Glaucoma – the “Sneak Thief of Sight”

Currently, there are more than 3 million people in the United States and over 60 million worldwide living with glaucoma, otherwise known as “the sneak thief of sight”.  It is estimated that half of those with glaucoma, do not know they have it.  The disease presents no symptoms and is the leading cause of irreversible blindness, taking as much as 40% of sight without notice.  January has been deemed National Glaucoma Awareness Month and is an important time to spread the world about this sight-stealing disease.

What is Glaucoma?

Glaucoma is a group of eye diseases that gradually progress, stealing sight, without symptom. Glaucoma can affect people of all ages but is most prevalent in middle-aged adults and the elderly.  While there is no cure, surgery or medication can slow its affects and help to prevent further vision loss.  The word ‘glaucoma’ is actually an umbrella term for a group of eye diseases that damage the delicate fibers that run from your eye to your optic nerve, which is the nerve that carries information about the images your eye sees to your brain. This damage is often the result of high fluid pressure inside the eye.

What can you do?

It is important to know your risks, those at higher risk include people of African, Asian, and Hispanic descent. Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.  Annual comprehensive eye exams are important to detect, prevent and treat the effects of the disease.

optomap’s role in the management of glaucoma

Results from recently published clinical studies suggest that optomap ultra-widefield (UWF™) retinal imaging may play an essential role in glaucoma management.  optomap enables eyecare professionals to discover, diagnose, document and treat ocular pathology that may first present in the periphery.  optomap is a high resolution single capture image of 82% or 200 degrees of the retina.  Currently, the gold standard tool for glaucoma detection is a clinical examination with a dilated slit-lamp bio-microscopy carried out by a glaucoma specialist to assess the optic disc.  Recent studies suggest that UWF imaging may be suitable for diagnosing glaucoma in situations where slit-lamp bio-microscopy or digital color stereoscopy are not available.  Another study also confirms that optomap has almost perfect agreement with color digital stereoscopy when assessed
by a glaucoma specialist. Continued reading on these studies and additional findings here

stereo pair of optic nerve head images with can be viewed using a stereo viewer, when there is suspicion of glaucoma

optomap is continuing to become a key player in the role of eye care professionals.  optomap provides details needed for specialty exams, while simultaneously delivering an integrated view to the eye, as said by Dr. Savak Tymoorian, MD of Harvard Eye Associates. When Dr. Tymoorian first began using Optos technology, he employed it primary for patients presenting with flashers or floaters.  While reviewing the images, he was able to pick up on more peripheral issues and early indicators of pathology.  “The more I use the device, the more I appreciate this dynamic technology, I now image all my patients this way”, states Tymoorian.   As a glaucoma specialist, Dr Tymoorian finds that optomap helps reassure him that he is not missing peripheral issues that could be relevant to the disease.

Recognizing January as National Glaucoma Awareness Month, allows us to shed light on glaucoma and stress the importance of protecting your sight and preventing the onset of the disease.  The best way to protect your sight from glaucoma is to get a comprehensive eye examination. This way, if you have glaucoma, treatment can begin immediately.

optomap UWF imaging captures more than 80% of the retina in a single image, whereas traditional imaging methods can sometimes only reveal 10 – 15%.  optomap is a fast and easy addition to a standard comprehensive eye exam.  Don’t hesitate, and ask your eye care professional about optomap today.

optomap Enables Detection, Diagnosis, and Guides Treatment in Age-Related Ocular Pathology

September is Healthy Aging month, however despite age related changes to vision, ocular health is often overlooked.  As the aging population grows, adding the first influx of generation X to the baby boomers in the over 50 demographics, the incidences of glaucoma and Age-related Macular Degeneration (AMD) are also on the rise.

Recent studies have demonstrated how optomap ultra-widefield™ (UWF) retinal imaging is fulfilling a need in supporting the detection and management of both ocular and systemic diseases associated with aging. UWF imaging provides a high resolution, single-capture image of 82% (or 200 degrees) of the retina.  Studies have confirmed that the resolution of the optomap image – is comparable to fundus photography – which captures 11% of the retina, in detection of diseases such as diabetic retinopathy, AMD and uveitis.  Additionally, studies have found that the additional area captured by optomap can enhance the ability to detect, diagnose and manage diseases in comparison to fundus photography and be captured more efficiently.  UWF is being increasingly used in optometric and ophthalmic settings and enables eye care professionals to detect, diagnose, document and treat ocular pathology including retinal disease that may first present in the periphery.

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over age 50. The Centers for Disease Control and Prevention estimate that by the year 2020, 196 million people worldwide will be living with some form of AMD.

