Volume 10, Number 2
July 2001
Research Update and
New Members Highlight Board Meeting
Inspiring words from Glaucoma Service Research
Center Director Dr. William Steinmann and the introduction of
three new Board members highlighted the June 5 meeting of the
Board of Trustees of the Glaucoma Service Foundation.
Dr. Steinmann spoke to 24 Board members and
guests about the Center’s great progress since moving into its
new quarters at 901 Walnut Street, propelled by his vision of
the research enterprise as the “Tiger Woods of clinical research.”
The Center, he explained, is young and attempting to do something
that has not been done before and do it superbly well: building
a model of a great clinical research foundation focused on glaucoma.
An important aspect of this is what he referred to as a “transparence”
between clinical and research activities: every patient
has something to teach us, and everything we learn from patients
contributes to their care.
Board member Mr. Stanley Tuttleman (left) and Wills Eye Hospital
CEO D. McWilliams Kessler at the June 5 Board meeting. |
Board member Ms. Nettie Taylor (left) and Board Chairman Mr.
S. Stoney Simons at the June 5 Board meeting in the Wills
Eye Hospital auditorium. Ms. Taylor has been active
in promoting glaucoma screenings at area churches. See
Mr. Simons’ in article below.
Photos by Robert Curtin |
New Members Introduced
Three new Board members were introduced at the
meeting: Ms. Megan Brunner, Dr. Andrew Medcalf, and
Ms. Bonnie Carr Long. In addition to running her own marketing
and public relations consulting business in Paoli, PA, for over
20 years, since 1993 Bonnie Carr Long has been Vice President,
Marketing for Home-Nurse, Inc. in Wayne, PA. Ms. Long has
the distinction of having been one of Dr. George Spaeth’s first
patients when he started the Glaucoma Service of Wills Eye Hospital
now nearly 40 years ago. Frequent headaches and a family
history of glaucoma led her to Dr. Spaeth when she was 19, during
her sophomore year in college. The diagnosis: primary open-angle
glaucoma. The treatment: two different drops, four times
a day. The drops caused so much blurring that she found
she could study for only short periods each day. Ten years
later she underwent trabeculectomy in both eyes. Today she
remains without any loss of visual field, on no medications.
“I am excited about the possibility of contributing
to the Foundation’s mission of education and research about glaucoma.
I was lucky in the sense that my glaucoma was caught very early
on. We have to develop screening techniques to enable us
to find people who are in the very early, most treatable stages
of the disease.”
Born in England, Dr. Andrew Medcalf received
his Ph.D. in Cancer Research from the University of London.
For 10 years he was a research scientist at the Institute of Cancer
Research in London and at Michigan State University. He
subsequently founded and operated a consulting firm in the field
of environmental toxicology. For the past three years he
has been a Financial Advisor at Legg Mason. Dr. Medcalf
has coached rowing at the University of London, the University
of Rochester and now at the University of Pennsylvania.
It was while rowing in London when he was 27
that he noted a milky film develop across his right eye.
This disappeared but not long after he saw haloes with his right
eye. An acute attack of angle closure in his right eye brought
him to the famous Moorfields Eye Hospital in London. The
pressure was 40 mm Hg. Treatment with a laser to reduce
the pressure was not as relatively painless and problemfree as
it is today. In 1979 it was painful and did not work immediately.
He was placed on Timoptic and pilocarpine, which kept his pressure
in the mid-20s. Later that year he underwent a trabeculectomy
in his right eye. At that point he learned ocular massage,
which he still does daily. Not long thereafter a trabeculectomy
was done in his left eye. When his ophthalmologist in Rochester,
New York, heard he was moving to Philadelphia, he recommended
Dr. Spaeth. Now he is off medications, and his visual fields
are stable.
Says Dr. Medcalf: “I am pleased that I may be
able to use my medical research background and experience with
glaucoma to further the Foundation’s goals.”
Megan Brunner has worked for a financial
services company in Oaks, PA, for the past eight years.
