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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.

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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.

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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.

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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.

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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.

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.

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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.

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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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If You Have Glaucoma, You're More Likely To Have
Other Serious Illnesses as Well

TAIPEI, Taiwan, December 2010 — Researchers have found that people with glaucoma are more likely to have additional serious health problems.

The conclusion is based on a nationwide study in Taiwan that compared the medical records of 76,673 people with open-angle glaucoma (OAG) with the records of 230,019 people without OAG, matched for age, gender and other factors.

More than half of the people with glaucoma had high blood pressure, and more than 30 percent had either diabetes or high levels of unhealthy fats in the blood. Overall, the glaucoma patients had at least a 3 percent higher prevalence of these diseases, plus stroke, liver disease and ulcer.

Glaucoma's exact cause is still unknown, but some scientists think it results from abnormalities in the blood vessels and circulation that nourish not only the rest of the body, but also the optic nerve, eyes and brain. These abnormalities can also be linked to the other diseases found in the glaucoma patients.

An estimated 50 percent of glaucoma cases go undiagnosed, so it is important to have regular eye exams, to catch the disease early on.

The full text of the study report is available on the American Academy of Ophthalmology website.

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New Lumigan Formula FDA-Approved for Eye Pressure Control

IRVINE, Calif., September 2010 — Lumigan 0.01% (Allergan) received FDA approval as a first-line therapy to reduce high eye pressure (IOP) in people with open-angle glaucoma or ocular hypertension.

Compared with the existing Lumigan 0.03% formula, Lumigan 0.01% is an optimized reformulation that, in a three-month patient study, lowered IOP up to 7mm Hg from baseline, with only one-third the exposure to the active drug bimatoprost.

Often a lower drug exposure results in fewer complications from the drug, though Allergan's press release did not mention such reductions for the new formula. Side effects of bimatoprost include conjunctival hyperemia (excessive blood in the vessels of the eyelids' inner lining), eyelash growth and increased pigmentation of the iris, eyelid and eyelashes.

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Head-Up Sleeping Position May Keep Intraocular Pressure
From Spiking at Night

TORONTO, July 2010 — If you have high eye pressure (IOP), you may want to consider sleeping with an extra pillow under your head.

In a small study of 17 glaucoma patients with controlled IOP and new disc hemorrhage, University of Toronto researchers compared their IOP at regular intervals while asleep and lying flat and while asleep and lying in a 30-degree head-up position.

The researchers measured an IOP reduction in the 30-degree head-up position of 20 percent or more in 35 percent of the subjects, with 16 of the 17 patients having lower IOP in this position than in the lying-flat position.

The study results appeared in Ophthalmology in July.

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Glaucoma-Monitoring Contact Lens Available in Europe

LAUSANNE, Switzerland, May 2010 — With sensors that measure changes in eye curvature, a new contact lens called the Triggerfish, by Swiss company Sensimed, can help eye doctors monitor high eye pressure in their glaucoma patients.

This could help control vision loss associated with the disease.

Eye pressure can change throughout the day and night, and eye pressure spikes can be very harmful to the eye's optic nerve, leading to vision loss.

Normally an eye doctor would take intraocular pressure measurements during a daytime appointment. Pressure tends to be at its lowest then, so the overall picture of the patient's condition is incomplete and doesn't reflect the pressure spikes that may be occurring at other times of the day or night.

The lens contains a chip that transmits the gauge's readings wirelessly to an external receiver that is worn around the patient's neck.

In the future the device may be able to monitor high-risk people who do not yet have glaucoma, catching the disease in the early stages so treatment can begin promptly, to minimize vision loss. Currently the device is available only in Europe.

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Green Tea's Antioxidants Found To Penetrate Eye Tissues, Perhaps Protecting Against Glaucoma

KOWLOON, Hong Kong, May 2010 — A new report documents how the eye's natural lens, retina and other eye tissues absorb antioxidants called catechins (crystalline yellow substances also used in dyes), which are found in green tea.

Such antioxidants are thought to help protect the eye against glaucoma and other eye diseases.