Although there have been many discoveries in the understanding of the causes of AMD, including links to genetics, there remains much unknown about this complicated, degenerative disease. Over time the retinal periphery has been able to be more easily studied in early AMD to determine the value in the detection and/or monitoring of the disease.  However, with the advent of multi-modality UWF imaging, novel studies are beginning to demonstrate this value. Color optomap imaging captures the structure and fundus autofluorescence (FAF) the function of the Retinal Pigment Epithelium (RPE) which is where AMD manifests within the eye. Studies have revealed that 97% of patients with AMD have evidence of the disease in the far periphery.

This outcome demonstrated that drusen were seen in a majority of eyes, strongly indicating that AMD is more than a macular condition but one that involves the entire retina. This is being investigated in a further study that will determine whether these peripheral changes are associated with the progression of the disease.   Read the Full Article

Glaucoma is another primary cause of blindness worldwide, affecting an estimated 70 million people. While early detection is key to taking steps to prevent vision loss, glaucomatous vision impairment is irreversible.  Unfortunately, glaucoma can be asymptomatic until the late stages, at which time the prognosis is poor.

The gold standard for detection and diagnosis of glaucoma is a clinical examination with dilated slit lamp biomicroscopy conducted by a glaucoma specialist.  However, this level of expertise is not always feasible or readily available to broadly evaluate an aging population. Exam efficiency has been increasingly addressed via use of color digital stereoscopic photography and/or retinal tomography via SD-OCT.

A recent  study explored the potential suitability of ultra-widefield retinal imaging in diagnosing glaucoma in situations where slit-lamp biomicroscopy or digital color stereoscopy are not available. The purpose of the study was to evaluate the reproducibility and validity of UWF in estimating Vertical Cup to Disc Ratio (VCDR) measurements and was the first study of its kind to explore whether optomap imaging could be suitable as a diagnostic support tool for glaucoma.

The study evaluated the data from color digital stereoscopic fundus images (CDS) and UWF images.  All the photographs and images were graded by two masked trained graders and one masked glaucoma specialist. The optomap images were graded using the ‘measure distance’ tool on the OptosAdvancesoftware, to measure and record cup to disc ratio (CDR).

The study demonstrated an almost perfect agreement between CDS and optomap when assessed by the glaucoma specialist.   The study concludes that optomap imaging has a high reproducibility in evaluating VCDR and agreement with stereoscopic optic disc imaging and indicates that UWF imaging may be suitable for glaucoma evaluation in settings where CDS is not available. Read the Full Article here….
Or visit our website to learn more about clinical studies utilizing optomap technology

https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/macular-degeneration
http://www.allaboutvision.com/conditions/amd.htm
https://nei.nih.gov/health/maculardegen/armd_facts
https://www.aaojournal.org/article/S0161-6420(16)31491-9/abstract
http://www.aaojournal.org/article/S0161-6420(16)31491-9/fulltext

Assisting Glaucoma Patients Living with Low Vision

Caused by excess fluid in the eye, glaucoma results in increased pressure in the eye that may eventually damage the optic nerve, according to The Glaucoma Foundation. Unfortunately, by the time vision loss is noticeable, it is also permanent. A regular comprehensive eye exam incorporating optomap®, which can help with early disease detection, is critical to prevent vision loss. For patients living with glaucoma and low vision, there is help. A low vision specialist can help you redesign your life so you can be safely independent.

 

Source: Pixabay

Source: Pixabay

 

Although there are many forms of glaucoma, the following four, according to The Glaucoma Foundation, are some of the most common:

 

1. Primary Open-Angle: Generally found in patients over 50, this is the most common form of glaucoma in the U.S. This form is characterized by blind spots that form first in the peripheral vision.

 

2. Normal Tension: Without the detection of higher-than-usual pressure in the eye, this form is thought to be caused by poor circulation of blood to the optic nerve. Vision damage can occur anywhere in the visual field.

 

3. Angle-Closure: Affecting nearly half a million Americans, this form of glaucoma affects those of Asian descent and far-sighted people the most. It is believed to be hereditary and may affect several family members.

 

4. Acute: Acute glaucoma occurs when the pressure in the eye builds rapidly. This form can be very painful in just a few hours and cause patients to see rings around lights and experience blurry vision.

 

According to the Glaucoma Research Foundation, regardless of the form it takes, living with glaucoma and low vision can be made easier with assistance from a low-vision specialist. Vision loss can be devastating, but often with glaucoma you have more vision than you may think. A specialist will perform an evaluation with you to determine how much vision you have and what your daily life entails.

 

By changing your living environment and how you accomplish some things, you can maintain your independence in a safe manner. Some simple, effective tips may include the use of an electronic magnifying device, bending the tip of your finger over the rim of a cup or glass to know when to stop filling, and reading books in large print.

 

Optos would like to impress upon you the importance of a regular, comprehensive eye exam using optomap to assist in the earlier detection of eye disease such as glaucoma.