A woman whose father suffered from severe glaucoma was advised Saturday to have her eyes checked regularly, because she has a greatly-increased likelihood of getting the disease herself.
When she called the Deseret News/Intermountain Health Care Hotline, the woman learned she probably faces odds of at least one in three that she inherited glaucoma. When she said her father developed the disease in his 30s, she learned that the odds may be even worse than that.Glaucoma is an eye disease that can cause blindness if not treated. Often it has no noticeable symptoms until it reaches an advanced stage.
The advice was among 44 replies given free to the public by two ophthalmologists who answered phone-in questions during the health hotline program. Callers contacted the paper through the toll-free number from as distant as Delta, Park City, Ogden, Layton and Paul, Idaho.
The Deseret News/IHC Health Hotline is offered as a service to the public on the second Saturday of every month, from 11 a.m. to 1 p.m.
Dr. Kirk E. Winward, on the medical staff of LDS Hospital, answered a question from a woman who has been taking medicine for a problem involving her bone marrow and blood cells. The medication apparently caused a cataract and a risk of bleeding, and the woman wanted to know if she should have cataract surgery.
"I told her she needed to have an ophthalmologist assess the cataract, then have her hematologist estimate the risk of bleeding from having surgery," he said.
After that, the woman and her doctors should be able to weigh the relative risks.
Dr. John F. Ramsey, on the staff of Alta View Hospital, discussed macular degeneration with a caller. This is a gradual deterioration of the central portion of the retina, the part of the eye that registers the images.
The deterioration can be caused by several factors, notably age, a genetic predisposition to the ailment, and exposure to too much sunlight.
"If you're a lineman, construction worker, ski instructor - you're in a high-risk job" for the disease, Ramsey said. Many ski instructors know about the potential of macular degeneration, he added, but some of the other workers don't.
"They should all wear dark glasses and a hat. Doesn't have to be expensive," he said.
Other questions he fielded concerned radial keratotomy, an operation in which the shape of the cornea (lens) is changed by cutting the edges with a laser. Re-formingthe lens allows the physician to reduce or eliminate nearsightedness.
Most callers asked about the price of the surgery, which is not covered by most health insurance policies. The cost is about $1,000 per eye, in this area.
The best candidate for the operation is over 30 years old, with nearsightedness that requires correction of six diopters or less. Six is a fairly strong correction. For a person requiring six diopters, the operation has a 75 or 80 percent chance of fully correcting the disorder, while someone needing only about two diopters can expect close to 100 percent chance of correcting nearsightedness, he said.
Why is the operation better for someone over 30? Ramsey said in younger people, the cornea tends to grow back. When it does, it re-forms in the same incorrect curvature it had originally, causing the same bad focus.
A woman asked Winward for advice about her 17-year-old daughter, who wears glasses and wanted to be fitted for contact lenses. The mother wondered whether she should play racket sports while wearing contacts.
"Racket sports, particularly racquetball, have a high rate of eye injury. We strongly recommend protective eyewear during racketsports," Winward said.
Ordinary glasses provide some protection, but it's better to wear glasses with shock-resistant lenses. Safety goggles like those worn by professional basketball players would be better yet, but most folks performing on the tennis court seem uninterested in them.