About 10 years ago, when she was being treated for cornea and
other eye problems by Wills doctors Jonathan Belmont and Irving
Raber, they referred her to Dr. Marlene Moster for a glaucoma
evaluation. She was on eye drops for about six years before
she eventually had tube-shunt procedures in both eyes. Her
glaucoma has been under control for the last two years, but she
still classifies herself as having low vision — she is unable
to drive, and makes frequent use of a magnifying glass.
She states that she made a New Year’s resolution
to get involved with a charitable organization. Although
she now sees her glaucoma as a “nuisance,” making her job and
being mother of a two-year- old more difficult, she feels that
she is fortunate. She is looking forward to her work with
the Foundation Board: “I hope I can be of some help to others
struggling with glaucoma.”
In Perspective
The Challenge and Promise of Glaucoma Research
George L. Spaeth, MD
Each May the Association for
Research in Vision and Ophthalmology has its annual meeting.
This has grown from a get-together of research-minded ophthalmologists
and Ph.D.’s meeting in several small, simple hotels on a beach
in Sarasota to a meeting at which thousands and thousands of researchers
from around the world congregate at Ft. Lauderdale to present
the results of their studies, to discuss their findings with others,
and to learn what others are doing. There were hundreds
of presentations in the section dealing just with glaucoma.
That so much attention is
being focused on glaucoma is surely exciting news for all those
whose lives have been touched by it. At the same time, however,
one would think that with all the effort going on the problem
of glaucoma would long since have been solved.
Glaucoma: A Different Kind of Disease
This apparent paradox arises
perhaps because we tend to think of disease on the model of small-pox,
for example, a disease successfully eradicated by dedicated research.
But glaucoma is a dramatically
different kind of disease. Smallpox has a highly specific
cause, is easily recognizable, and affects only one species, the
human. Smallpox is caused by a virus related to a different
virus, which causes cowpox in cattle. The two viruses are
enough alike that when a human being is exposed to cowpox, that
individual develops the antibodies that will allow it to prevent
itself from getting smallpox if in the future it is exposed to
the smallpox virus. The World Health Organization recognized
that if virtually everybody in the world were vaccinated for smallpox
the number of individuals who would contract smallpox would become
so small that it might be possible that there would not be enough
individuals to infect other people. And indeed that is what
happened. A massive campaign across the entire planet to
vaccinate human beings to prevent them from contracting small-pox
brought magnificent results: smallpox as a disease
no longer existed.
“With effective
research, education, and medical systems, it is possible that
in the future no person would ever lose vision as a result of
glaucoma.”
Glaucoma is a very different
kind of disease, requiring a very different kind of research strategy.
In the first place, glaucoma is not a specific disease, but rather
a complex group of diseases affecting different tissues in different
ways with different causes and different treatments. Secondly,
none of the various kinds of glaucoma are caused by a virus, but
rather are most likely the result of genetic defects. The
only way to eliminate the pain and disability caused by smallpox
was to eliminate the disease entirely. This is not the case with
glaucoma.
Let us consider the mechanism
for one type of glaucoma, acute primary angle-closure glaucoma.
This condition is known to be related to a small front part of
the eye, and in almost all individuals can be prevented by performing
a peripheral iridotomy (making a small hole in the iris with a
laser). Performing a peripheral iridotomy on every person predisposed
to developing primary angle-closure glaucoma would almost completely
eliminate the disease in those individuals in whom the iridotomy
was performed.
Still, we cannot say that
we have eliminated angle-closure glaucoma in the way that smallpox
was eliminated. Individuals with small fronts of the eyes will
still pass on the predisposition to this type of glaucoma to the
next generation. However, what we have done, practically speaking,
may be nearly as good: we have the knowledge enabling us to eliminate
all of the disability and pain caused by angle-closure glaucoma.
Research Strategies
Angle-closure glaucoma is
only one of many, many types of glaucoma. Different strategies
need to be developed for each of them. Nevertheless, the
fact that most of the glaucomas involve the injury and potential
death of the ganglion cells of the retina suggests common, promising,
research strategies.
