Volume 13, Number 3
December 2004
How Does Having Glaucoma Affect Quality
of Life?
Ken Parker, PhD
Dr. George Spaeth has been studying the effects
of glaucoma on patients’ quality of life for some time.
His thinking is that if doctors had a more specific understanding
of just what these effects are they could better help their glaucoma
patients. I asked Dr. Spaeth some questions to elicit his views
on this issue.
What does “quality of life” mean?
Dr. Spaeth: Basically, when we talk about a person’s
“quality of life” we’re talking about that person’s
“health” in the broadest sense — his physical,
emotional, and spiritual well-being. “Quality of life”
captures something more extensive and wideranging than what we
usually think of as “health.” For example, the fact
that a person has just had a thorough physical examination and
been pronounced “100% healthy” does not necessarily
mean that his “quality of life” is better than someone
whose health has been judged less than perfect.
Why are you, as a glaucoma specialist, interested in something
as broad as your patients’ quality of life? Shouldn’t
you be focusing on lowering their intraocular pressure, for example?
Dr. Spaeth: I believe our ultimate goal as physicians
is to restore, maintain or enhance health or quality of life.
If I think that helping a particular patient lower her intraocular
pressure will likely improve her quality of life I will try to
help her do that. But lowering a patient’s intraocular pressure
doesn’t automatically assure an improvement in the quality
of life of a glaucoma patient. The side effects of some eye drops,
for example, may decrease a person’s quality of life without
guaranteeing that her glaucoma will not get worse.
What does it mean, then, to say that you are studying
quality of life, for example, in glaucoma patients?
Dr. Spaeth: What we are pursuing is an objective,
valid, reproducible way of measuring quality of life. We know
that having glaucoma decreases a person’s quality of life.
Just being informed that you have glaucoma decreases your quality
of life. What we don’t know is exactly how having glaucoma
of varying levels of severity affects people’s ability to
carry on the tasks of daily living and therefore their quality
of life. If we don’t have a way of validly measuring a patient’s
quality of life and how it is affected by our treatments, we cannot
be sure whether or not we are achieving our goal as physicians
— to restore, maintain or enhance quality of life.
How do you measure something as seemingly
abstract and elusive as quality of life?
That is a problem. Three general approaches
have been tried.
Objective Approaches
If we don’t have a way of validly
measuring a patient’s quality of life and how it is
affected by our treatments, we cannot be sure whether or not
we are achieving our goal as physicians — to restore,
maintain or enhance quality of life.
The most common is based on things we can measure
relatively easily: visual acuity and intraocular pressure, for
example. More difficult to measure, but still objective, is the
extent to which the optic nerve in a glaucoma patient has deteriorated.
Visual field testing, although it has a strong subjective component
— it depends on a person’s response — is also
basically an objective measure.
The extent to which measurements of these things
allow us to estimate a person’s quality of life is of course
quite variable. If a person’s distance vision is not too
bad and can be corrected with glasses, this visual limitation
may not affect his quality of life very much at all. However,
if visual field testing reveals that a person cannot see in various
areas in which a normal person can, it is questionable that that
person can safely drive a car.
And not being able to drive in our society very
often means a substantial reduction in quality of life. Still,
if a person does not drive and does not need to drive, visual
field limitations may not affect his quality of life to a great
degree.
Even more indirect in determining a person’s
quality of life are measurements of intraocular pressure and the
health of a person’s optic nerve. Absent other factors,
knowing a person’s intraocular pressure — unless it
is truly extremely high or low — practically speaking tells
us nothing about a person’s quality of life. Again, unless
extreme, it is difficult to say how much a certain amount of damage
to the optic nerve may affect a person’s quality of life.
In brief, none of these and other objective clinical measures
related to vision are necessarily good predictors of a person’s
ability to perform vision-related functions. They are even poorer
predictors of a person’s quality of life. This is largely
because they cannot take into account people’s own perceptions
of their abilities and disabilities and their values — what
is of most importance to them.
