Volume 15, Number 2

August 2006

• Save the Date Glaucoma Service Foundation CARES Conference
• PBS Documentary Filmed on the Glaucoma Service
• Letter from the Executive Director
• Talk to Your Family and Help Stop Vision Loss from Glaucoma 
• Understanding Glaucoma Terminology
• IN THE NEWS
• Dr. Michael Pro Joins the Wills Eye Glaucoma Service
• What is EMR?
• Glaucoma Service Research Fellows
• The Foundation Mourns the Loss of Board Member – Stanley C. Tuttleman
• An Interview with Chat Room Moderator Steve Beck

Save the Date
Glaucoma Service Foundation CARES Conference

As you may know, January is Glaucoma Awareness Month. In an effort to promote awareness and to educate patients with glaucoma and those at risk for developing glaucoma, the Glaucoma Service Foundation to Prevent Blindness is hosting a patient directed educational conference on Saturday, January 20, 2007. It is our 1st Annual Glaucoma Service Foundation CARES* Conference. (*Community Awareness through Research, Education and Support) This exciting event will be held on the 8th floor of the new Wills Eye and will include lectures given by Glaucoma Service physicians, screenings for glaucoma patients’ family members 18 years or older, information about glaucoma and the resources available to patients living with glaucoma.

Vendors will include pharmaceutical companies with patient assistance programs, Low Vision Services, Associated Services for the Blind, Glaucoma Research Center, and assisted living facilities with low vision services.

Space is limited so please register early. Click here to register online.

There is no charge to attend.

Call: 215-928-3283
Email: kkuzmanich@willseye.org
Mail: Kathy Kuzmanich
Program Director
Glaucoma Service Foundation
840 Walnut Street, Suite 1130
Philadelphia, PA 19107

Please tell your family about this exciting opportunity to learn about glaucoma.Together we can raise awareness about glaucoma and educate those at risk.

We’ll see you in January!

PBS Documentary Filmed on the Glaucoma Service

The Glaucoma Service was pleased to host a PBS film crew in July 2006. Producer, Joe Jabaly* and Cameraman, Jason Banguela spent 4 days in Philadelphia learning about glaucoma. The first two days were spent interviewing Dr. George Spaeth and observing surgical procedures, glaucoma examinations, visual fields and clinical research. The remaining time was spent interviewing glaucoma patients at their homes and offices.

This is a wonderful opportunity to educate people about glaucoma in addition to highlighting the efforts of the physicians on the Glaucoma Service at Wills Eye. The show is anticipated to air on PBS in October 2006.

The Foundation would like to thank Ms. Abbi Buchanan, Ms. Bonnie Carr Long, Mr. George Strimel and Msgr. John O’Brien. We would also like to recognize the staff on the Glaucoma Service for their cooperation and assistance.

* Joseph D. Jabaly is a multiple EMMY-winning writer / producer / director with over eighteen years of major market and network television experience in every facet of production - from conception through delivery - and over onehundred national producer credits on Public Television, ABC, The Learning Channel, Discovery Networks and CNBC; as well as over 50 international producer credits in Japan, Hong Kong, Great Britain and Australia. With individual EMMY-Awards in four separate categories - including writing, directing, and producing - Jabaly has written every national production that he has produced. These productions range from a variety of long-form documentaries, comedy specials and public affairs programs; to a number of performance specials, an eightpart medical series and four separate national cooking series.

Letter from the Executive Director

Dear Friends,

As you know from reading Searchlight on Glaucoma, the Glaucoma Service at Wills Eye is full of activity. Our patient related programs such as support, education, chat sessions, and screenings, as well as physician education and research, require a significant amount of work.We at the Glaucoma Service Foundation are very fortunate to have a great deal of help from the many volunteers interested in making a difference in the lives of people with glaucoma.

The Foundation’s Board of Trustees is made up of generous, talented, and committed individuals, some of whom have glaucoma and some who do not. They give their time and talents to coordinate educational and fundraising events in addition to raising awareness about glaucoma in the Philadelphia community. They also work with staff members to formulate the Foundation’s long-range plan and oversee its financial stability.