For example, much research
is being done on the nature of those ganglion cells and how they
can be protected. Very likely such research sooner or later
will bear good fruit, allowing many patients with many different
types of glaucoma to be helped. A longer-term and more complicated
strategy lies in genetics. In his article in this issue
of the Searchlight, Dr. Rhee talks about these and other research
approaches.
True, none of these strategies
will eliminate glaucoma in the way that smallpox was eliminated.
Glaucoma will probably be a part of human existence for as long
as there are humans. But with effective research, education,
and medical systems, it is possible that in the future no person
would ever lose vision or develop pain as a result of glaucoma.
That is worth working to achieve!
What's
Hot?
The New Phosphene Eye Pressure Monitor
Marlene R. Moster, MD
People
with glaucoma usually have an intraocular pressure (IOP) too high
for their eyes to tolerate, risking damage to the optic nerve
and eventual loss of vision. Lowering the pressure decreases
the risk of damage. Measuring intraocular pressure (IOP)
is crucial in the diagnosis and treatment of glaucoma.
All glaucoma patients are
familiar with the “pressure check” in which a drop of anesthetic
is placed on the eyeball and a device to measure the pressure
is placed directly on the eye. The gold standard for IOP
measurement is the Goldmann tonometer, which measures the force
required to flatten a small area of the central cornea.
The accuracy of the Goldmann tonometer is well established to
within 1 to 2 mm Hg.
The problem is that IOP tends
to vary throughout the day and night, and the pressure the doctor
measures in the office, maybe every month or even every week,
cannot reflect this variation. Until now the only way to
get a more accurate picture has been to have the patient spend
all day in the office, having the pressure checked at regular
intervals.
Measure Your Own Intraocular Pressure
Wouldn’t it be nice if patients
were able to measure their intraocular pressure at home as prescribed
by their doctor and report the results to him or her?
Enter the new Proview™
phosphene eye pressure monitor marketed by Bausch and Lomb,
scheduled to be released this summer. It’s portable and
requires no anesthetic or skilled technician. Invented by
Bernard Fresco, O.D., the instrument relies on a phenomenon known
as “phosphene,” recognized as long ago as by Aristotle in ancient
Greece. A phosphene is a sensation of light produced in
the eye by something other than light. You can easily observe
a phosphene caused by mechanical pressure by gently pressing with
your finger on the eyelid where it meets the nose. This
pressure phosphene typically appears as a bright central area
surrounded by a dark ring with an outer bright halo.
The Proview eye pressure
monitor is a pencillike device which contains a small flat probe,
an internal spring, and a readable pressure scale. The IOP
is measured through a half-closed eyelid by applying gentle pressure
with the monitor in the upper portion of the eye near the nose.
Because the IOP is measured through the lid it is painless and
requires no anesthesia. As soon as the patient sees his
or her pressure phosphene ring, the indentation is stopped and
the IOP can be read directly off the scale. The phosphene
eye pressure monitor never touches the eyeball directly, thus
reducing the chance of infection or injury to the eye.
How Does the Phosphene Eye Pressure Monitor
Compare?
Dr. Fresco reported the comparative
results of IOP measurements obtained in 100 patients by both the
phosphene eye pressure monitor and the Goldmann tonometer.
Impartial observers checked the IOPs, and the results obtained
by each observer were not shared with any other observer.
Dr. Fresco found that in 51% of the eyes the differences in the
pressures measured by the two devices were with-in ± 1 mm Hg of
each other, in 74.9% within ± 2 mm Hg, and in 90% within ± 3 mm
Hg.
Although the possibilities
introduced by this handheld device are exciting, many questions
remain. At Wills, we will be conducting a prospective study
to evaluate the device in terms of its accuracy, ease of use,
and compatibility with patients’ lifestyles during home use.
After gathering these data, we will be able to determine if indeed
the phosphene eye pressure monitor is “ready for prime time.”
Using the new Proview™ phosphene eye pressure monitor.