Subjective Approaches
The second approach to measuring quality tries
to do just that, that is, consider the person’s own perceptions
of what he can and cannot do and how he perceives those limitations
as affecting his life. Based on the assumption that how a person
perceives his ability to function and his satisfaction with his
life are important aspects in assessing a person’s quality
of life, a variety of tools to measure these perceptions have
been developed. These are usually in the form of questionnaires,
basically extensions of the crucial question of the doctor to
the patient: “How are you?” In the same way that using
objective measurements to infer quality of life is limited by
the fact that doing so ignores a person’s own perception
of what he can or cannot do and how he feels about his life, answers
to questions on a questionnaire by definition lack objectivity.
Just because a person says that he has no trouble recognizing
friends on the street does not necessarily mean that a person
actually observing him would come to the same conclusion. Another
example is the results of a scientific survey of drivers in which
over 80% said they thought they were better-thanaverage drivers.
Performance-Based Approach
A third approach to measuring vision-related
quality of life is evaluation of measures based on observation
of patients actually doing things that require visual input. These
are referred to as “performancebased” measures.
We have developed a test, “Assessment
of Function Related to Vision” (AFREV), to assess actual
functional ability of people with various eye conditions. This
consists of a battery of performance-based tests designed to assess
a person’s ability to perform daily routine tasks such as
dialing a phone, opening a lock, reading, etc. Rather than relying
on tests for visual acuity, etc., or people’s opinions about
their abilities, to guess how well they should be able perform
such tasks, a person asks them actually to perform the tasks and
then observes them to see just how well they actually do.
What quality-of-life studies are you
involved with now?
Dr. Spaeth: We have one under
way and another one for which we are seeking funding. The one
we’re currently working on is an evaluation of how psychological
aspects of patients or their personalities affect their quality
of life related to vision. For example, consider two patients
with cataracts. One is an upbeat, adaptable person, whereas the
other is a pessimist and complainer. An eye examination shows
that both have a visual acuity of 20/80 with mild limitation of
visual field due to moderate cataract. However, when each patient
is asked to provide an assessment of his quality of life, the
results are dramatically different. The former person considers
himself to have a superb quality of life and the latter one views
his life as totally miserable.
In a study for which we are seeking funding,
we will extend our AFREV test to include the full range of the
most common types and amounts of visual disability: glaucoma,
cataract, macular degeneration, diabetes, and refractive error.
We hope to provide for the first time an objective measure of
how the most common eye diseases actually affect people’s
lives. We believe such a measure will make it possible to monitor
the course of eye diseases and the effects of treatments with
regard to what really counts, specifically, actual performance.
It will also provide a reliable guide for those charged with deciding
how to employ or compensate individuals with visual disability.
None of these clinical measures related
to vision are necessarily good predictors of a person’s
ability to perform vision-related functions. They are even poorer
predictors of a person’s quality of life.
Visiting ophthalmologist from
Buenos Aires, Dr. Jorge Lynch, observes Dr. George Spaeth in the
operating room. Notes Dr. Lynch: “The time I have spent
with Dr. Spaeth has been important to me in coming to understand
his practical approach and the importance of considering the patient
as a whole person and not only the glaucoma itself.”
Photo by Roger Barone
Glaucoma Specialists of the Future Train
on the Glaucoma Service
Dr. Chandrasekaran (“Dru”) Krishnan
received his BA in Biological Basis of Behavior from the University
of Pennsylvania and took his medical degree from Case Western
Reserve University. Following an internship at Chestnut Hill Hospital
in Philadelphia, he completed an ophthalmological residency at
the New England Eye Center in Boston.
His specific interest in glaucoma is rooted
in his motivation for entering the field of medicine — namely,
it offers an opportunity to develop relationships with people
and at the same time help maintain or improve the quality of their
lives: “The practice of glaucoma fits into this scheme well:
proper treatment can prevent blindness, and the long-term nature
of the disease promotes longterm doctor-patient relationships.
Recent advances have changed the diagnosis and treatment of glaucoma,
and new technologies are redefining the disorder itself. This
ever-changing atmosphere ensures that the diagnosis and treatment
of glaucoma will always provide intellectual stimulation.”
Dr. Grace Lee graduated magna cum laude from
the University of California at Los Angeles with a BS in Biology,
and received her medical degree at the University of California,
Irvine. Following an internship at the California Pacific Medical
Center in San Francisco, Dr. Lee completed an ophthalmology residency
at the Edward S. Harkness Eye Institute at Columbia University
in New York.
