Importance of Family Screening for Glaucoma
- drgunjandeshpande
- Jan 9, 2023
- 3 min read
Glaucoma can be inherited; genetic and hereditary factors are considered to play a key role in all major forms of glaucoma. Although everyone is at risk of developing glaucoma, individuals who have a family history of the disease are more likely to be affected.
What is Glaucoma?
Glaucoma is a group of eye conditions that can damage the optic nerve, leading to vision loss and blindness. Worldwide, glaucoma is the leading cause of irreversible blindness, and there are estimated to be 76.0 million affected individuals. It is the second leading cause of irreversible blindness in India, with an estimated 11 million individuals affected. Of these, majority are undetected.
According to the Glaucoma Society of India, India is projected to account for 20% of the global burden for glaucoma. One in 9 individuals aged above 40 years either has glaucoma or is at risk of the disease.
Glaucoma is often referred to as the 'silent thief of sight' because it usually has no symptoms in the early stages, and vision loss may occur gradually over time. This is why regular eye exams and screenings for risk factors are so important for detecting and managing glaucoma, minimizing vision loss and preventing blindness.
What is family screening?
One way to identify potential cases of glaucoma in a family is through screening the family members. This involves having all of them undergo regular eye exams and evaluations for glaucoma, even if they do not have any symptoms. This is particularly important for individuals who have a positive family history, as they may be at an increased risk of developing the condition.
The American Academy of Ophthalmology recommends the following frequency for comprehensive eye examinations according to age group:
every 1-2 years for >65 years
every 1-3 years for 55-65 years
every 2-4 years for 40-54 years
5-10 years for <40 years
How is the family screening performed?
There are several different tests that may be used to screen for glaucoma, including:
Eye pressure test: This test measures the pressure within the eye, which can signify glaucoma.
Visual field test: This test measures the range of vision and can detect any areas of vision loss (including peripheral field) that may be caused by glaucoma.
Optic nerve examination: This test involves examining the optic nerve (the structure that carries information from the eye to the brain for processing) for signs of damage or abnormalities indicative of glaucoma.
Retinal examination: This test involves examining the retina (the light-sensitive tissue at the back of the eye) for any signs of damage or abnormalities that may be related to glaucoma.
If a patient is considered a glaucoma suspect, further testing may be necessary to confirm the diagnosis and determine the appropriate course of treatment, which include gonioscopy, pachymetry and optic nerve imaging using OCT. Newer computer-based imaging and stereoscopic photography may provide different and complementary information about optic nerve status. Smartphone- and tablet-adapted fundus cameras are also available and are becoming increasingly affordable for widespread use.
Are there any other conditions which entail glaucoma screening?
Several medical conditions may also be associated with glaucoma, including diabetes, sleep apnoea, migraine, sarcoidosis, HLA B27-associated diseases, and rheumatoid arthritis.
In addition, the use of steroids in any formulation or route of administration elevates intraocular pressure and is associated with an increased risk of glaucoma.
Conclusion:
It is important to note that not all individuals who have a family history of glaucoma will develop the condition. However, undergoing regular eye exams and screenings can help to identify potential cases of glaucoma early on and ensure that individuals receive the necessary treatment to manage their condition and prevent further vision loss.
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