Photo courtesy of
Bausch and Lomb |
 Glaucoma
Treatment: On The Frontier
What’s New in Glaucoma Treatment?
Douglas J. Rhee, MD
Dr. Rhee will be the newest
member of the Glaucoma Service, when he arrives from the National
Institutes of Health in August. He is a Board-certified
ophthalmologist, glaucoma specialist, and molecular biologist.
In addition to caring for his patients, Dr. Rhee is developing
directed gene therapy for glaucoma and working to determine the
cause of primary open-angle glaucoma. His clinical research
interests involve studying the effects of blood flow to the optic
nerve. He is also scientifically analyzing alternative medicine
treatments for glaucoma.
In the news, there are so
many new and exciting developments in medicine. Every day,
there seem to be new advances in health care. What’s new
in glaucoma?
Over the last 12 months,
a number of new medications have been released for the treatment
of glaucoma. How new are these drugs? Most of them are updated
versions of older medications which may be a little more effective
with a slightly more favorable side effect profile than their
predecessors. These are all good things, but all of the
drugs, laser and incisional surgeries follow the same paradigm
of treatment we have used for the last 100 years — lower the intraocular
pressure (i.e., pressure inside the eye).
At this time, lowering intraocular
pressure is the only scientifically and clinically proven method
to slow the progression of glaucoma. Aside from lowering
intraocular pressure, there have been no other proven strategies
for the treatment of glaucoma. This is because the cause
of primary open-angle glaucoma is not known.
In the last decade, our understanding
of glaucoma has increased dramatically leading to the possibility
of new treatment strategies and possible cures. Most are
still in the laboratory testing phase and will not be available
for many years. However, one is closer than you think.
Memantine
Memantine (pronounced mem-an-
teen) is a medication which has been used for the treatment of
Parkinson’s disease. It does not lower intraocular pressure,
but has been experimentally shown to prevent optic nerve damage
from excitotoxicity.
Excitotoxicity has been shown
in experimental animals to be an important component of optic
nerve damage from glaucoma that is not dependent on intraocular
pressure. Memantine is now being tested in several selected
hospitals to see if it can help prevent further damage from glaucoma.
It has been used safely in people since the 1960s. If it
is proven effective, it will represent the first new treatment
strategy for glaucoma in the last 100 years. The Glaucoma
Service is one of the selected centers investigating memantine.
Dr. L. Jay Katz is spearheading our efforts but all of us are
participating in this effort.
Gene Therapy
What about gene therapy?
Many of you may have heard about the French researchers in the
late 1990s who were the first people to ever successfully treat
a human disease with gene therapy. They cured some patients
with SCIDS, Severe Combined Immune Deficiency Syndrome, an extremely
rare congenital disease of the immune system. (Some of you
may remember reading about children who had to live in a plastic
bubble because their immune system was so weak they would die
from the slightest infection.) What about using gene therapy for
glaucoma?
First of All, What Are Genes?
Genes are in your chromosomes
and are made up of DNA. Genes are in every cell of your
body and help determine what makes you, you. In conjunction
with the environment in which you live, genes determine your hair
and eye color, height, and likelihood that you will develop a
disease – like glaucoma. More than one gene is responsible
for most diseases, including glaucoma. This means that,
although glaucoma can run in families, a person will not necessarily
get it because one of his parents had it. Nevertheless,
people whose parents had glaucoma are at a much higher risk for
developing it and should certainly see an ophthalmologist.
What Is Gene Therapy?
Gene therapy refers to inserting
into the appropriate tissue a healthy copy of a defective gene
that will help diseased cells function better. When a disease
is caused by only one gene, it may be possible to insert a healthy
copy of the defective gene, once the gene responsible has been
identified, as in the case of SCIDS.
I am developing a novel delivery
system and approach to gene therapy for glaucoma. At this
stage, it is still in the laboratory phase of testing, but has
shown great promise. I am hopeful that it will one day be
a cure for glaucoma.