The other many volunteers include those who help with the Foundation’s chat room and screenings, those who share their experiences so that others may learn through our public awareness campaign, and those who have helped with our mailings. Each person brings their own unique experiences to this work as well as a commitment to helping others.

I would also like to recognize the physicians on the Glaucoma Service who generously give their time and knowledge to the Foundation’s support group/lecture series, chat sessions, Searchlight on Glaucoma and to teaching the clinical and research fellows.

Without all of these individuals, the important work of the Glaucoma Service Foundation would not be possible. Their generosity, talent, and commitment make a difference in the lives of glaucoma patients here and around the world!

With my sincere thanks,

Nancy Petrongolo

Talk to Your Family and Help Stop Vision Loss from Glaucoma

By Tricia L. Thomas, MD

Over 2.2 million individuals in the United States age 40 or older have glaucoma and half of these are unaware they have it. As a result, many are not receiving treatment and are needlessly losing vision from glaucoma. In fact, glaucoma is the second leading cause of blindness in the world. However, with early diagnosis and treatment we can prevent blindness or vision loss in many of these individuals.

Why are so many people being missed? First, glaucoma is a silent disease and is only noticed by individuals late in the disease process. Second, mass screenings have not been found to be very effective yet, although research continues. Third, glaucoma cannot be detected simply by measuring the intraocular pressure but needs a thorough eye examination and examination of the optic nerve.

How can we reach these millions of undiagnosed individuals? Family history is a known important risk factor for developing glaucoma and a number of glaucoma causing gene mutations have been found. If you have a family member with glaucoma, your chance of developing glaucoma can be 10 times higher than the regular population. The Nottingham Family Glaucoma Screening Study found that the risk of developing glaucoma in siblings of glaucoma patients increases with age and is approximately 20% by the age of 70.

If you have glaucoma, you can help us identify individuals at risk for glaucoma – they are your own family. Tell all of your adult family members (mother, father, brothers, sisters, children and grandchildren) to have a thorough eye examination. Tell them to inform their eye doctor that they have a relative with glaucoma. They should have regular eye checkups; intraocular pressure, visual field testing and optic nerve examination. Even if they are initially found to not have glaucoma, they need to be followed throughout their lifetime because their risk for glaucoma increases as they get older.

Help us prevent blindness in your family. Spread the word. Together we can stop thousands of people from losing their precious sight.

Among all adults, glaucoma affects

• 2% of Caucasians
• 6% of African Americans
• Hispanics over the age of 60 have a greater risk of glaucoma
• People of Asian descent are more at risk for angle closure glaucoma.

Understanding Glaucoma Terminology

In a recent chat session, Dr. Elliot Werner and participants discussed glaucoma terminology. There are many terms used in association with glaucoma that can lead to confusion. We hope you will find the following information helpful.

Defining glaucoma:

Glaucoma is not a disease. It is a family of diseases that have in common the tendency to produce a particular type of optic nerve damage we call cupping. Most, but not all, glaucomas are also associated with a tendency to have elevated pressure inside the eye.

Glaucomas can be divided into several categories. Primary glaucomas are those that result from some abnormality of the structures that control the eye pressure or the optic nerve, and there is no other detectable underlying abnormality. Secondary glaucomas are those that result from some other underlying eye disease that can be seen to cause the abnormal eye pressure and / or optic nerve damage, such as uveitis, trauma, diabetes, etc.

