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Glaucoma runs in my family. How worried should I be?

The question: My mother was diagnosed with glaucoma at the age of 60 and my sister was just diagnosed at 40. I'm 35 and pretty healthy, but I'm concerned about my risks of developing the condition too. Should I be worried and what can I do?

The answer: Glaucoma can run in families and with your mom and sister both being affected, you are at higher risk of developing it as well. The good news is that by being aware of this risk, you can take action to potentially minimize the chances of developing glaucoma in the future.

Glaucoma is a disorder of the eye involving damage to the optic nerve that can lead to permanent loss of vision. This nerve is responsible for transmitting signals from the eye to the visual centres in the brain that are then processed into what we see. The optic nerve can become damaged if it is compressed or if it lacks nourishing blood flow.

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For most, glaucoma can occur when there is an increase of the pressure in the eye (intraocular pressure), due to an excess build-up of the clear fluid known as the aqueous humor. The accumulation of fluid can occur if its natural drainage is blocked, which can result in compression and damage to the optic nerve.

There are two types of glaucoma, the more common open angle glaucoma that accounts for 90 per cent of cases and acute angle closure glaucoma. Open angle glaucoma involves slow progressive changes that over years leads to gradual vision loss. Because it is so gradual, open angle glaucoma can be without symptoms or noticeable loss of vision until it is quite severe. Acute angle closure is an urgent condition because the blockage of drainage can occur quickly, causing a sudden, painful loss of vision that needs emergency intervention in order to preserve sight.

In addition to family history, other risk factors for glaucoma include advanced age (>60), health conditions such as high blood pressure and diabetes, and a history of trauma or surgery to the eyes. People of African-Canadian descent have higher rates of glaucoma as well.

Damage to the optic nerve is irreversible, which highlights the importance of early detection and modification of risk factors. So the first step for you would be to make an appointment to see your eye specialist (optometrist or ophthalmologist) to have a dilated eye examination. Having a sibling with glaucoma increases your risk threefold while having a parent with the condition increases the risk twofold, so be sure to share your family history with your doctor. Based on the results, they will advise you on how often you'll need to be monitored.

For those without any risk factors for glaucoma, the consensus from the Canadian Ophthalmological Society (COS) is to have an eye exam every 10 years in those aged 19-40, then every 3-5 years after that time. If you have any of the risk factors mentioned above, you may need to have more frequent eye examinations.

The key with managing and preventing glaucoma is to be proactive with your eye health. Get regular examinations, protect your eyes from trauma by wearing eye protection if you work with power tools or play racket sports, and minimize the risk factors that are within your control by maintaining a healthy lifestyle.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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