How Patients Can Help
-
Is there anything you
the patient can do to help? You can volunteer to participate
in a research trial. Some trials simply take extra measurements
of your eye. Some trials involve trying a new medication.
When thinking about participating in a new medication trial,
you should understand that years of research have been performed
to assure the safety of new medications.
-
You can donate money towards
the research efforts of the Wills Glaucoma Service.
Research costs a lot of money in terms of materials, laboratory
space, and personnel. Even the
smallest donation helps.
-
Some of our patients have
elected to give us the most precious gift of all, by donating
their eyes to Wills after they pass away. Without their
donation, our research efforts would be greatly impeded.
Ways to Help Meet
the Challenge of Glaucoma
Gifts in Memory of Loved Ones
Joseph Leive, Director of Development,
Wills Eye Hospital
Many friends of the Glaucoma
Service Foundation often ask what they can do to support our work.
Besides contributing to the Annual Fund, many individuals have
found that making a memorial contribution in the name of a loved
one can be a very meaningful gesture.
Memorial gifts honor the
memory of someone you care about and also provide the Foundation
with support for its work in research, education, and patient
care.
 Here’s
how a memorial contribution can be made. Please make a check
payable to the Glaucoma Service Foundation in any amount and tell
us the name of the individual you are choosing to memorialize.
Please provide us, as well, with the name(s) and address(es) of
that individual’s next of kin. We will let the family know
that you have made a memorial gift in their loved one’s name (we
do not tell them the amount of your contribution).
Many families are deeply
appreciative that such gifts are made at a time of loss.
Please call the Foundation office at 215-503-2986 if you would
like additional information.
Share Your
Experiences with Other Searchlight Readers
Do you have a story about dealing with glaucoma
that might be helpful or inspiring to others? Have you discovered
ways of coping with everyday problems resulting from your glaucoma
that others might find useful? The Searchlight wants
to be a forum for glaucoma patients to speak to each other.
If you have something to say but need help writing it, let us
know and we will work with you.
Searchlight
Readers Ask
Link Between Glaucoma and Migraine
Headaches?
Judi Holmes of Terry, Montana,
writes:
“I’d like to know if there is any link between glaucoma
and migraine headaches.”
Dr. Spaeth answers:
The answer to that is a qualified
“yes.” Quite a few years ago a rheumatologist and an ophthalmologist
at the University of Iowa noted that there was an increased incidence
of a certain type of glaucoma in some patients who had migraine
headaches. That observation has been confirmed by others.
In a study we did, we also found that a certain type of glaucoma
that we first described, so-called “focal glaucoma,” in which
the optic nerve becomes damaged in a very specific area, appears
to occur more frequently in individuals who have migraine than
in individuals who do not have migraine. This particular
type of glaucoma affects women about three times as often as men,
and is usually seen in people who have relatively low intraocular
pressures. Consequently, it is one of the so-called “low-tension
glaucomas.”
Because of this apparent
association between migraine and glaucoma, a considerable amount
of research has been done to see if understanding the mechanisms
for migraine would shed light on the mechanisms for glaucoma.
Spasm of the blood vessels was considered a possible common mechanism.
However, this line of research has not been particularly fruitful.
Nevertheless, there is continuing investigation to learn more
about this intriguing relationship.
For the moment, migraine
should be considered a minor risk factor for the development of
glaucoma.
Chat Room Praised
The Foundation Web site recently received the following
e-mail:
Hi,
I’m Helen Russell, 36 years old, from Sydney, Australia.
Thank You, Thank You, Thank You, for your
web site.
On Wednesday, May 2, I was diagnosed with
Chronic Narrow-Angle Glaucoma after going to see the specialist
about my dry eyes. (I am adopted and had no way of knowing my
family history.) A provocative test for Glaucoma saw my
pressures go from 11 to 21, and I also had evidence of a weakened
corneal lining.
I walked out of the rooms in shock and by
the time my brain was working it was the weekend. I started
searching the web for information and came across your wonderful
site. Your site answered a lot of my questions, which
I rediscussed with my specialist on Tuesday, May 8. What
was so wonderful about your site is that it taught me about
my condition when I came out of the shock/ denial stage.
