Kathy Roberts knows the value of protecting eyesight.

        But Ms. Roberts, social service manager for the Cincinnati Association for the Blind, was surprised when a routine eye exam several years ago revealed she had glaucoma.

Dr. Elliot Kirstein demostrates glaucoma testing. (Dick Swaim photo) | ZOOM |

        Ms. Roberts was lucky, experts say: Too many adults wait until the disease has already damaged their eyesight to get their eyes checked.

        Better screening procedures and new medications mean it's easier than ever for doctors to find glaucoma and treat it effectively, says Dr. John Cohen, a surgeon with the Cincinnati Eye Institute.

        But first they have to convince patients to come in for the test, he says.

        “I think there's still a very big problem with people that don't know they have glaucoma,” Dr. Cohen says. “Most patients experience damage to vision without having any symptoms. They're not even aware it's occurring.”

        In glaucoma, fluid builds up inside the eye, putting pressure on the optic nerve. Uncorrected, the pressure can damage the optic nerve, causing vision loss and, potentially, blindness.

        Ms. Roberts, 51, of Madeira, knew she was at risk for the disease: Her mother and an older brother had already been diagnosed with it. But she was surprised that she developed glaucoma so young: She was only in her 40s when the exam detected it.

        “We used to do glaucoma screenings free here, and we would find it in people of all ages,” she says. “It isn't just an old people's thing. Or people get lax in seeing an eye doctor, and they think they see just fine, not realizing they can have it and not know it.”

        Glaucoma patients can use one of several types of eye drops or pills to correct the pressure. Some patients may also require surgery to improve drainage of the fluid in and out of the eye, which then corrects the pressure, says Dr. Elliot Kirstein, an optometrist with Harper's Point Eye Associates in Symmes Township.

        The Food and Drug Administration has recently approved Travatan, manufactured by Alcon, and Lumigan, manufactured by Allergan, to treat glaucoma. The two, both drops, only have to be administered once or twice a day, unlike older medications, which may have to be administered four or five times daily.

        Doctors have also learned that a standard screening for glaucoma can be misleading. Many of us have undergone the “puff” test, which measures the eye's resistance to a puff of air as a means to determine how high fluid pressure is in the eye.

        But the “puff” tests measures surface pressure, and doctors have learned that people can test normal on the “puff” test while they are in the early stages of glaucoma, Dr. Kirstein says.

        Screenings for glaucoma should include visual acuity tests (checking how well the patient sees at various distances), visual field tests (measuring the patient's peripheral, or side, vision) and pupil dilation, which gives the doctor a chance to get a close-up view of the optic nerve to check for signs of damage.

        Several standard tests for checking fluid pressure inside the eye — called tonometry — are also used.

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