The ongoing COVID-19 pandemic has affected U.S. healthcare in ways never seen before. One unfortunate result is that people have delayed medical care. As a member of the Mass General Brigham health system, Mass Eye and Ear is participating in the Safe Care Commitment and taking unprecedented steps to ensure in-person visits are welcoming and safe. Focus spoke with David S. Friedman, MD, PhD, on why people with glaucoma or other vision issues should not skip or delay their appointments.
A large percentage of people are cancelling or putting off medical care due to COVID-19 concerns. Dr. Friedman, director of the Glaucoma Service at Mass Eye and Ear, says it’s vitally important to stay on top of your preventive eye exams and for those diagnosed with vision issues, treatment visits. This is especially true for patients with glaucoma, he told Focus.
[Watch this video with Dr. Friedman explaining the importance of glaucoma screenings]
Glaucoma is a group of eye diseases that damage the optic nerve, resulting in vision loss. Although it is a leading cause of blindness in the United States, vision loss can often be slowed or stopped if the disease is diagnosed and treated early.
However, people with glaucoma often don’t show symptoms. Fifty percent of those with this condition don’t even know they have the disease, according to the National Eye Institute.
“One of the problems with glaucoma, is it tends to get worse gradually, which can be difficult for patients to detect. They can’t feel the changes in eye pressure or their condition worsening from one day to the next, which is why glaucoma is referred to as the ‘silent thief’ of sight,” he said. “Unfortunately, untreated glaucoma leads to vision damage that cannot be reversed. When we catch glaucoma early, we stand a much better chance of preserving vision.”
Untreated Glaucoma Leads to Vision Loss through Optic Nerve Damage
Glaucoma effects about 3 million Americans, and is the second-leading cause of blindness worldwide. The causes of glaucoma are unknown, but the risk of the disease increases with age. However, people of all ages — even young children — can have glaucoma. Groups at the highest risk for glaucoma include African Americans over 40 years old, all adults over age 60, people with a family history of glaucoma, and people with diabetes.
People with glaucoma can benefit from treatments such as eye drops and other procedures that reduce eye pressure to help slow the disease and preserve vision. For some cases and types of glaucoma, people may require surgeries or laser procedures.
Having perfect vision and no obvious symptoms of eye problems does not mean you don’t have glaucoma. The only way to find out definitively is through a comprehensive vision exam, according to Dr. Friedman. During an eye exam, an ophthalmologist will look inside the eye using a non-invasive lens. If the doctor sees nerve damage, he or she will do additional testing, such as measuring side vision with a special machine. Glaucoma researchers, including those at Mass Eye and Ear, are investigating other diagnostic tools to catch glaucoma such as laser devices that can scan the eye for disease.
If diagnosed with glaucoma, regular eye exams with a specialist are required on a schedule your care team will determine.
“Glaucoma typically gets worse in the vast majority of people slowly, on average over 20 years, but with some people, vision can decline very quickly. The way to think of most glaucoma visits are screening exams to make sure your eye sight and condition are not getting worse,” said Dr. Friedman. “Unfortunately, as a result of the COVID-19 pandemic, some patients have had glaucoma worsening due to delays in their care.”
Any Type of Vision Difficulty can Affect Quality of Life
Any vision problem can have a major impact on a person’s life and should prompt them to get a vision test as soon as possible, said Dr. Friedman. People with less than perfect vision may have difficulty functioning in the world. Low vision can lead to reduced social interactions (even virtually through platforms like Zoom), an increased risk for falls, problems with independence, and depression. The good news is that many vision issues can be resolved, some just requiring glasses, with regular eye exams.
“Some people have put off doctor visits, thinking they feel good overall so it won’t have a huge impact on their health and lives,” said Dr. Friedman. “But there’s more to an eye exam than other routine types of care. If you’re noticing issues with your vision, it’s something that we can treat, which will make a major difference in your everyday life.”’
About Our Expert
David S. Friedman, MD, PhD, MPH, is the Director of the Glaucoma Service at Mass Eye and Ear, who specializes in treating all forms of glaucoma for adults. Dr. Friedman sees patients at Mass Eye and Ear, Main Campus in Boston.