October 22nd, 2013


Dr. Andrew Calman is an ophthalmologist based in San Francisco, California. He has a diverse, multilingual practice, and often speaks three or four languages daily in order to communicate with his patients. One of the most common problems he sees in his practice is glaucoma, the silent thief of sight.

Glaucoma is a disease that affects the optic nerve and can lead to blindness if the patient does not receive treatment. Early detection and various therapies can preserve the patient's sight. When the eye’s trabecular meshwork becomes inefficient and does not allow fluid to drain, intraocular pressure increases. Glaucoma is characterized by a build-up of this aqueous fluid pressure; over time, the optic nerves suffer damage.

There are several different types of glaucoma; the most prevalent is primary open-angle. Open-angle glaucoma presents few symptoms early on, but as the disease progresses, blank spots can interfere with the patient's vision as the optic nerve becomes compromised.

Individuals with type 1 or type 2 diabetes might have to deal with a number of related conditions, including diabetic retinopathy. This disorder damages the blood vessels of the retina. Initially, people with this condition might not notice any change in their vision, but over time it can lead to blindness. In fact, diabetic retinopathy is the leading cause of legal blindness in working-age Americans.

The early form of the disorder is marked by leaky blood vessels in the retina. Microaneurysms caused by diabetes can leak blood and fluid into the retina, causing blurred vision. Advanced, or proliferative, diabetic retinopathy is considered more problematic because it features the growth of abnormal blood vessels, which can lead to severe bleeding, retinal scar tissue and glaucoma.

Doctors base treatment on the patient's form of diabetic retinopathy. Those with early diabetic retinopathy may not need immediate care, other than controlling blood sugar and blood pressure. However, advanced diabetic retinopathy often requires medication injections, laser treatment, or even surgery. With early diagnosis and treatment, 90% of diabetes-related blindness can be prevented. That's why an annual dilated eye exam is so important for all persons with diabetes -- even if you see 20/20!

About the Author:

Based out of Premier Eyecare of San Francisco, Andrew Calman, MD, cares for patients as a board certified ophthalmologist. Diabetic retinopathy is one of the conditions he treats.