I could then ask my specialist intelligent questions and not
waste his time looking for standard information.
A peripheral iridotomy was performed on both
eyes (May 11 and May 18) and plugs inserted in my tear ducts.
To my delight the digital clock and the microwave
oven clock no longer ‘glows’ at night, another surprise that
this was not ‘normal’.
Once again, thank you.
Helen Russell
View from the Boardroom
Glaucoma Research at Wills Eye Hospital
S. Stoney Simons
Mr.
Simons has been the Chairman of the Glaucoma Service Foundation
Board since 1997. He brings to the Foundation a background
of 20 years’ leadership experience at SmithKline Beecham in marketing,
research and development, service on a variety of Boards, including
those of Chestnut Hill Hospital and Fox Chase Cancer Center, and
key positions in health consultancy, insurance, and banking.
For generations the Wills
Eye Hospital has been a world-class institution whose physicians
have provided the best compassionate care for patients and have
trained succeeding generations of physicians to treat local and
international patients.
More recently, the physicians
of the Glaucoma Service have recognized that even greater benefits
to a greater number of patients can be achieved through organized
clinical research, that is, by organizing, combining, and analyzing
the findings of many physicians. The results are impressive.
Just as impressive, they are being widely shared with clinicians
and researchers through publications, conference presentations,
and through the Glaucoma Service Web site, reaching physicians
and patients near and far.
Practical Information for the Glaucoma Patient
Tips for Using Eye Drops
Jeffrey Henderer, MD
Physicians
commonly treat disease with medications, and glaucoma specialists
are no exception. One of the mainstays of treatment is medication
designed to lower eye pressure. Unfortunately, this can
be easier said than done. Despite studies showing that patients
frequently do not use glaucoma eye drops as instructed, little
attention has been paid to improve this problem. One reason
may be that the patient forgets. Another may be that the
drops are too difficult to get into the eye. This article
will offer tips to overcome these problems.
Hints for Remembering
Forgetting drops is a common problem.
Generally, the more drops per day, the more chance of forgetting.
Fortunately, most glaucoma drops are used twice a day, although
some are used three or four times, and some are used just once.
How should one remember when to use the drops?
First, make a schedule and post it in a prominent
place like the refrigerator door. Check off each drop as
the day progresses. Second, attach the bottle of once-a-day
medication to your toothbrush with a rubber band. This makes
taking the prescribed drops easier to remember in the morning
or at night . You can place twice-a-day medications near
food that you will eat for breakfast and dinner — even in the
refrigerator. This will space the doses about 12 hours apart.
Three-times-a-day drops should be used once
in the early morning, once in the early to midafternoon and once
in the mid to late evening. Very often the afternoon dose
is the hardest to remember. Placing the bottle in your lunchbox
might be a helpful prompt. Placing it on your desk at work might
be an option, or in a jacket pocket or purse. Just be careful
that the bottle does not get too hot, however.
Four-times-a-day drops are most often given
only during waking hours. Often this means with meals and
at bedtime. After glaucoma surgery, some drops are given
up to eight times a day. This should usually be interpreted
as with meals, between meals and at bedtime unless your doctor
tells you otherwise.
What should you do if you miss a drop?
If it is not too long after you were supposed to put it in, go
ahead and do so. If you missed a dose completely, do not
panic. Just put the next drop in as normal.
Hints for Getting Drops in the Eye
Once you remember to use the medicine, you must
still get the drop in your eye. This can be a complicated
task, especially for those with arthritis. The best way to put
the drops in is to have someone else do it for you.
If that is not an option, I tell patients about
a technique that I learned from Dr. Paul Palmberg at the Bascom
Palmer Eye Institute in Miami. To place a drop in your right
eye, hold the bottle between your left thumb and first finger
with the tip pointing down. Take your right hand and curl
your fingers halfway toward your palm to make a “C.” Tip
your head back, and use the tips of the fingers of your right
hand to pull your right lower eyelid down. Then rest the
heel of your left hand on the back of your right hand. The
bottle should be positioned above your eye, pointing down.
