New Medicare Benefits and
Advances in the Detection of Glaucoma
by Vincent J. Giuseffi, MD of The Eye Center
As of January 1, 2002, Medicare has approved annual glaucoma screening for African
Americans, diabetics, and those with a family history of glaucoma. For those
patients already diagnosed with glaucoma or suspicious for glaucoma, Medicare
generally covers an advanced test to detect and track glaucoma called a nerve
fiber analyzer. Even non-Medicare patients could and should benefit from this
and other new technologies for the detection and treatment of glaucoma.
WHAT IS GLAUCOMA?
Glaucoma is generally a condition of elevated fluid pressure within the eye that
ultimately damages the optic nerve fibers in the eye which transmit visual
information to the brain. There are however a large group of other types of
glaucoma with or without elevated eye pressure that can damage the optic nerve
and seriously affect vision. Untreated, glaucoma can slowly or quickly lead to blindness.
WHO SHOULD BE SCREENED?
After the age of 35, the chance of developing glaucoma continues to increase
with age and of Americans over the age of 65, one in twenty are affected. The
risk of developing glaucoma increases if there is a family history of glaucoma
or you are of African American or Asian decent. Diabetics and those taking steroid
medication (by mouth, eye drops, or inhalation) are at increased risk. Glaucoma is
more common in nearsighted people and those having had injury to their eyes.
HOW IS GLAUCOMA DETECTED?
Unfortunately, symptoms of glaucoma are not generally noticed by an individual until
considerable damage to the eye has already occurred. Damage already done is not
generally reversible and there currently is no cure for glaucoma. Early detection
and treatment are the key to minimizing vision loss and this can only be accomplished
by seeing an eye care professional trained in the detection of glaucoma. Standard
testing for glaucoma is simple and painless and generally involves determining the
eye pressure and visualizing the health of the optic nerve. Further testing may
include goniosopy (looking at the fluid drainage area within the eye) and perimetry
(checking the visual field). Advanced testing involves the recently available optic
nerve analyzer which has the capability of detecting glaucoma at the earliest stages
and therefore provides the best options for treatment and protecting against severe
visual loss.
HOW IS GLAUCOMA TREATED?
The mainstay of treatment is the use of eye drops and significant advances continue
to be made in this area. Laser treatment can be effective in lowering the pressure
in up to a 80% of those treated. Surgery is generally reserved for advanced cases.
WHERE TO GO FOR EVALUATION AND TREATMENT?
See your current eye care professional to discuss the specific need for screening,
evaluation, and treatment of glaucoma. If you do not have a doctor, when calling to
find someone ask if they evaluate and treat glaucoma and what type of screening or
testing is available. At The Eye Center we currently provide treatment for all types
of glaucoma and have specially trained doctors and staff and offer the most advanced
testing (including the optic nerve analyzer) and treatments.
WBPA - The Warren Showcase - June 2002
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