DEAR DR. DONOHUE: My family doctor gives me a thorough examination every year. As part of the exam, she looks into my eyes with a scope. This year she saw changes that she feared were due to glaucoma. I am scheduled to see an eye doctor. Does this mean I will go blind? How could she tell glaucoma from looking in my eye? – D.R.

You are not going blind. When detected early and treated, glaucoma does not lead to blindness.

There are two criteria that establish the glaucoma diagnosis. One is an increase in fluid pressure within the eye. The front one-third of the eye is filled with a fluid that constantly flows into that chamber and flows out of it at the same rate. When fluid production speeds up and drainage does not, fluid pressure in the eye rises. The same thing can happen if the drainage apparatus is not wide open.

A rise in fluid pressure compresses the optic nerve, the vision nerve that relays images to the brain for sight. Changes in the nerve impair vision, and if the pressure is not relieved, blindness ensues. In a small number of people, the same changes can be found even though the eye has normal fluid pressure. In this instance, too, without treatment vision can suffer.

I am certain that changes in your optic nerve aroused your doctor’s suspicion of glaucoma. The eye doctor will look at the nerve and measure the fluid pressure in your eyes.

What sounds like a fatuous statement is that you are in luck. If the eye doctor confirms the glaucoma diagnosis, the doctor will prescribe medicines that preserve the function of the optic nerve. Sometimes those medicines are eyedrops. Sometimes oral medicines are the treatment of choice. And once in a while, both drops and oral medicines are used.

Since glaucoma creeps up on people silently, people over 50 need a glaucoma check every two years.

DEAR DR. DONOHUE: What does being “susceptible” to hepatitis B mean? I had a blood test done as part of the requirements for taking a job in the health care field. The blood test came back saying I was susceptible to hepatitis B. What should I do? – V.K.

The entire world is susceptible to hepatitis B infection.

Only people who have been immunized against it or who have had the infection and recovered from it are not susceptible to hepatitis B.

I can almost assure you with absolute confidence that the next time you hear from your prospective employer, you will be asked to have the hepatitis B immunization.

Adults who are at risk for infection with the hepatitis B virus include doctors, nurses, lab techs and people who have many sex partners. Infants are now routinely immunized for it.

DEAR DR. DONOHUE: I recently found out that I have breast calcifications. It really frightens me. Is this something I should be concerned about? My last mammogram showed no change. I take calcium supplements and drink milk daily. Should this be changed? – E.H.

Breast calcifications can be harmless, incidental findings on a mammogram, or they can be a sign of cancer.

The radiologist – the doctor who interprets mammograms — notes the calcifications’ size, the way they are grouped and their shape to ascertain whether they indicate cancer or are nothing. The fact that your mammograms show no change in calcification argues strongly against them being cancerous.

Harmless calcifications occur for a number of reasons. An insignificant, self-healing infection or a minor bump to the breast can lead to calcifications. Neither your calcium supplement nor your daily milk contributes to such calcifications.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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