Squeeze the bottle gently and let the drop fall into your eye.
One drop is sufficient.
If you keep the medication in the refrigerator,
the coolness of the drop will let you know that you got it into
your eye. More than likely, some of the drop will run down
your cheek. This is normal and does not mean that you “missed”
or that you need another drop.
After putting in the drop, it is generally a
good idea to close your eye for a couple minutes while putting
pressure on the inner corner of your eye against your nose.
This will close the tear duct and both maximize the drops’ absorption
into the eye and minimize the absorption into the rest of your
body.
Side Effects
If you believe that the drops are causing you
a problem, call your doctor right away. Both your eye doctor
and your regular medical doctor should be aware of all medicines
you are taking. Eye medications have a wide variety of side
effects that can affect both the eye and your body. Be on
the alert for problems of burning, redness, blurred vision, fatigue,
sleepiness, trouble breathing and any aches and pains. All
these problems, and more, can be the result of the drops. If your
have any problems, stop the drop! Call your eye doctor and
discuss the situation.
Even if you are having no side effects, make
sure you talk about the drops when you see your doctor. Items
to discuss include any changes to your oral medications and unusual
or new problems with your eyes. Mention if you are having
difficulty putting the drops in your eye. Be honest about how
often you use the drops. If you just can’t remember to use them,
another form of treatment may be better.
Medication is one of the mainstays of glaucoma
treatment. These tips will hopefully make it easier to use
correctly to maximize its benefits.
What’s Up, Doc?
News from the Glaucoma Staff
Jonathan Myers, MD
-
One source of excitement for the physicians
on the Glaucoma Service is the release a couple of months
ago of the two new anti-glaucoma medications, Lumigan (bimatoprost)
(Allergan) and Travatan (travoprost) (Alcon). These
two new medications have both proven to be very effective
in clinical trials and our clinicians have been anxious to
get a chance to try them for their patients. Although
it is still quite early, several of the staff have noted positive
experiences with these agents, with some patients achieving
significantly lower pressures.
-
Many of the staff were able to attend the
annual meeting of the American Glaucoma Society (AGS) in April.
Several presented results from recent research and everyone
enjoyed seeing Dr. Spaeth recognized as “Honored Guest” for
his enormous contributions to the field of glaucoma, including
being the first President of the Society.
-
Most staff members also attended the annual
meeting of the Association for Research in Vision and Ophthalmology
(ARVO) in May. Glaucoma Service clinicians and fellows presented
nine posters. New thoughts on neuroprotection, optic
nerve imaging, genetics, and surgery were some of the myriad
subjects presented at the conference. This exciting
but nearly overwhelming event each year allows the Wills staff
and research and clinical fellows to present and discuss their
recent findings with those of other researchers and clinicians
throughout the world.
-
The Service enjoyed one of Glaucoma Service
Research Center Director Dr. William Steinmann’s regular visits
in June. During these bimonthly visits from his main
office at Tulane he spends three days meeting with the physicians
and research staff to assess current projects and to plan
for the future. Currently on the docket is coordination
of research and clinical pursuits in the new Wills facility.
The new facility’s steel skeleton is now in place, stretching
eight floors up from the Walnut Towers building, across Ninth
Street from the current Wills Eye Hospital. Scheduled
to open in July of 2002, the new facility promises great opportunities
or improvement and expansion of the mission of the Glaucoma
Service: world-class clinical care, teaching, and
research.