“I am excited about a fellowship in glaucoma
from a professional, scientific, and social perspective. Specifically,
I am interested in developing the skills necessary to properly
diagnose glaucoma and suggest effective medical and surgical treatments.
In addition, given that the understanding of glaucoma is in its
infancy, I am looking forward to participating actively in clinical
research.
Finally, as this insidious disease
increases in our aging population,
I know that the clinical and
research skills I develop on the
Glaucoma Service will allow me
to better serve the community.”
Dr. Marc Mydlarski received his
BSc in Anatomical Sciences
from McGill University in
Montreal, Canada, his medical
degree from the University of
Alberta in Edmonton, and a PhD
in Neurology and Neurosurgery
from McGill. Following an
internship at the Sir Mortimer B.
Davis Jewish General Hospital,
McGill University, he completed
his residency in ophthalmology
at McGill.
Dr. Mydlarski has an extensive background in
basic research that informs his current research interest: the
role of free radicals in ophthalmic disease. “During my
second-year ophthalmology course, my knowledge of normal and disturbed
astrocyte biology, free radicals, stress proteins, and the aging
nervous system inspired me to consider the various disease processes
affecting the eye in general, and the retina and optic nerve in
particular.” In 2002 and 2004 he was awarded the Best Clinical
Research Prize at McGill for his work on the expression of heme
oxygenase-1 in the aging human eye.
“I look forward to acquiring the necessary
knowledge, clinical acumen and surgical skills to be a competent,
comprehensive, confident and compassionate glaucoma specialist.
I find that the clinical practice of glaucoma is both challenging
and intellectually stimulating. It provides the specialist a wealth
of opportunities to develop expertise in diagnostics, medicine
and surgery. The diversity of patients and the potential to employ
cutting-edge, hightech equipment in their care, appeal to me.
I believe that my experience as a fellow on the Glaucoma Service
at Wills Eye Hospital is definitely helping me to achieve these
goals.”
Glaucoma Fellow Dr. Dru Krishnan
(left) in the operating room with Dr. George Spaeth.
Photo by Roger Barone
Glaucoma Service fellow Dr.
Dru Krishnan (right) with Claudene Thompson, medical receptionist
for the private practice of Drs. Spaeth, Katz, Myers, and Rhee.
Photo by Ken Parker, PhD
Glaucoma Service fellow Dr.
Grace Lee (left) works with Dr. Jonathan Myers.
Photo by Ken Parker, PhD
Glaucoma Service fellow Dr.
Marc Mydlarski (left) works with Dr. Marlene Moster (right) to
help Dr. Moster’s patient, Eva Dandridge.
Photo by Ken Parker, PhD
Glaucoma Service faculty and
fellows at Friday glaucoma rounds. (left to right) Glaucoma Fellow
Dr. Dru Krishnan, Research Fellow Dr. Undraa Altangerel, Glaucoma
Fellow Dr. Grace Lee, Glaucoma Service faculty members Dr. Douglas
Rhee and Dr. L. Jay Katz.
Photo by Ken Parker, PhD
Dr. Marc Mydlarski answers
questions following his presentation at glaucoma rounds on glaucoma
and the aging process.
Photo by Ken Parker, PhD
Glaucoma Fellow Dr. Dru Krishnan Wins Pfizer
Award
Glaucoma Fellow Dr. Dru Krishnan received one
of ten Pfizer Glaucoma Fellowship Awards for his proposed project,
“Changes in Multifocal Visually Evoked Potentials (VEP)
after Acute Lowering of Intraocular Pressure.” According
to Joel Fain, PhD, Senior Manager and Regional Medical & Research
Specialist for Pfizer Ophthalmics, 38 applications for the Awards
were received.
Multifocal VEP testing offers a sensitive and specific way to
determine if a patient’s glaucoma is being controlled. Unlike
standard visual field testing in which patients click a button
each time they see a light flash, multifocal VEP testing requires
only that patients stare at a pattern on a computer monitor. Thus,
multifocal VEP testing is particularly useful in patients who
cannot perform a standard visual field test.
 Joe
Grande, a technician with the private practice of Drs. Spaeth,
Katz, Myers, and Rhee, works with a multifocal visual evoked potential
instrument (Accumap, ObjectiVision, Sydney, Australia). The instrument
is used for detecting defects of the retina-to-brain nerve pathway.
