GLAUCOMA: THIEF IN THE NIGHT GETS A NEW ENEMY

They call it a thief in the night.

Glaucoma, a disease of the optic nerve, is the leading cause of blindness in the United States, especially in older Americans.

The disease often develops gradually and painlessly without symptoms. Professionals say it can't be prevented, but with early detection it can be controlled.

New technology and medical procedures are helping doctors detect the disease earlier than ever, cutting down on the likelihood of glaucoma-related blindness.

Richard L. Kies, an ophthalmologist at Kies Eye Center in Cape Girardeau, has seen the damage glaucoma can do. He has invested about $30,000 in a state-of-the-art early detection tool called the Heidelberg Retina Tomograph.

"Glaucoma historically is diagnosed after the damage is done," Kies said. "What this machine enables us to do is apply technological advances in computers and imaging equipment, marry those and develop a more precise image of the optic nerve beyond anything we've been doing."

The Heidelberg machine enables Kies to take three-dimensional images of the optic nerve. He then can quickly and more easily look for abnormalities in the nerve.

The images and other information is processed and stored on a computer system. By having images taken at every exam of a patient, Kies can watch for changes in the nerve.

"We can now detect changes at a much quicker and earlier rate than with the old vision field," Kies said. "We can deal with it if we find it, but finding it is the biggest problem."

Eye care professionals commonly use pressure testing to help detect the presence of glaucoma. The Heidelberg machine, Kies said, is a more accurate and effective tool.

People with glaucoma often do not notice changes in their vision until it is too late. Noticeable symptoms include a gradual loss of side vision or blurred vision.

In addition to older people, African Americans, people with a family history of glaucoma and people who are nearsighted or diabetic also are particularly prone to the disease.

Glaucoma develops when the pressure in a person's eye rises and damages the optic nerve.

At the American Optometric Association's 103rd Congress in Las Vegas during the summer, J. James Thimons, O.D., said he has diagnosed more young people and juveniles with glaucoma. That concerns him.

"Those who are suspect for developing the disease need to be monitored very closely, and that can be done only with frequent, thorough exams," Thimons said.

Kies said it is possible for people with glaucoma to lose as many as one-third of the nerves in their eyes.

"Once you lose them, you don't get them back," he said.

The AOA recommends annual eye examinations for people at risk for glaucoma. Kies said the more often people are tested, the earlier the disease can be detected, leading to less of a chance of blindness.

"What is so attractive about the Heidelberg machine is it gives us a means to follow our treatment," he said. "It really is a phenomenal step forward.