Terms associated with glaucoma:

• Perioperative – refers to the time just before, during, and after surgery.
• Pseudo – false.
• Trauma – injury (a frequent cause of secondary glaucoma).
• Bleb – a blister-like structure that forms on the surface of the eye after certain types of
  glaucoma surgery. The fluid in the eye leaks out into the bleb, which lowers the pressure
  inside the eye.
• mm Hg – millimeters of mercury. A measure of pressure (in glaucoma, it’s a measure of the pressure inside the eye). The same units are used to measure blood pressure and atmospheric pressure.
• Ciliary Body – a structure located just behind the iris. The ciliary body is responsible for accommodation (focusing the eye for near work) and production of fluids that fill up the inside of the eye.
• Angle of the Eye – located where the iris (the colored part of the eye) and the cornea (the white part of the eye) meet. The angle is responsible for controlling the flow of fluid in the eye and maintaining normal eye pressure.
• Hypotony – too low eye pressure, usually less than 6 mm Hg.
• Aqueous – the clear watery fluid that fills and circulates in the front part of the eye, between the cornea and the lens.
• Schlemm’s Canal – a vein located in the angle of the eye that is responsible for draining the circulating fluid in the eye out of the eye, and back into the blood stream.
• Trabecular Meshwork – located in the angle. It functions like a strainer as the aqueous fluid passes through it to get into Schlemm’s canal and ultimately out of the eye.

Suffixes associated with glaucoma terms:

• ectomy – refers to removing something.
• otomy – refers to cutting into something.
• plasty – refers to altering the shape of something.
• ostomy – refers to creating an opening.

IN THE NEWS

New Board of Trustees Chair

The Foundation’s Board of Trustees is pleased to announce the new Chairman of the Board, Mr. Stephen Harmelin. Mr. Harmelin is the Managing Partner of Dilworth, Paxson, Kalish & Kauffman in Center City. He has been a Glaucoma Service Foundation Board member for eight years and serves on the Executive Committee.

The Board of Trustees would also like to recognize past Chairman of the Board, Dr. Andrew Medcalf. Dr. Medcalf has worked with the Foundation since 2001 and enthusiastically served as Board Chair for the past three years. He will continue to serve as a member of the Board of Trustees as well as Chairman of the Long-Range Planning Committee.

From the Patient’s Point of View

Is a trabeculectomy in your future? Through the efforts of volunteer and glaucoma patient Pat Dickson, we now have an article outlining a typical uncomplicated trabeculectomy from a patient’s perspective. To view the article on our website, please visit: www.willsglaucoma.org or to receive a copy by mail, please contact the Foundation office at 215-928-3283. We would like to thank Pat for taking the time to share her experiences!

Public Awareness Campaign Update

• On May 13th at 7:30 PM, Channel 6 ABC/WPVITV aired "Visions," with Glaucoma Service physician, Dr. Tricia Thomas and guests. Special thanks to patients: Mr. Phuoc Le, Ms. Nu Chau w/Ms. Jennifer Diec, and Ms. Elizabeth Kennedy.
• Glaucoma Service Clinical Fellow, Dr. Jerome Ramos-Esteban, wrote two articles for the local Hispanic Newspaper, El Hispano. The first article focused on the prevalence of glaucoma in the Hispanic Community and the second addressed glaucoma classification and gonoscopy.
• On July 15th at 7:30 PM, Channel 6 ABC/WPVITV re-aired “Visions.”

Glaucoma Service Physician Awarded Polish Medal

During a recent trip to Wroclaw, Poland, Dr. George L. Spaeth was awarded the “OPTIME DE GLAUCOMATOLOGIA MERENTI” 2006 medal, for outstanding service in the field of glaucoma, by the president of the Polish Glaucoma Society.

Recent Support Group Meeting/Lecture Series

May 21, 2006
Helping Your Doctor Help You – Kalpana Jatla, MD

Association of Research in Vision and Ophthalmology (ARVO)

The Glaucoma Service Physicians along with the Clinical and Research Fellows presented the following posters at the national meeting in May:

• The Efficacy and Repeatability of Selective Laser Trabeculoplasty in Open Angle Glaucoma
• Intermediate-Term Results of ExPRESSTM Miniature Glaucoma Implant Under Scleral Flap
• Is Anemia a Risk Factor for Glaucoma?
• Comparison of Therapeutic Decision Making in Glaucoma with Heidelberg Retinal Tomograph (HRT) Progression Analysis and Standard Automated Perimetry
• A Randomized Prospective Clinical Trial of the Efficacy of Cyclosporin Ophthalmic Emulsion 0.05% Following Trabeculectomy With Antimetabolite
  