Sponsored by:
Glaucoma Service
To Prevent Blindness
900 Walnut Street
Philadelphia, PA 19107
|
Introducing Our
Support Group for Parents of Children
with Glaucoma
Sunday, September 30th, 2001
Wills Eye Hospital 1st Floor Auditorium
1:30 PM to 3:30 PM
An Overview of Glaucoma in Children
By: Dr. Courtland Schmidt
Childcare is available. Please
call the Foundation office before September 28th to let us
know how many children you will be bringing with you and their
ages. We will have an appropriate number of chaperones. Thank
you for your consideration. |
Glaucoma Patient Support Group
The first meeting of the 6th season of the Glaucoma
Patient Support Group will take place Sunday, October 21, 2001,
from 1:30 to 3:00 PM in the Wills Eye Hospital auditorium on the
1st floor of the Hospital. Dr. Jeffrey Henderer of the Glaucoma
Service will speak about visual field examinations — the
latest techniques, what the results mean and do not mean, and
important points to remember when taking the test. As always,
there will be plenty of time for questions and answers on all
topics related to glaucoma. The monthly sessions are free, with
light refreshments served.
On Sunday, November 18, again from 1:30 to
3:00 PM, new Wills Glaucoma Service staff member Dr. Douglas Rhee
will continue the series speaking about what glaucoma patients
should know about genes and glaucoma.
The program for the rest of the season will
appear in the next Searchlight
in November.
Dr. Wilson Discusses “Living with Glaucoma”
with Chat Support Group
On Wednesday, June 13, Dr.
Richard Wilson of the Glaucoma Service staff discussed “Living
with Glaucoma” with the Chat Support Group. Here are some
highlights from that session:
Dr. Rick Wilson: You all
are the experts on this topic. Everyone please chime in
and give advice about what works best for you.
Participant (P): Asking
questions, and not stopping until I get an answer I understand!
P: Good point. But
I get upset when I hear other glaucoma patients saying their doctor
didn’t explain things to them. I say, then get an answer
you can understand.
Dr. Wilson: I agree. I would
like family there for important discussions. It is too easy
for the patient to focus in on one point and hear nothing thereafter.
Moderator: Dr. Wilson,
do most of your patients come with someone or do they come alone
to your office?
Dr. Wilson: Probably 30
to 40% bring someone.
Moderator: I try to take
someone with me anytime I see the eye doctor, even if it is a
routine visit. Sometimes two people hear two different things.
P: I am very disciplined
about taking my drops (Alphagan twice a day and Xalatan once a
day). But sometimes it seems so futile. Nothing seems
to have any effect.
Dr. Wilson: I spoke about that in
a lecture I gave Friday in San Francisco. It is hard to
remember to take medications when you won’t see the results of
not taking them for months to years. My wife would do terribly
with that scenario. She takes medicine as long as she feels
terrible. As soon as she feels better, she forgets to take
the medication.
P: When I was first diagnosed,
I thought for sure I would go blind. But over the years,
as Dr. Wilson said, most patients do not.
Dr. Wilson: Keep a positive
attitude, because the majority of vision lost to glaucoma occurs
before the patients see the eye doctor, and are diagnosed and
treated. Once treated, most patients suffer only slow deterioration
over long periods and die with close to the vision they had at
the time of diagnosis. Exercise, eat right, stop smoking,
lose weight and keep yourself in as good health as possible.
It makes a huge difference in the long-term prognosis, especially
in patients as they age.
P: Dr. Wilson, this site,
and those who contribute to it, have helped to reassure me that
this mystery of glaucoma and the non-specific treatment regimes
are the best that I can do. It keeps me from lying awake
at night thinking I should be trying some magic elixir.
P: After more than 30 years
on drops, a detached retina, a couple of trabeculectomies in both
eyes, needling, blood injections, Holmium laser, and cataracts
removed from both eyes, I am now off drops because I followed
my doctor’s instructions. I didn’t fight it. I am
not out of the woods yet, as the pressure in the left eye has
dropped to five.
Dr. Wilson: Nice going. But
what a struggle!
Chat Support Group
willsglaucoma.org/support
Wednesdays 8:30 - 9:30 pm
Hosted by a Glaucoma specialist.
Mondays 8:00 - 9:30 pm
Wednesdays 8:00 - 8:30 pm
Saturdays 10:00 am
Sundays 9:00 pm
Patient and family members only.
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