I’m amazed at how many patients (and even physicians outside the eye care world) think glaucoma is simply high eye pressure.
Glaucoma is a neuro-degenerative disease of the eye and a leading causes of blindness. A person with glaucoma has a faster rate of loss of nerve fiber tissue compromising this nerve which communicates between the retina and brain. In fact, many leading doctors (this one included) believe glaucoma does not stop at the optic nerve; it INCLUDES the brain. The disease is characterized by the progressive loss of retinal ganglion cells (RGCs) and their axons as part of the optic nerve, which may or may not be associated with elevated intraocular pressure (IOP). Current glaucoma therapies target reduction of IOP, howver since RGC death is the cause of irreversible vision loss a neuro-protective approach may be an effective strategy for glaucoma treatment.
Did you know that anything which reduces the vascular nourishment and proper oxygenation (not oxidation) of the central nervous tissue comprising the optic nerve can lead to glaucoma? This includes sleep apnea, COPD (Congestive Obstructive Pulmonary Disease), Carotid artery atherosclerosis, even frequent inverted body positions such as head stands in yoga!
A primary risk factors for glaucoma is increased oxidative stress. Drugs with anti-oxidative properties such as valproic acid and spermidine seem to inhibit apoptosis (cell death) through a signal-regulating kinase 1 (an enzyme involved in oxidative stress) have been reported to prevent glaucomatous retinal degeneration in mouse models of glaucoma. This is important to know because this tissue is central nervous system tissue. No wonder there are very strong correlations between loss of retinal ganglion cells and neurological disorders like Parkinson’s and Alzheimer’s diseases. ¹ Newer diagnostic technologies such as O.C.T. (Optical Coherence Tomography) can measure ganglion cell thickness. Alpine EyeCare Center has such a device.
Optic neuritis is a demyelinating inflammation of the optic nerve resulting in visual impairment. It is commonly associated with M.S. (multiple sclerosis – a chronic demyelinating disease of the central nervous system) and often the first presenting symptom. Although steroids are commonly used for treatment of optic neuritis, reducing the oxidative stress with treatments such as gene therapy can be effective in reducing optic nerve demyelination in pre-clinical studies.
The take-home: your visual and physical health are all related. Advanced technologies can diagnose early stages of disease in time to begin treatments aimed at the underlying disorder, not just the symptoms. Risk factors can be multi-factorial however, new treatments are emerging to effectively treat the resulting disorders.