Glaucoma Service Physicians - Sharing Their Knowledge

• Jeffrey D. Henderer, MD – May 13th Toronto, Canada – Initial Medical Options for Glaucoma – June 22nd Wilmington, DE – Treating Glaucoma, Evaluating the Evidence – July 24th Montreal – Initial Medical Options for Glaucoma – which will be video taped and distributed throughout Canada as part of the McGill University School of Medicine Continuing Medical Education course.

• Marlene R. Moster, MD – April 23rd Delaware Valley Eye Care Conference – Looking at the Optic Nerve – May 23rd Shanghai, China – Evidence based Comparison of Prosaglandins vs. Beta Blockers for First Line Therapy in Primary Open Angle Glaucoma; Adjunctive Therapy for Primary Open Angle Glaucoma; Glaucoma Surgery Complications: Diagnosis and Treatment, and How to Manage a Failing Bleb.

• George L. Spaeth, MD – April 14th-15th Indianapolis, Indiana – An Overview of Glaucoma (and Medical Care [and Life]) – April 19th-22nd Wroclaw, Poland – The Tragic Consequences of Generic Labels; Indications for Treatment; Releasable Sutures in Glaucoma Surgery and a New Method of Administering 5-FU; The Treatment of Glaucoma. June 9th-13th Asia Pacific Academy of Ophthalmology, Singapore – The Colored Glaucoma Graph – An Essential Aid in Proper Care of Patients; Ethics Course – Traditional, Medical and Spaethian.

• L. Jay Katz, MD – May 17th Scheie Eye Institute, Philadelphia, PA – Glaucoma Imaging – May 19th- 21st – Sao Paulo, Brazil – Target IOP: How to Determine It; New Perspectives on the Surgical Treatment of Glaucoma; Argon Laser Trabeculoplasty vs. Selective Laser Trabeculoplasty – June 22nd-23rd Malaga, Spain – Clinical Results of Argon Laser Trabeculoplasty.

• Jonathan S. Myers, MD – May 13th Memphis Eye Society Annual Meeting, Memphis, TN – When and Why do I like SLT; Optic Nerve Imaging – What’s not to love?; Electronic Medical Records: Coming soon to an office near you. June 9th – The Paul Stringer Memorial Lectureship in Ophthalmology, McMaster University, Hamilton Ontario – Glaucoma Update 2006.

• Richard P. Wilson, MD - May 4th-7th – Auckland, New Zealand – The Diagnosis and Management of Ocular Hypertension; Managing the Burden of Glaucoma; Common Mistakes in Glaucoma Management – Keynote Speaker, Royal Australian and New Zealand College of Ophthalmologists – Future of Glaucoma Surgery. – June 8th-10th – First International Peruvian Glaucoma Society Congress Lima, Peru – The Role of Pachymetery in Glaucoma Treatment and New Tonometers; What Technology Should I Use to Evaluate the Optic Nerve; First Line Medical Treatment of Glaucoma; When Do I End Medical Treatment and Move to Surgery; Management of the Filtering Bleb.
  

Dr. Michael Pro Joins the Wills Eye Glaucoma Service

We are extremely pleased to announce that Dr.Michael Pro will be joining the Glaucoma Service at Wills Eye and the Wilson / Moster / Schmidt practice. Dr. Pro graduated from Pennsylvania State University and completed his medical degree at Hahnemann University. He completed a transitional Residency Program at St. Barnabas Medical Center where he received the Abdul H. Islami, MD Award for Outstanding Transitional Resident of the Year. Dr. Pro then completed his residency and glaucoma fellowship training at New York Eye and Ear Infirmary.

Welcome Dr. Pro!

What is EMR?