These defects may help to pinpoint optic nerve problems in glaucoma
patients, problems which the patient ordinarily would not be aware
of in day-to-day life. The person being tested, with electrodes
placed on the head, stares at shifting squares on a monitor (such
as those shown on the monitor to the left in this photo). Watching
these images causes electrical impulses to travel from the optic
nerve to the brain. The computerized device then measures the
time it takes for these electrical impulses to reach the brain.
Abnormally short or long times suggest possible defects in the
retinato- brain nerve pathway.
Photo by Ken Parker
Unsung Heroes in Meeting the Challenge
of Glaucoma
When we think about all those individuals who are working to
meet the challenge of glaucoma — doctors, researchers, and
those who support research and education about glaucoma —
we may forget to consider some very important people who contribute
enormously to the effort: friends and family members of glaucoma
patients. As can be gleaned from the following “chat”
that took place on the Foundation website September 1st, the individuals
who are “there for” those living with glaucoma, play
an indispensable role in improving their quality of life.
V: The topic tonight concerns our
main sources of support. We have no doctor here tonight, but some of
us have our main support person sitting beside us or at another
computer.
K: I am here, on my own computer,
as V's main support person. However, I think this group
provides her with as much support as I do.
N: My husband is on the other computer,
working on genealogy. He calls himself my seeing-eye dog.
MY: I will see if I can get my husband to
come in here. He provides foot-and-shoulder rubs for me.
P: Hello, everyone. I'm MH's
husband and main glaucoma helpmate.
V: Do those of you providing
support find that you often need to remind your GlaucoMate to
take medication, and make and keep appointments?
K: My role
definitely includes reminders and encouragement to use the eyedrops,
as well as reminders that needing to wear dark glasses isn't such
a bad thing.
V: I just don't like people
wondering why I have dark shades on when it is raining.
It looks funny.
V: How much do you support people
tell others about your GlaucoMates' glaucoma? Do you consult
with your GlaucoMate first about how much information they want
known?
P: How much should a supporter tell
friends who ask about a GlaucoMate's glaucoma? It's often
awkward, because I don't want to feel that MH's a topic of gossip.
K: I really only discuss with
others what V wants others to know.
MY: You know how parents like to
compare notes on things, like illnesses and treatments?
Well, if your child is over age 18, that's invading their privacy.
That's all I have to say about that subject.
MNN: I always hated it when my
family told too much when I was a child.
P: I try to give a brief answer, and
encourage friends and family to talk to her directly.
ND: I think that most of the time people
ask just to be polite. They really don't expect to hear
many details.
V: I think it is important to
tell family members because of the risk factor.
T: Yes. I persuaded two family
members to have eye examinations.
V: My brother has never even
seen an eye doctor!
MY: I guess I tell my husband the
minimum that he would understand, so he doesn't have much to pass
on to others. My niece (the only blood link on my side)
and my kids know about my glaucoma.
N: Glaucoma has been in my family
for four generations. So the questions are, "How is your
intraocular pressure?" Or "What did the doctor say?"
PG: In my case, it's important
that my kids understand that my glaucoma is secondary, not inherited.
MY: I finally got my brother to
get his eyes checked. I am informed about my mother's
age-related eye problem, which is not glaucoma.
S: I don't broadcast that I have
glaucoma. If I am asked, I say, "It's under control."
MY: When my husband and I first learned I had
glaucoma, it was scary. We were both thinking I was going to go
blind. Then as I learned more, I shared it with him. He has been
pretty short-fused when it comes to my having to cope with side effects from
drops. He wants me to demand the doctor give me drops with no side
effects, but are still effective, which is not necessarily
realistic.
K: As the healthy partner, it's
difficult sometimes for me to deal with all the problems that
go along with V's glaucoma. It's difficult because it's
her illness and I have to go by her "rules."
T: I find that keeping my family
up to date about my glaucoma helps allay their fears.
J: I still call family members
more than they call me, but if things got serious, I know
they would be there for me. They live in a different state,
but I would be welcome.
P: For me, the challenge as a supporter
is that sometimes I have more need to talk about MH's glaucoma
than she does. Talking about it helps me feel better, and
gives me ideas about how to help her more. But she only
wants certain people to know, especially if things aren't going
well.
