Eyesight Health: Coping with Glaucoma

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Eyesight Health: Coping with Glaucoma

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by Edith Marks with Rita Montauredes

Avery Publishing Group, Inc.

120 Old Broadway, Garden City Park, New York 11040 USA, 1-800-548-5757
1997, softcover, $13.95, 304pp.
One of our most precious and surprisingly, least cared for faculties, is our eyesight. We rarely think about the health of our eyes -- until we reach middle age and bifocals. Even then, we don't think in terms of eye "health" -- we just accept the need for prescription eyeglasses as an inevitable sign of aging.

There is, however, a growing population of people with glaucoma and cataracts, serious eye diseases which, left untreated, lead to blindness. After reading Coping With Glaucoma I realized that we hear quite a lot about successful laser surgery for cataracts, but very little about treatments for glaucoma, for the simple reason that there are no cures for this eye disease, only partially effective treatments.

The authors of this book, both stricken with glaucoma, met in a support group. Edith Marks had had laser treatment and one eye operation: Rita Montauredes had a series of operations, each of which left her more devastated than the one before. Both women were frustrated by the treatments and their side-effects, and began to search out information from other sources.

They found that of the 3 million Americans who have glaucoma, half of those affected do not even know they have it. Sixty-eight percent of them are over 65; many are African-American; many are diabetic and myopic. The authors' research provided many answers to their questions: what diagnostic tests were available; what the state of research into the causes of glaucoma was; what medications were recommended (and their side-effects). And they also discovered complementary therapies, and began to take charge of their own lives and health.

The first chapter explains the anatomy of the eye in language understandable by everyone, and provides a foundation for the following chapters on glaucoma, its diagnosis, medications, surgeries, and complementary therapies, including nutrition.

Glaucoma is now believed to be the end product of a number of distinct structural and systemic diseases characterized by high pressure inside the eye and optic nerve damage. Diagnosis is based on three factors: intraocular pressure (IOP), characteristic changes in the visual field, specifically a loss of peripheral vision; and signs of damage to the optic nerve. The authors give detailed explanations of primary open-angle glaucoma, and narrow-angle glaucoma, which are considered a structural problem, and other forms which are considered to be related to systemic disease.

However, it is not a simple disease to diagnose. Case histories cited in the book make for painful reading, as a patient seeks help from four ophthalmologists with four differing diagnoses. Some glaucomas result from medical interventions that were meant to cure other problems: postcataract (surgery) glaucoma; steroid-induced glaucoma; and probably other pharmaceutical drugs may set the stage for glaucoma.

The authors take the reader step-by-step through an ophthalmology examination, explaining what each diagnostic step is testing for, and what the exam should include. Every aspect of the diagnosing of glaucoma is covered, as well as the newest technologies and some of their limitations.

The primary medication used after diagnosis is often eyedrops to lower intraocular pressure. The authors feel that the eyedrops can be the first line of defense and may halt or delay the advance of glaucoma, but they also explain the serious side-effects, and feel they should be used with care. Oral beta-blockers and many other drugs are examined, with both effectiveness and side-effects discussed. The authors also give their own invaluable experiences with these drugs, and how they have learned to use them -- for glaucoma patients, medication is a fact of life.

Laser trabeculoplasty, and other laser treatments are covered, giving detailed assessments of both the effectiveness and the contraindications, as some forms of glaucoma respond better to laser treatment than other forms. Surgical procedures are examined, as well, and the cataract connection (surgeries and medications sometimes cause injury to the lens, and glaucoma patients often develop cataracts after glaucoma treatment).

The second half of Coping with Glaucoma dispels some of the grim scenarios of conventional treatment described in the first half of the book. The authors began to investigate complementary therapies because of the seriousness of their vision problems, and the limitations of conventional treatments, and they bring the same attention to detail in researching alternative therapies as adjuncts to conventional treatment. They cover relaxation, eye exercises ala the Bates Method, acupressure, exercise, herbal remedies, and an excellent chapter on nutrition and supplementation.

Coping with Glaucoma is unusually comprehensive, and well-researched, with the added weight of the authors' own experiences in coping with this serious eye disease. They have provided invaluable information and advice for glaucoma sufferers everywhere.

Townsend Letter for Doctors & Patients.

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By Irene Alleger

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