By Dr. Jonathan Myers

EMR stands for Electronic Medical Records, and is sometimes referred to as EHR, Electronic Health Records. Simply put, EMR is recording the data in a patient’s record in digitized or computerized form, rather than on paper.

Across America there now is a great wave of conversion from paper based recording systems to EMR. Physicians, hospitals, and insurance companies are investing a lot of time and money to make this conversion. There are many factors that are driving this sweeping change in healthcare.

First, the government is promoting EMR. During his most recent State of the Union address, President Bush referred to his drive for conversion to EMR within the next 10 years. CMS (the United States Centers for Medicare and Medicaid Services) has launched initiatives tying hospital reimbursement to patient outcomes that are to be based on information from EMRs.

In 1990, the Veterans Administration hospital system began the process of converting to EMR, and saw its prescription error rate drop by 100 fold. One cannot overstate the advantages of having legible medical records. A medical record that can be easily read and understood by everyone, not just the person who wrote a particular entry, is safer for the patient, and saves time and effort for all other healthcare providers in not having to repeat work. The VA and its patients also benefit from having patients’ records available throughout the country when a patient moves.

“It’s great being able to pull up a patients file instantly when their doctor calls with questions,” adds Dr. Katz.

Jonathan Javitt, MD, MPH, a former Wills Eye Hospital resident in ophthalmology who went on to chair the president’s task force on technology in healthcare, noted that almost one in five laboratory tests were ordered because the results of previous tests were unavailable. By allowing the health record to be almost instantly up to date, and available at multiple locations, EMR can save the healthcare system a great deal of money and patients a great deal of testing.

Doctors and hospitals can also save money in the long run with EMR. It is estimated that finding a patient’s paper chart to return a phone call or for an upcoming office visit costs three to five dollars, not to mention the frustration when the chart is not easily located because it is out of place, perhaps sitting on a desk waiting for a test to be interpreted. With EMR, the information is available after a few seconds of typing at a terminal. Additionally, much of the transcription costs of dictating letters to other physicians can be reduced as the data from an office visit can be automatically loaded into a letter. This can save a small practice tens of thousands of dollars a year, and a hospital millions of dollars.

From a patient perspective, the most important advantages of EMR are safety and security. As mentioned above, the legibility of a computerized chart reduces the potential for confusion and possible mistakes regarding allergies, medications, and prior treatments and conditions. EMR is also more secure than paper records. EMR systems typically involve several layers of passwords making it much more difficult for unauthorized viewing of a patient’s record. Paper charts are often all too accessible to anyone who passes by or works in a clinic. There have been cases in which a patient’s electronic health records have been made publicly available accidentally in other parts of the United States, but in each of these cases the underlying cause has been complete disregard for even the most basic security procedures akin to leaving patients’ charts out in the lobby. In this regard EMR, just like paper records, can be compromised by incompetent or unethical administration.

Often the question arises as to whether EMR is dependable - will the system crash and the data be inaccessible or lost. Typical EMR systems are “backed up,” meaning the data is copied to another system on a daily basis, and the copy is kept at another location. This means that should a fire or flood destroy the building, only one day’s office visits should be lost. Most systems have multiple back-up strategies in place, further protecting this extremely important information. In this regard these systems have proven to be much more dependable than paper charts, which occasionally are misplaced or misfiled and are then unavailable when needed, or can be completely destroyed by local disasters.

On the Wills Eye Glaucoma Service, Dr. Louis Schwartz has been using electronic medical records since 1975. Over the years, as technology has improved, his practice has updated and changed systems. Dr. Schwartz notes that EMR has eliminated lost charts for his practice, allowed him to understand his partners’ notes, helped to ensure his technicians to ask important questions at patient visits, and allowed the doctors to document examinations more completely.

So why hasn’t everyone switched to EMR? Obstacles include costs (more than $100,000 for most group practices, millions for a typical hospital), time and effort to convert, and the uncertainty of the lack of any single established system. Most of the current systems are not compatible with each other, and choosing the right one for a particular practice is important, yet difficult.