V: Do you support people go
along on visits to the doctor?
PG: Mine does, and he takes notes.
SS: Once I became
involved and went with MNN to every appointment, I understood
all the little things that upset her between appointments and
had created stress for both of us.
K: I try to go along on most visits, but I
work full time, and can't always get off work.
MY: My husband went with me at first,
until I became more informed about glaucoma.
N: What bugs me is family members
on the non-glaucoma side who have no medical knowledge and say
things like, "Do you think it was something you ate?" or, "If
you take this vitamin you will get better." I have to tell
them that when the optic nerve is gone, it's gone.
SS: As far as the fear, I try to
make sure I do not make light of it. What may seem minor
to me does not make it minor to MNN. So I just try to empower
her, and try to help carry the load emotionally.
P: When I go with MH to the doctor I
often take along a list of questions and information I've
found. I take notes and do the driving for MH.
N: Since I no longer
drive, my husband takes me to the doctor and often asks questions,
too.
K: Taking notes is a good idea.
V and I always hear different things.
V: That is so true. K
hears one thing; I hear another.
MY: I have had no major surgical
procedures and no big problems, so my care is pretty easy.
I get support from this group and I can e-mail my glaucoma specialist.
PG: The day I was diagnosed was
tough. "B" was with me and we both left pretty shell shocked.
SS: I do not like MNN going to the
doctor without me. Although she is a strong woman, the people
in the office have learned what not to do when I am around.
V: I like someone to be there
with me in the doctor's office, but will go alone. I do
need to know someone is a phone call away -- just in case.
K: There have been many scary
times for us.
ND: My husband has always gone with
me to doctor visits. He writes down IOPs, and other important
information. He has helped find information in the literature
ever since my glaucoma was discovered in 1988. He's well
informed. I would have had a much more difficult time without
him. I am fiercely independent, but welcome his advice and
knowledge.
K: One of the times when V's
intraocular pressure was quite high and the doctors couldn't
bring it down, she was in incredible pain. That was difficult
for me to witness.
MR: You are all so lucky to
have supporters!
ND: I feel sorry for glaucoma patients
who have had relationships and marriages end, because the partner
could not cope with the other person's glaucoma problems.
V: Yes, it's sad. I know
of at least two.
MH: Lying in the operating room,
thinking of everyone who was thinking about me, and loving me,
was a great moment. Strangely enough, I felt great under
such circumstances.
MNN: Next time, I want whatever
drugs you had!
MNN: I don't know if I would have
made it through my surgery without my main supporter.
V: When my left eye was sick
I didn't have this chat support group. When I had problems
with the right eye, having you guys made a big difference.
ND: Do any of you belong to local glaucoma
support groups? I don't.
N: No.
V: No.
MY: Why would I need one? I've got
you guys!
SS: No.
T: This is the only support group
I belong to.
MNN: No.
MR: Is there such a thing?
J: One of my supporters was the
glaucoma specialist.
SS: I feel as though I'm part of
this support group. I hear all of your names every week.
PG: No.
MY: I just want to say that although
I don't have a severe case of glaucoma, when you have dealt with
a life-threatening disease, that really puts glaucoma in perspective.
MY: When I hear some of the more
emotional newbies saying they would rather die than have glaucoma,
I have to shake my head. With great support, it is not so bad.
There are worse things.
MNN: But it is a life sentence.
MY: A life sentence, but a life,
not a death, sentence. Big difference when you really have to
face something serious that can kill you.
ND: One of my favorite quotations
is, "What does not destroy me makes me stronger." (Nietzsche)
MY: That is my hubby's theme song.
It's his way of saying, "Suck it up and get past it already.
Move on!"
MNN: Those with serious complications
live with chronic pain and often feel like they are being tortured.
It can be a lot, psychologically, to bear.
NT: It's hard to give up driving.
I haven't driven in seven months, and have adjusted to it.
Fortunately, my hubby is very supportive.
V: How many of you get support
from your doctors?
ME: I do.
MY: My doc is pretty supportive,
but a couple of times he hurt my feelings. That was hard.
K: I think V has a very supportive
doc, but she does not agree with him sometimes.
PG: No! My doctor is a great
surgeon, but is very abrupt, bordering on rude.
