Editor’s Note:
AHMC Healthcare and National Yang Ming Chiao Tung University Hospital presented seven expert lectures on screening, treatment, and prevention. This is the second article in the series.
Clear sight doesn’t mean healthy eyes. Painless vision loss can go unnoticed.
Dr. Shih-Hwa Chiou, deputy superintendent of National Yang Ming Chiao Tung University Hospital, warned that glaucoma and age-related macular degeneration can silently steal sight.
Early exams, prompt attention to warning signs, and ongoing treatment help preserve sight before irreversible damage disrupts daily life.
Narrowing Vision, Hidden Damage
Glaucoma damages the optic nerve, which carries visual signals to the brain. Common chronic forms often cause no early discomfort.
Patients may still read and recognize faces as their visual fields shrink, leaving damage unnoticed until substantial peripheral vision is lost.
Dr. Chiou emphasized that eye pressure alone cannot diagnose or rule out glaucoma. Optic nerve damage can occur even at normal pressure.
Evaluation combines an optic nerve exam, visual field testing, optical coherence tomography (OCT), and drainage-angle assessment. Corneal thickness may also inform pressure readings.
Visual fields measure function; OCT examines nerve fiber structure. Comparing results over time reveals progression.
Older adults and people with a family history of glaucoma, high myopia, elevated eye pressure, or long-term steroid use need follow-up tailored to their risk.
Lower Pressure, Preserve Vision
Glaucoma treatment aims to preserve remaining sight. Depending on disease type and severity, eye drops, laser treatment, or surgery lower pressure by reducing fluid production or improving drainage.
Minimally invasive surgery offers options for selected patients, while conventional procedures remain important. All require continued monitoring.
Proper eye-drop use matters. Wash your hands, keep the bottle tip from touching your eye, and use drops as prescribed.
Afterward, close your eyes and gently press the inner corner for at least one minute.
Space different drops as directed, and never stop treatment simply because your eyes feel fine.
Sudden severe eye pain, redness, blurred vision, rainbow halos, headache, nausea, or vomiting may signal acute angle-closure glaucoma. Seek immediate eye care or emergency treatment.
Wavy Lines, Warning Signs
Glaucoma often steals side vision; macular degeneration blurs the center. Words fade, faces blur, and straight lines look wavy.
Don’t dismiss these warning signs as aging or a need for reading glasses.
Age-related macular degeneration (AMD) has two forms: dry, marked by drusen buildup and tissue damage that can progress to geographic atrophy; and wet, where abnormal blood vessels leak or bleed, risking rapid vision loss.
Dry AMD can become wet AMD. New distortion or central blurring warrants prompt evaluation.
An Amsler grid can help monitor changes at home. Cover one eye, focus on the center dot, and check for wavy, missing, or blurred lines; then switch eyes.
Testing each eye separately can reveal changes to the other eye masks, but does not replace an eye exam.
Control Leakage, Choose Wisely
Wet AMD is commonly treated with intravitreal injections of anti–vascular endothelial growth factor (anti-VEGF) medication to reduce leakage and bleeding.
OCT monitors fluid, helping guide injection and follow-up intervals. Stable disease still requires monitoring.
Daily care includes quitting smoking, eating a balanced diet, exercising, and managing blood pressure and cholesterol.
Leafy greens supply lutein, but supplements cannot replace diagnosis or treatment.
According to the National Eye Institute, AREDS2 supplements can reduce progression risk in selected patients with intermediate AMD or late AMD in only one eye. They are not preventive supplements for everyone.
Current and former smokers should avoid older AREDS formulas containing beta-carotene. Discuss supplements with an eye doctor before use.
Regenerative Promise, Cautious Progress
Chiou’s team is exploring retinal repair by reprogramming patients’ blood cells into iPSCs, then differentiating them into retinal pigment epithelial cells for transplantation.
The team reported two compassionate-use procedures, the first in November 2021, and is pursuing a Phase I/IIa trial. The treatment remains investigational; safety and effectiveness require further study, and vision recovery is not guaranteed.
Protecting sight starts with early action and continued care. Share your family history, degree of nearsightedness, and medications, and review eye pressure, visual fields, and OCT findings at follow-up visits. (Part 2 of 7)
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