Drs. Spaeth, Katz, Myers and Thomas made the switch to EMR in 2001, only to have the company that supported their system go bankrupt six months later. Last year, the practice again made the transition to EMR with a new system that has a wide following across the United States, and a solid financial picture as well. Drs. Spaeth and Myers both agree that the transition to EMR was difficult. Everyone was already very comfortable recording the examination findings on paper, but learning to fully utilize the system to access and record the information took time and effort. Dr. Myers notes, “One thing I love about EMR is that I don’t spend time re-writing and dictating the same parts of the examination that haven’t changed, but instead spend more time on new issues or concerns.”

Nationwide, about 15% of physicians are currently utilizing EMR for their patients’ records. At Wills, many practices are in the process of choosing an EMR system now. Between government mandates, concerns over quality of care, and increasing costs, the proportion of doctors using EMR is expected to increase greatly in the next few years. Reaching the President’s goal of complete conversion within 10 years appears to be a long shot, but some experts predict that more than half of doctors will be on EMR systems within 5 years.

Glaucoma Service Research Fellows

Dr. Luciano Lorenzana from the Philippines, Dr. Tutul Chakravarti from India, and Dr. Daniela Sanchez M. de Barros and Dr. Renata Siquiera DaSilva from Brazil. Dr. Lorenzana first earned a Bachelors Degree in Nursing and pursued Medicine at the University of Santo Tomas, Manila, Philippines. He finished his Ophthalmology residency in the same institution and is a third generation Ophthalmologist in his family. He is currently involved with the ADREV study with Dr. Spaeth and will be on the Glaucoma Service for one year. Dr. Chakravarti just completed a three-month research fellowship on the Glaucoma Service. She worked with Dr. Spaeth on the prevalence of myopia in eyes with angle closure. Dr. Barros is spending a year at Wills to deepen her understanding of glaucoma by observing in the clinic and OR as well as participating in research. She completed her residency and glaucoma fellowship at Rio Preto Eye Hospital in Sao Jose do Rio Preto in Brazil. Dr. DaSilva worked with Dr. Spaeth on a new surgical study and recently completed her six-month research fellowship on the Glaucoma Service.

(photo by Nancy Petrongolo)

Meet Dr. Sheila Bazzaz

Dr. Sheila Bazzaz received her medical degree from the University of Southern California School of Medicine with honors. Following an internship at Cedars-Sinai Medical Center in Los Angeles, she completed a residency in ophthalmology at Baylor College of Medicine. Dr. Bazzaz’s interest in ophthalmology and glaucoma developed in medical school through research at the Los Angeles Latino Eye Study and grew throughout residency. The combination of extensive patient contact in the clinic and surgical precision in the operating room is the motivation for her decision to subspecialize in glaucoma. “The balance of medically managing glaucoma versus the different surgical interventions continuously provides for academic growth. In addition, the prospect of developing long lasting relationships with patients offers an opportunity for education, prevention, and continuity of care. As a physician I believe that my role is not only to treat the disease, but to provide education, emotional support and guidance to understand the global effects that glaucoma can have upon a patient’s life. I look forward to this fellowship year as an opportunity to enhance my knowledge base, surgical skills and develop patient-physician relationships with the many wonderful patients here at Wills Eye.”

Meet Dr. Corey Batiste

Dr. Corey Batiste received his medical degree from Wayne State University School of Medicine where he received letters of commendation in Family Medicine, Neurology, and Obstetrics and Gynecology in addition to the Shin Outstanding Research Award, the Ferguson Research Award and theOphthalmology Research Award for Outstanding Student/Resident Research Presentation from the National Medical Association. He then completed an internship at Sinai- Grace Hospital and an ophthalmology residency at Wayne State University, Kresge Eye Institute.