ND: Most busy eye docs these days have
only limited time to spend with a patient, so the doctor-patient
relationship is often not what it should and could be.
SS: They only have limited time,
if you let them get away with it. I won't let them leave
the room until MNN has all her questions answered. If I
let him out too soon, then I have to answer questions on the four-hour
ride home.
SBC: My doctor is supportive.
He knows when to listen, and goes along with my requests.
MH: Mine gave me his personal cell
phone number in the midst of a crisis, and said call at ANY time.
PG: My doctor told me that if I
got into trouble to go to the emergency room or see a general
ophthalmologist. He never mentioned calling him.
MJ: Good evening, everyone. This
is my first time in the chat room. I am 29 years old
and was just diagnosed with pigmentary glaucoma last week.
This is all new to me, so I hope you all will be able to
teach me a thing or two.
ND: Welcome, MJ. Be sure to read
the highlights of the Wednesday night chats. You might want
to begin by typing "pigmentary" in the search window.
D: I can see I have missed a lot
by not coming in here for these chats.
N: I'm glad I found this site.
I have learned so much.
BC: I appreciate everyone's willingness to be open here
tonight. I have learned a lot, too.
Patient Support Group Meetings
Patient Support Group Meetings Meetings are from 1:30 to 3:00
PM on Sundays in the 8th floor auditorium of the “new”
Wills Eye Hospital, southeast corner of 9th and Walnut Streets,
with the entrance on Walnut Street, near 9th Street.
For information on future, as yet unscheduled, meetings please
call the Foundation office (215-928-3283) and ask to be put on
the support group mailing list.
January 30:
Dr. Marlene Moster
Who Gets Glaucoma and Why?
February 20:
Dr. Geoffrey Schwartz
Update on Laser Treatments for Glaucoma
March 13:
Dr. Richard Wilson
Stem Cell Research and Glaucoma
April 3:
Dr. Jonathan Myers
How to Talk With your Doctor
May 15:
Dr. Marc Mydlarski
Glaucoma and the Aging Process
Ongoing Glaucoma Research Center
Studies
The Glaucoma Research Center is actively involved in clinical
trials that are attempting to improve diagnostic and treatment
strategies for people with glaucoma. If you would like additional
information, please call the Center at (215) 928-3123.
• A multi-center study comparing the effects of the prostaglandin*
Travatan (travaprost, Alcon) and the carbonic anhydrase inhibitor**
Azopt (brinzolamide, Alcon) with Travatan and the selective alpha-2
adrenergic agonist*** Alphagan P (brimonidine, Allergan) in patients
with elevated intraocular pressure. 12 patients enrolled / goal
15.
Sponsor: Hermann Eye Fund (via former Glaucoma Service
fellow Dr. Robert Feldman, Herman Eye Center, Houston, TX)
Principal Investigator: Dr. Katz
• A national, multi-center study, with the coordinating
center at Wills Eye Hospital, comparing medication therapy with
laser therapy with the new selective laser as an early treatment
for patients with glaucoma. Needed are patients diagnosed with
primary open-angle glaucoma or ocular hypertension who have not
been previously treated with more than two glaucoma medications.
15 patients enrolled on site / goal 20.
Sponsor: Glaucoma Service Foundation
Principal Investigator: Dr. Katz
• A comparison of the effects on the trabecular meshwork
of patients who have taken the prostaglandin Lumigan (Allergan)
for 2 years vs. a non-prostaglandin drug. Specifically, we are
interested in determining the level of build-up of the prostaglandin
in the trabecular meshwork as compared with that of a nonprostaglandin.
3 patients enrolled / goal was 1. Enrollment is continuing.
Sponsor: Allergan
Principal Investigators: Drs. Katz, Myers, Rhee, Moster
• An evaluation of the safety and effectiveness of a new,
investigational surgically implanted device, the GMP Quintiles
Bi-Directional Glaucoma Implant (the “GMP Shunt”)
for use in patients with advanced glaucoma. 1 patient enrolled
/ goal 10.
Sponsor: GMP Vision Solutions, Inc.
