January 2022
Glaucoma Awareness Month
Left: Normal vision. Right: What a person with glaucoma sees. With glaucoma, vision loss begins in the periphery, and eventually closes in and impacts central vision.
Detecting glaucoma before it impacts vision
The most common type of glaucoma causes vision loss so gradually, that it has become known as the “silent thief of sight.” By the time you start noticing trouble with your vision, you may already have severe glaucoma damage.
“A common scenario is for a person to notice poor vision in one eye which causes them to seek evaluation. Then we find severe irreversible vision loss from glaucoma in that eye, with the other eye starting to worsen,” said glaucoma specialist Lisa McHam, MD,  “It is always surprising how much vision people can lose before they seek out care. Unfortunately, vision loss from glaucoma cannot be reversed. But with treatment, we can prevent further vision loss in most patients.”
Only half of the people with glaucoma know that they have it.

Three million Americans have glaucoma, yet since the disease does not present symptoms, only 50 percent of people with glaucoma know that they have it. [1] Vision loss starts in the periphery, which is why open angle glaucoma, the most common type, goes unnoticed until it impacts central vision. What happens is that pressure from a buildup of fluid in your eye, called intraocular pressure (IOP), damages the optic nerve which serves as the pathway between your retina and your brain. This clear fluid, called aqueous humor, normally enables your eye to maintain a constant healthy eye pressure. Much like a sink, in a normal eye, the faucet is always on and the drain is always open. With glaucoma, the drain gets clogged.
The only way to catch glaucoma before it impacts vision is to have an eye exam.
“Anyone with a family history of glaucoma should have a baseline comprehensive eye exam, no matter how old they are,” said Dr. McHam. “During that exam, the doctor will look for glaucoma risk factors that will determine the appropriate screening interval for that patient. Everyone else should have a comprehensive eye exam at around 40 years of age because this is when the prevalence of many eye diseases starts to increase, especially glaucoma.”
Treatment for glaucoma usually involves applying therapeutic eye drops that lower eye pressure. Many patients are now treated with a laser at the earliest stages of glaucoma to lower eye pressure, but the laser’s affect wears off with time, therefore ongoing monitoring is still very important, said Dr. McHam. More advanced glaucoma may also be treated by surgery or a combination of therapies.

[1] “Don’t let glaucoma steal your sight”. Vision Health Initiative. Centers for Disease Control and Prevention. https://www.cdc.gov/visionhealth/resources/features/glaucoma-awareness.html
Staying ahead of glaucoma during
challenging times
Glaucoma requires close follow up with your doctor. If you have been diagnosed with glaucoma, it is extremely important to follow your doctor’s treatment plan.
“Regular follow up examinations are essential for ensuring that intraocular pressure is within a desirable target range and that the condition of the optic nerve is not deteriorating,” said glaucoma specialist Michael Chang, MD.
The pandemic has presented a challenge for those with glaucoma and other eye conditions that require regular follow up. Telehealth visits can be part of the equation, but they do not allow doctors to measure eye pressure and perform other aspects of the eye exam that confirm that a patient’s glaucoma is under control. 
“While many patients have sought care even during the pandemic, some patients are overdue for their examinations,“ said Dr. Chang. “It so important for those patients to recognize that without follow up, intraocular pressure could become elevated and the optic nerve could become damaged without the patient knowing. We advise all of our patients with glaucoma to maintain a regular schedule for monitoring.”

OCB EHS ophthalmologists want patients to feel comfortable knowing that their practice strictly adheres to the heightened COVID safety precautions at each practice location and that it is safe for you to come in for your regular follow up for glaucoma and other eye conditions that require ongoing monitoring.
Equally important to note, is adherence to the eye drop regimen, even if you do not notice the progression of symptoms.
“Medical therapy is effective only when the pressure-lowering eye drops are used on a regular and consistent basis,” said Dr. Chang. “When used consistently, the intraocular pressure is stably controlled, thereby preventing additional damage to the optic nerve. If medications are not used consistently, the intraocular pressure will not be controlled and irreversible damage, possibly leading to blindness, could ensue, even in the complete absence of symptoms.”

Applying Eye Drops Correctly

If you are concerned about whether you are applying your eye drops correctly, or if you struggle with adhering to the regimen, please see Tips on applying your glaucoma drops and call your OCB EHS eye doctor who can help.
We are committed to protecting your safety
The health and safety of our patients and our staff remain our top priority.
We are deeply committed to providing the safest possible environment for your eye care. We appreciate your cooperation and your patience complying with OCB EHS COVID procedures.

First and foremost, if you are experiencing any of the following symptoms, please reschedule your appointment: fever, sore throat, cough, runny nose, headache, muscle aches, loss of smell/taste or shortness of breath.

During COVID, OCB EHS must require the wearing of masks and physical distancing. To protect our patients and keep the number of people at a minimum, we cannot allow visitors in OCB EHS clinics until COVID subsides. Essential caregivers may accompany our patients, however, they are the only exception. Patients and essential caregivers will be screened for symptoms, and must wear a mask at all times. Caregivers must stay with the patient for the entire visit. Again, we appreciate your understanding and look forward to seeing you soon! Please visit our website to learn more about our safety measures.
Schedule your visit through Patient Gateway!
Did you know you can request an appointment with OCB Eye Health Services through your Mass General Brigham Patient Gateway account?

If you are already a patient with us, you can easily request an appointment through Patient Gateway!

Here's what to do:

  1. Once you have logged on to the Patient Gateway site, select the "Visits" tab.
  2. Here you will find a "schedule your appointment" tab.
  3. That will bring you to a list of your doctors.
  4. Here you can request an appointment. Simply select your OCB Eye Health Services doctor to request a convenient appointment date and time.

If you do not yet have a Patient Gateway account, we highly recommend setting one up. Through the secure portal you can not only request appointments, but you can message your doctor directly, view test results and pay your medical bills online! Just go to Patient Gateway and follow the steps to create an account.

If you are a new patient, you could also request your first visit through the OCB EHS website.

If you wish to cancel/reschedule and upcoming appointments, you can do this HERE OR by going to www.eyeboston.com, clicking on the "Plan Your Visit" tab and selecting cancel/reschedule appointment.
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