Before now it was unclear whether catechins in green tea really did make their way from the digestive system into eye tissues. In a study, laboratory rats drank green tea and were found to have significant amounts of individual catechins in their eyes. For example, the retina absorbed the highest amounts of gallocatechin, one type of catechin.

The researchers said the oxidative stress reduction that resulted from the antioxidant absorption lasted for up to 20 hours.

The study report appeared in the American Chemical Society's Journal of Agricultural and Food Chemistry in April.

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Trabeculectomy Procedures Falling;
Other Glaucoma Treatments on the Rise

NAPLES, Fla., April 2010 — Medicare data has revealed a decrease in the number of trabeculectomy surgeries in the United States to treat glaucoma, but an increase in other types of glaucoma surgery.

Selective laser trabeculoplasty, endocyclophotocoagulation and use of aqueous drainage devices such as shunts are becoming more common, however.

All the aforementioned methods are designed to lower high eye pressure that damages the optic nerve and causes vision loss.

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Contact Lenses Containing Vitamin E May Increase
Effectiveness of Glaucoma Medications

SAN FRANCISCO, April 2010 — Usually the first treatment choice for people with glaucoma is eye pressure-lowering eye drops. But glaucoma eye drops do have drawbacks.

"The problem is, within about two to five minutes of putting drops in the eye, tears carry the drug away, and it doesn't reach the targeted tissue," said Anuj Chauhan, PhD, of the University of Florida in Gainesville, in a press release. "Much of the medicine gets absorbed into the bloodstream, which carries it throughout the body where it could cause side effects. Only about one to five percent of drugs in eye drops actually reaches the cornea of the eye."

To address this problem, Dr. Chauhan and his colleagues incorporated vitamin E into medicated contact lenses that glaucoma patients would wear. The large vitamin E molecule clusters form a barrier designed to keep the much smaller glaucoma medication molecules in contact with the eye for a longer period of time.

The researchers are testing this method in animals and have found that the vitamin E lenses keep the glaucoma drugs in place up to 100 times longer than most commercial contact lenses. Dr. Chauhan added that the lenses could be designed for continuous wear for up to a month and that vitamin E's antioxidant properties could benefit the eye in other ways. He also commented that the vitamin E molecules would block UV radiation, offering more protection against the sun's harmful rays.

Dr. Chauhan presented the research at the American Chemical Society's annual meeting in March, where he said that clinical trials studying the concept may begin in a year or two.

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Possible Link Between Glaucoma Medication and Lower Death Risk

ANN ARBOR, Mich., March 2010 — A new study suggests that glaucoma medications may be associated with a reduced mortality risk.

Researchers from the University of Michigan examined 21,506 individuals over age 40, with an average age of 60 years. More than half of the participants had suspected glaucoma, and the rest had one or more types of glaucoma. All participants were enrolled in a managed care network.

Participants were surveyed over a four-year period, from January 2003 to December 2007. About 28 percent took one or more glaucoma medications, and about 9 percent had glaucoma surgery. By the end of the study, 237 participants or about 1 percent had died.

The researchers found that those using any type of glaucoma medication had a 74 percent reduced risk of death. Demographic characteristics and other medical conditions associated with mortality were taken into account.

According to the researchers, further studies are needed to determine the protective effect of glaucoma medications and other factors, such as access to care and providers' prescribing patterns.

The study was reported in the February issue of Archives of Ophthalmology.

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Higher Risk of Glaucoma for Diabetics

SAN FRANCISCO, February 2010 — The American Academy of Ophthalmology is reminding Americans that diabetics are at higher risk than others for glaucoma and need to have their eyes examined to prevent the vision loss that results from the disease when untreated.

About 3 million Americans have glaucoma, but only about half know that they do, because at first the symptoms are unnoticeable or even non-existent.

Neovascular glaucoma is a variation that appears most often in diabetics. It can be treated with drainage implants, lasers and VEFG inhibitor medications, but treatment is most effective when it begins early.

The Academy will commit $1 to its diabetic eye health education efforts for each person who pledges to have an annual diabetic eye exam. All you have to do is visit the EyeSmart EyeCommitted website and take the pledge.

Please click here for more glaucoma news from 2009.

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[Page updated November 28, 2011]