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Eye disease can sneak up on the uninformed
July 24, 2008
As a local cornea, cataract and refractive surgery specialist, Dr. Asim Piracha knows what can happen when people put eye health on the back burner.
Earlier this month, he saw a patient who'd basically lost all vision in one eye and who was "starting to lose vision in the other eye, and only then did he come in to be seen," said Piracha, medical director of the John-Kenyon American Eye Institute.
"It turns out he has an advanced case of glaucoma," an eye disease that can cause blindness, but had not been treated for it, so "all we can do now is be very aggressive to prevent further (vision) loss," Piracha said. With this condition, "whatever (sight) you lose, you lose. You don't get it back."
As Baby Boomers age and the elderly population increases, the country is expected to see more and more people with serious eye problems.
In 2004, researchers projected that the number of Americans with major eye diseases -- glaucoma, diabetic retinopathy, cataracts and advanced age-related macular degeneration -- would increase from 28.6 million to 43.5 million by 2020.
Yet, many Americans have information gaps about these potentially sight-robbing diseases, according to survey results highlighted earlier this year by the National Eye Institute and the Lions Clubs International Foundation.
The findings are from the 2005 Survey of Public Knowledge, Attitudes, and Practices Related to Eye Health and Disease -- a telephone survey of more than 3,000 randomly selected adults.
Though most people reported that losing their eyesight would greatly impact their life, only 8 percent knew that there are no early warning signs for glaucoma, according to the institute, which is part of the National Institutes of Health.
There were similar findings on diabetic eye disease in the survey. Fifty-one percent had heard of diabetic eye diseases, which include diabetic retinopathy, but only 11 percent knew about the absence of early warning signs.
Furthermore, only 16 percent were familiar with the term "low vision," which is vision loss that typical therapies, such as standard eyeglasses and contacts, cannot correct.
That lack of knowledge is significant, considering that the prevalence of low vision and blindness is projected to grow from 3.3 million people to 5.5 million by 2020, according to the institute.
These trends are "really something that we all have to be aware of," said Piracha, an ophthalmologist.
Low vision and blindness often show up in older people, especially after age 65. So their children "may see signs or may need to be more … aggressive in terms of getting the older patients to the eye doctor for evaluations and screenings to make sure that they're not having any eye conditions," he said.
Quality of life
Visual impairment can have a significant impact on the quality of life, leading to many problems, including falls, isolation, depression, anxiety and difficulty managing medications, said Dr. Tongalp Tezel, a retinal surgeon who's also an associate professor at the University of Louisville. "It's a trigger that starts a bunch of things."
Yet, some people don't place the same importance on regular eye exams as they do on getting other kinds of medical tests or screenings, Tezel said.
Often, "patients are not having regular eye checkups" or miss the follow-up exams and skip around from doctor to doctor, Tezel said. "My suggestion to readers is just stick with a certain center or certain place." (Or make sure that your records are carried to the next provider.)
It's also important for people to report declining vision, Piracha said.
"Some people may just ignore it because they say, 'Well, things break down as you get older,' " he said. But "that's not really the right approach because a lot of these eye conditions that affect patients as they get older can be treated and can be controlled, and if they're treated early, patients can maintain their vision longer and (sometimes) even prevent further loss of vision."
Even when you don't notice any changes in your vision, there are signs that an eye professional can pick up, such as increased pressure in the eye, which is associated with glaucoma, said Khashayar Tonekaboni, director of the Indiana University School of Optometry's Atwater Eye Care Center.
"People get confused and as long as they see 20-20, they think … everything is fine," said Tonekaboni, an optometrist. That's "far from the truth." Piracha stressed: "Even without a family history (of eye disease), you should have at least one, good dilated eye exam to rule out these type of medical problems."
Baseline exam
The American Academy of Ophthalmology recommends a baseline exam for eye disease at age 40 for people who have no signs and no risk factors for eye disease. If you have symptoms or risk factors, such as a family history of a particular condition, you may need to be seen earlier, so ask
your eye doctor for advice.
The baseline exam is not meant to replace regular visits to the ophthalmologist to treat ongoing diseases or injuries, or the vision examinations that people get for eyeglasses or contact lenses, according to the academy.
To preserve vision, you also should protect your eyes from the sun since ultraviolet light can lead to cancer of the eye and may "increase the risk for cataract formation or earlier cataracts or more aggressive cataracts," said Piracha, who recommends sunglasses with UVA and UVB protection for outdoor wear, and appropriate goggles for tanning-bed users.
Piracha and the other eye professionals also encourage a healthy lifestyle, and in some cases, taking certain vitamins and antioxidants (ask your doctor). "All the things that are good for your health like exercise and good diet and not smoking, controlling your cholesterol, controlling your high blood pressure and (controlling) diabetes are all good for the eye as well," Piracha said.
Reporter Darla Carter can be reached at (502) 582-7068.
To view the Courier-Journal story - click here.