Principal Investigator: Dr. Wilson and Dr. Moster
• A comparison of side effects of the prostaglandin
Xalatan (Pfizer) vs. those of the prostaglandin Lumigan (Allergan),
testing the feasibility of sending data on the newlydiagnosed
patients enrolled in the study at 67 sites in the Delaware Valley
via the internet to Wills for data analysis. Total enrollment
across all 67 sites = 65, 25 of whom are from Wills / goal 250.
Sponsor: Pfizer
Principal Investigator: Dr. Wilson
• An evaluation of the capability of Restasis (Allergan,
used to treat dry eyes) to improve the success of trabeculectomy
because of its demonstrated ability to reduce inflammation. 37
enrolled / goal 40.
Sponsor: Allergan
Principal Investigator: Dr. Moster
• An evaluation of a new, non-contact and noninvasive optical
technology developed by Biometric Imaging Incorporated designed
to determine the metabolic state of the retina at several different
locations, thereby providing the first spatial maps of retinal
metabolism. This study is designed to determine whether such metabolic
maps may be useful in diagnosing and treating glaucoma. 0 enrolled
/ goal 75.
Sponsor: Pfizer
Principal Investigator: Dr. Myers
• Comparison of the effects of the betablocker**** Timoptic
(Alcon) and the prostaglandin Xalatan (Pfizer) with a new medication
combining the prostaglandin Travatan (Alcon) and Timoptic. 3 enrolled
/ goal 10.
Sponsor: Alcon Laboratories
Principal Investigator: Dr. Rhee
• A study among glaucoma patients of the effect of a person’s
personality on his/her selfreported quality of life. 10 enrolled
/ goal 200.
Sponsor: Dr. Spaeth’s Wills Eye Hospital
Glaucoma Research Fund
Principal Investigator: Dr. Spaeth
*Prostaglandin analogs increase aqueous outflow.
**Carbonic anhydrase inhibitors decrease aqueous
production.
***Alpha-2 adrenergic agonists both increase aqueous
outflow and decrease aqueous production.
****Beta-blockers decrease aqueous production.
Foundation Committee Launches Glaucoma
Awareness Campaign
 The
Glaucoma Service Foundation Public Relations Committee —
Chair Bonnie Long, Joe Watson, George Strimel, Chris Urban, Dr.
Jeff Henderer and Foundation Executive Director Nancy Petrongolo
— have been working on various projects to increase public
awareness of glaucoma. In addition to print advertisements such
as the ones shown below, the Committee is working on materials
designed to increase the effectiveness of Foundation-sponsored
glaucoma screenings: a video with Dr. Jeff Henderer encouraging
those discovered possibly to have glaucoma to follow up with a
comprehensive eye exam, and an educational piece developed to
increase participants’ understanding of glaucoma.
The Public Relations Committee works on the
Foundation’s Glaucoma Awareness Campaign. Standing left
to right are Joe Watson, George Strimel, and Chris Urban. Seated
are Chair Bonnie Long (left) and Foundation Executive Director
Nancy Petrongolo. Not pictured is Committee member Dr. Jeff Henderer.
Photo by Ken Parker, PhD
 
Named Giving Opportunities
We are pleased to announce named giving opportunities available
to those who wish to support a specific Foundation program with
a substantial gift. For example, you may wish to be named as:
- a sponsor of the Searchlight for a gift of $5,000, $10,000,
$15,000, or $20,000
- a sponsor of the Glaucoma Service Fellowship program for a
gift of $3,000, $5,000, or $8,000
For more information, please contact the Glaucoma Service Foundation
office at 215-928-3283 or visit our
website at www.willsglaucoma.org.
You Can Still Make a Difference!
By now you should have received our year-end mailing for the
Foundation’s 2004 Annual Fund. If you have already made
a donation, many thanks for your support! If you haven’t
yet, we hope you will take a moment and contribute today. Your
gift will truly make a difference.
Planned Giving Opportunities to
Help the Foundation
The Glaucoma Service Foundation is seeking to
strengthen and extend available giving opportunities by providing
techniques that will enable donors to make gift commitments that
not only will achieve their own financial planning objectives
but also will help address the Foundation’s long-term needs.
Such giving opportunities include:
• Cash
• Securities
• Bequests
• Retained Life Income Gifts
• Annuities
For more information, please contact the Glaucoma Service Foundation
office at 215-928-3283 or visit our
website at www.willsglaucoma.org.
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