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The Disability Black Women Don’t See Coming

Catch this silent thief of sight that can begin in our 40s.

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Glaucoma was the last thing on my mind when I made my first appointment with an ophthalmologist. I was in my mid-30s and had good health insurance at the time, so I decided to add an eye exam to my annual healthcare routine. That’s when I learned that my eye pressure was slightly elevated (also known as ocular hypertension), and as a result I had borderline glaucoma. Thankfully, my ophthalmologist didn’t give me a reason to panic. She simply gave me samples of lubricant eye drops and said to come in for annual check-ups.

The most common form – open-angle glaucoma – is usually symptomless early on, which explains why 50% of people with glaucoma don’t know they have the disease.

Then in my early 40s, as many of us experience, one day I literally couldn’t read the fine print and I purchased my first pair of drugstore readers. I asked my new ophthalmologist if wearing non-prescription reading glasses was hurting my eyes. But he assured me it didn't matter if readers came from the dollar store or an expensive eyewear boutique. As he explained, glaucoma is related to high eye pressure and even patients with perfect 20/20 vision can still develop glaucoma.

Now in my early 50s, during the pandemic I noticed subtle changes in my vision that were beyond needing readers to magnify smaller text. Without my readers, images on the TV and movie screen were blurry. Initially, I thought eyestrain from daily computer use was the culprit. But when I went in for an ophthalmology appointment after skipping a year, I got some unexpected news.

“It looks like it’s gotten worse and it’s time to treat this,” my eye doctor said after taking longer than usual to read my test results.

While freaking out on the inside, I calmly asked if this meant I had progressed from borderline glaucoma to glaucoma?

Apparently, the answer wasn’t clear cut. Instead of reassurance, my ophthalmologist offered me treatment options to lower my intraocular pressure: Laser surgery or prescription eye drops. I weighed the pros and cons and opted for the less daunting daily drops. Although the drops have side effects, including red or stinging eyes, one positive side effect is eyelash growth. And after trial and error using a combination of drops for several weeks, another test showed my eye pressure significantly improved.

Although I’m pleased with my progress, I’m still concerned about my vision. My father has glaucoma and the risk is 20% higher if glaucoma is in your family. The eye disease also strikes earlier and progresses faster in African Americans, according to the Glaucoma Research Foundation. So in addition to a six month follow-up with my ophthalmologist, I will consult with a woman of color glaucoma specialist to gain more insight into my specific case.

What is glaucoma?

Glaucoma is a progressive and degenerative disease of the optic nerve. It usually happens when fluid builds up in the front part of your eye, which increases the pressure in your eye and damages the optic nerve, notes the American Academy of Ophthalmology. Glaucoma is called the “silent thief of sight,” and it’s the second leading cause of blindness worldwide. The most common form – open-angle glaucoma – is usually symptomless early on, which explains why 50% of people with glaucoma don’t know they have the disease. Currently, there is no cure for glaucoma, but if detected early, you can preserve your vision and prevent vision loss.

Read more about the warning signs of glaucoma here, and more about eye health in’s Eye Center.

What puts African Americans at higher risk?

“We are still unpacking why African Americans have a higher risk for glaucoma. This is likely for a number of reasons, some genetic and some related to social determinants of health that also affect disease,” says Ahmara Gibbons Ross, M.D., assistant professor of ophthalmology and neurology at the University of Pennsylvania.

In addition to race, risk factors that may increase our risk of glaucoma include: being 40 or older; family history of glaucoma; high internal eye pressure; extreme nearsightedness or farsightedness; and medical conditions such as diabetes, migraines, high blood pressure and sickle cell anemia.

Don’t let cost be a deterrent to getting eye care.

Get the facts, sis. You may have put off an eye exam because you heard they aren’t covered by your provider. But this applies to eye exams for eyeglasses and contact lenses, which are covered separately by vision insurance. And remember, getting your prescription for eyeglasses or contact lenses updated (refractions) isn’t the same as checking on your eye health. However, health insurance plans may cover eye exams to detect disease, and Medicare may cover you if you have a risk factor like diabetes or family history. There are also no-cost and low-cost eye care programs, such as EyeCare America, which offers free comprehensive eye exams — and up to one year of care — to people ages 65 and older and to people at higher risk of glaucoma.

Find a qualified eye care specialist you can trust.

Ask your sister circle for referrals and use your health insurance provider as a resource to find a board-certified ophthalmologist (not an optician or an optometrist) to diagnose, treat and perform surgery for glaucoma, cataracts and other eye conditions like diabetic retinopathy (an eye disease caused by diabetes).

Unfortunately, some older African Americans with chronic conditions like diabetes aren’t being advised by their primary care providers to get regular eye exams. So when it comes to your health, it’s imperative to educate yourself and to speak up for what you need or enlist a friend or family member to advocate on your behalf.

“Stay informed about the risks associated with glaucoma, its symptoms, and the importance of regular eye check-ups,” says Dr. Ross, a board-certified ophthalmologist with fellowship training in glaucoma and neuro-ophthalmology.

“If diagnosed with glaucoma, strictly follow the treatment plan prescribed by your eye care professional. This may involve eye drops, medications, or surgical interventions.”

The comprehensive eye exam isn’t as scary as you think.

We know this isn’t something you look forward to, but your 80-year-old self will thank you for doing this now. Research suggests that getting a comprehensive eye exam by the age of 40 can help catch glaucoma and other eye diseases early. And trust us, the process – which includes an air puff tonometry test that checks eye pressure and a dilated eye exam (the doctor inserts special eye drops to widen your pupils) – is simple and painless.

Bring a pair of sunglasses (UV protective, of course, which you should use regularly to ward off damage to your eyes) if you are getting dilated, and give yourself extra time in case you’ll need to wait a bit before driving home.

Read more about health conditions that can be detected through an eye exam, here.

You can still live well and prosper with glaucoma.

Glaucoma doesn’t mean you have to give up things you enjoy like Netflixing and chilling or reading bestsellers, which you can do by using a tablet that enables reverse polarity (white letters on a black background instead of black letters on a white background).

While there’s no strong evidence computer use is a risk factor for glaucoma—the glare from the screen is one potential worry—digital devices can lead to eye strain. To limit that strain, take breaks and focus on something 20 feet away for 20 seconds every 20 minutes and blink often to prevent dry eyes.

You might be able to keep on trucking, too. Similar to people who have cataracts, some drivers with glaucoma report they have difficulty with glare, night driving, and low contrast situations, but can still drive safely by take extra care to scan the visual environment. However, if you sense vision impairment is affecting your road skills, ask a friend or family member to ride with you to assess your driving. AARP also has a driver safety program.

Learn about vision benefits and discounts for AARP members here.

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