as well.

This finding is from a University of Michigan Kellogg Eye Center study of billing records of more than 2 million people 40 and older who were enrolled in a managed care network and who visited an eye care professional at least once from 2001 to 2007.

The diabetics in the group had a 35 percent increased risk for OAG, while those with hypertension alone had a 17 percent increased risk. The increased risk was 48 percent for people with both diabetes and hypertension.

The study was funded by the National Eye Institute, and the report appeared online in July in the journal Ophthalmology.

Study Reveals Possible Cause of Greater Glaucoma
Risk Among African-Americans

ST. LOUIS, August 2011 — Measuring oxygen inside the eye during surgery for cataracts or glaucoma or both, researchers found that oxygen levels are significantly higher in the eyes of African-Americans with glaucoma than in Caucasians with the disease.

The Washington University School of Medicine researchers suspect that more oxygen may cause oxidative stress that damages the fluid drainage system in the eye, resulting in high eye pressure that can harm the optic nerve and cause blindness.

The study provides the first physiologic link between race and risk for glaucoma. Glaucoma is the leading cause of blindness among African-Americans — the disease is about six times more common in African-Americans than among Caucasians, and blindness caused by glaucoma is roughly 16 times more likely in African-Americans.

The study authors said the next step is to extend their studies of patients and to explore the effects of elevated oxygen levels in animal models of glaucoma. "When we understand the underlying reason for elevated oxygen and how it may damage the eye, we will be in a better position to develop ways to prevent this disease," said lead investigator Carla J. Siegfried, MD.

The study findings appear in the July issue of Archives of Ophthalmology.

Is It a Good Idea To Measure Your Own Eye Pressure?

July 2011 — We've all experienced it: the dreaded "puff test" that eye doctors use to measure eye pressure and help detect glaucoma. But this isn't the only kind of tonometer. Others can measure intraocular pressure (IOP) through a closed eyelid.

Using the Icare One personal tonometer to measure eye pressure. (Image: Icare Finland)

It is this kind of tonometer that faculty at the New Jersey Institute of Technology (NJIT) and University of Medicine and Dentistry of New Jersey (UMDNJ) have developed and patented. They've also signed a license agreement for it with The Incubation Factory, based in St. Louis, with the aim of bringing a device to market soon.

The new device will be a personal tonometer, which glaucoma patients will be able to use at home. Since people who are at risk for glaucoma tend to have eye pressure that fluctuates throughout the day, it's difficult to get a good overall picture of their eye pressure situation with just one periodic reading at the eye doctor's office.

The NJIT/UMDNJ device will let glaucoma patients check their eye pressure and report it to their eye doctor in real time over the Internet. This will help their eye doctor prescribe appropriate glaucoma medication dosages to keep the eye pressure from spiking. It is those spikes that cause the most damage to the optic nerve, which in turn causes peripheral vision loss.

In studies conducted by Sanjay Asrani, MD, at Duke University, patients used a personal tonometer called Icare One to test their own eye pressure. Caregivers of children with glaucoma were also evaluated. The idea was to see if inexperienced users could determine IOP as accurately as trained technicians. Dr. Asrani's conclusion was that the test was easy to learn, accurate and reliable.

The device, manufactured by Icare Finland, uses a rebound method of measurement that requires the eye to be open. But the company describes it as a gentle probe that is barely noticeable, adding that no anesthetic drops are necessary. The Icare tonometer is already used in U.S. doctors' offices, but the at-home version, Icare One, is awaiting FDA approval.

Study Finds Glaucoma Risk Rates for Various Racial Groups in the U.S.

ANN ARBOR, Mich., May 2011 — In the eye care community it's no surprise that in the United States, African Americans have the highest risk for glaucoma. But the risk for Asian Americans was not well quantified until a recent review of insurance records, conducted by researchers at Kellogg Eye Center, University of Michigan.

The records were of 2,259,061 eye care recipients aged 40 and over who were enrolled in a managed care network in 2001-2007. Among the findings:

U.S. Latinos and Asian Americans have roughly the same risk for open-angle glaucoma (OAG), with both having a little more than half the risk of African Americans.

Asian Americans have the highest risk for narrow-angle glaucoma (NAG), with U.S. Latinos coming in second.

Normal-tension glaucoma rates are fairly low for all groups, but Asian Americans have the highest risk, at 0.73 percent, twice the prevalence for white Americans. In normal-tension glaucoma, the optic nerve and vision are damaged even though the eye pressure registers as normal.

The study also looked at glaucoma prevalence among Asian American subgroups. Notably, those of Japanese origin had a 9.49 percent prevalence of OAG, with Indian and Pakistani Americans at 7.78 and 7.70 percent. For NAG, Vietnamese and Chinese Americans had the highest prevalence (4.08 and 3.74 percent). For NTG, Japanese Americans had the most risk, at 1.99 percent.

The study authors noted that previous studies had found lower prevalence of glaucoma rates among Asians, but offered possible explanations, including the fact that this study reviewed records of multiple eye exams (rather than just one exam) for many of the eye care recipients. The more eye exams a person has, the more likely it is that his or her glaucoma will be detected.

A report of the study, which was funded by the National Eye Institute, was published in the journal Ophthalmology in February.

Study Says Many Have Trouble Using Glaucoma Eye Drops

BALTIMORE, Md., January 2011 — Glaucoma patients who have lost some or most of their sight aren't using their glaucoma medication eye drops properly, leading to a waste of costly eye drops and possible bottle contamination.

In a study of 204 glaucoma patients, all of whom were visually impaired and had already used eye drops for more than six months, the participants were videotaped while trying to administer a single drop onto their worst-seeing eye. They also completed a survey about their use of the eye drops.

Only 71 percent were able to get a drop into the eye, and only 39 percent did so without touching the bottle to the surface of the eye. Of the 142 people who said they didn't touch their eye with the bottle, 24 percent actually did, according to the videotape.

Some were getting multiple drops in the eye, instead of the one drop they were instructed to instill. Also, people over 70 had more trouble than the younger study participants.

The researchers concluded that the study showed problems with eye drop waste, potential contamination of the eye drop bottles and poor understanding of the situation among the participants.

They recommended that thought be given to the ability of a person to self-administer eye drops and the cost of wasted drops before glaucoma eye drops are prescribed. They also recommended that better ways of instilling eye drops be found.

A report of the study appeared in the December 2010 issue of the journal Ophthalmology.

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[Page updated May 2013]