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ALENA REZNIK, MD Assistant Professor of Clinical Ophthalmology USC Eye Institute Q: What is glaucoma? Glaucoma is a disease that affects the optic nerve that goes from the eye to the brain. It af- fects peripheral vision fi rst followed by central vision. If diagnosed in the late stages, vision loss will be permanent. Q: Who is affected by glaucoma? Two percent of the general population is affected by glaucoma and half of those people are undiagnosed. You are at a higher risk if you have a family history of glaucoma, have had ocular trauma, infl ammation of the eye or previous eye surgeries. Q: Who can diagnose glaucoma? An optometrist or ophthalmologist can evalu- ate for glaucoma during a routine eye exam using eye pressure measurements, visual fi eld test (a computerized test that measures your peripheral vision) and by looking at the optic nerve. If surgery is needed or diagnosis of glau- coma is in question, you might be referred to a glaucoma specialist, who is an ophthalmologist with additional training specifi c to glaucoma and glaucoma surgery. Q: What are the fi rst signs of glaucoma? Glaucoma is often called the sneak thief of sight because in most cases there are no early symptoms or signs: no pain, blurred vision or eye redness. The vision is lost slowly over sev- eral years or decades, starting with peripheral vision. If glaucoma is diagnosed after vision is lost, there are no current treatments available to restore the sight. Our goal is to diagnose and treat glaucoma at the early stages prior to vision loss. At USC Eye Institute, we have state-of- the-art equipment to help diagnose optic nerve disorder/glaucoma in its infancy. Q: I have heard there are different types of glaucoma. What is the most common one? The most common is open-angle glaucoma. It is more prevalent in mature people, ages 60 and above. The intraocular pressure in the eye is elevated and the draining channels are open though not functioning properly. Another form of open-angle glaucoma is low-tension or normal-tension glaucoma. It is a highly aggressive and progressive form that is not characterized by elevated intraocular pressure and often affects younger people above age 40 and of Asian descent. Another category is closed-angle glaucoma, which occurs when outfl ow channels of the eye are closed by the iris (colored portion of the eye). Usually people are predisposed to closed angles by the anatomy of the eye. It can be treated by an ophthalmologist in the offi ce prior to any damage occurring. Q: My eye doctor told me that I am a glau- coma suspect. What does that mean? A glaucoma suspect refers to a patient with pre-glaucoma; you might have glaucoma but it's too early to tell. Perhaps your eye pressure was elevated during the eye exam visit, or you have family history of glaucoma and your optic nerve looks different than the general population. You don't have glaucoma yet, however, I ask my patients to come back every six months to check that there is no progression to glaucoma and no treatment needs to be initiated. Q: Is the treatment the same for all glau- coma patients? No, treatment depends on the kind of glau- coma, stage of the disease (early or late) and the patient's lifestyle. As a glaucoma specialist, I may offer eye drops or laser treatment to lower intraocular pressure as a fi rst step. If the disease isn't responding well to the fi rst step or is more advanced, I may recommend surgery. I make sure to discuss all the available options with my patients. Q: Would you recommend a second opinion before agreeing to laser treatment or surgery? Absolutely. If you have any doubts it is benefi - cial to obtain a second opinion. It all depends on the situation and treatment recommended. For example, if the glaucoma is uncomplicated and in its early stages then laser may be indi- cated. But if there is severe damage or previous laser treatments have been ineffective, then surgery may be a better option. The bottom line for everyone to remember is that regular eye exams are critical to detecting and treating glaucoma to prevent blindness. Contact Info: USC Eye Institute, 1450 San Pablo St., 4th fl oor Los Angeles, 90033, 323.442.6335 FEBRUARY 2016 47 B O D Y, M I N D A N D S P I R I T HEALTH & WELLNESS health_Feb16.indd 47 1/20/16 2:38 PM