Glaucoma is the #1 cause of blindness in the Black population, but anyone can have it.  It is a disease in which the optic nerve fibers are damaged.  Normally, this is a result of elevated eye pressure due to an impaired drainage of the aqueous fluid within the eye.  There are several types of glaucoma.

Open angle glaucoma is the most common type.  There are usually no symptoms.  The eye appears to look and see normally.  Mild pressure elevations gradually damage the nerve fiber layer.  As more and more nerves die, a depression called cupping increases.  When enough damage takes place, peripheral vision develops defects.  Only in the later stages of the disease does the patient notice a loss of vision.

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A choroidal nevus is a clump of pigment cells in the choroid below the retina. It's like a freckle on your skin. The eye doctor sees it as a greyish splotch.  It is a benign condition but may sometimes become a choroidal melanoma, which is life threatening.  It should be monitored by an eye doctor.

In this common eye condition there are blocked oil glands in the eylid margins. The oil in the glands becomes very thick and ineffective. The symptoms are itchy, red eyelids.  It tends to be a chronic condition.  It is often found to co-exist with dry eyes.  Treatment usually is warm massages of the eye lids in the shower. Sometimes antbiotics are helpful.

An estimated 29 million Americans age 20 years or older have either diagnosed diabetes mellitus, undiagnosed diabetes, or impaired fasting blood glucose levels.  About one-third are not aware that they have the disease.  If the diabetes is poorly controlled, diabetic retinopathy can develop.  This is the #1 cause of blindness in the Hispanic population. 

In early diabetic retinopathy, the blood vessels leak blood and fluids into the retinal tissues.  If the leaking becomes extensive enough, vision worsens.  This is referred to as Non-Proliferative Diabetic Retinopathy (NPDR).  The picture to the right is severe NPDR.

 

As the condition worsens beyond NPDR, fragile new blood vessels which leak more blood will grow.  This is referred to Proliferative Diabetic Retinopathy (PDR).  Fibrous bands of tissue develop along the new vessels and later shrink, pulling on the retina which results in a retinal detachment and possible blindness.   The picture to the right is severe PDR.

 

 

Diabetic retinopathy can be treated with lasers to destroy the new blood vessels and injections into the eye to slow the growth of the blood vessels.  Individuals with diabetes are 25 times more likely than the general population to become blind.

 The macula is the part of the retina that has the straight ahead good vision.  Macular degeneration is a disease in which the macula degenerates. This disease is much more common in White people. It's also six times more common among smokers than nonsmokers

The most common type is called "Dry" Age Related Macular Degeneration (ARMD). Ninety percent of people with ARMD have the dry form, in which there are pigmentary changes and/or degenerative spots called drusen within the macula.  The top picture shows advanced Dry ARMD.  As these degenerations get worse, straight ahead vision becomes less clear. There is no treatment for this disease, however some studies indicate nutritional supplements may be a benefit.   If you or someone in your family has ARMD, talk to your doctor about supplements.  This may be very important.

Ten percent of people with ARMD develop the "wet" form of the disease and 90% of them end up with legal blindness. In these cases, blood vessels grow into the macula and then hemorrhage (See the lower picture).  This significantly reduces straight ahead vision.  The wet form is often treatable if caught soon enough. This is sometimes treated with a lazer.  The newest treatment is injections of drugs into the affected eye that slow or stop new vessels from growing.

Age-related macular degeneration (AMD) is the #1  cause of irreversible legal blindness among the White population.  Glaucoma is #1 in the Black and Asian populations and diabetic retinopathy is #1 in the Hispanic population.  The prevalence, incidence, and progression of AMD increases significantly with age.   

Sometimes the optic nerve leaves the back of the eye at an unusual angle resulting in a "tilted disc".  It's one of those things that look strange but is not serious.