When asked why he chose to pursue a career in glaucoma, Dr. Batiste replied, “Early in my career in medical school I realized the importance of the doctor-patient relationship. I noticed that maintaining a good relationship yielded more compliant patients, which in turn led to better overall patient care. The chronic nature of glaucoma demands that the physician be able to develop and maintain these relationships with his or her patients. I enjoy meaningful interaction and enjoy getting to know the person, not just the patient. My choice to pursue a career in glaucoma seemed to be a natural progression of my growth as a physician.”

Meet Dr. Albert Lin

Dr. Albert Lin obtained his medical degree from the UCLA School of Medicine followed by a medical internship at the Cedars-Sinai Medical Center in Los Angeles and a residency in ophthalmology at the Cullen Eye Institute, Baylor College of Medicine in Houston, Texas. During his medical training, he has been particularly interested in mentorship, education, and community outreach. He has served as director of the Asian Pacific Medical Student Association at UCLA that participates in health screenings in underserved communities and Doctors Ought to Care; an outreach program that teaches middle school students about smoking, sexually transmitted diseases, and domestic violence. He has also served as a teaching fellow and a member of the admissions committee at his medical school and coordinated mentorship programs and career workshops in medicine.

Dr. Lin is interested in glaucoma because it is a potentially blinding disease that can be well managed through early detection and treatment. “I have chosen glaucoma because I enjoy the preventative aspect of the field. As a good clinician, I can detect and prevent the progression of glaucoma in patients who may otherwise progress to blindness. I derive great satisfaction from identification and thorough evaluation of a problem in order to layout an individualized treatment plan for my patients.”

Dr. Lin’s long-term career goal is to become a university based ophthalmologist where he can continue to participate in education and community outreach as well as providing excellent care to his patients. He is also interested in research and has had several peer-reviewed publications in the areas of immunology, general surgery, and ophthalmology. He is looking forward to joining many of the on-going clinical research projects on the Glaucoma Service.

The Foundation Mourns the Loss of Board Member – Stanley C. Tuttleman

By Nancy Petrongolo

The Glaucoma Service Foundation is sad to report the passing of longtime friend and Board member Mr. Stanley C.Tuttleman. Mr.Tuttleman was a patient of Dr. Spaeth’s and worked closely with Foundation staff for the last several years guiding the Foundation’s course. He was instrumental in the planning and success of the Foundation’s Celebration of 40 Years of Fellowship in 2003. Mr.Tuttleman was always available to work with us to further efforts of the physicians on the Glaucoma Service and assisted in the continued development of the Foundation Board. It is rare to have had the opportunity to work with such an extraordinary, generous and kind man. I will miss his guidance, wisdom, loyalty, and most of all his friendship.

A Tribute by George L. Spaeth, MD

Stanley C. Tuttleman was an individual of extraordinary generosity, courage, decisiveness, and vision, who truly knew how to help. I recall well one time when Stan was at Wills Eye for a visit. He was limping a bit and I asked why. He explained that about a month previously he had broken his hip, and with his characteristic optimistic vigor quickly added that he was healing well, and would soon be back to his usual self. “How did it happen?” I asked. “I was learning to roller blade…” It hardly needs to be noted that few octogenarians start learning to roller blade, nor that few at any age are “back to usual” about a month after a serious trauma, such as a broken hip. But Stan Tuttleman was not usual in any sense.

Stan achieved greatly, in business, and in the many communities in which he had actively participated: artistic, religious, and educational. Because of his helpfulness he has been given awards by The Philadelphia Chamber of Commerce, The American Cancer Society, The Allied Jewish Appeal, The Jewish Theological Seminary, the University of Chicago, Northeast High School, Hebrew University, Graduate Hospital, and the Associated Services for the Blind and Visually Handicapped. He became one of the most generous and effective philanthropists in Philadelphia’s history.

Stan never lost the common touch, nor considered himself above others. When planning the Celebration of 40 years of Fellowship, not only did Stan agree to serve on the Steering Committee, but he attended ALL of the meetings – often two or sometimes even three in a month. He participated fully, with good ideas, wisdom, emotional and financial support, and an astounding level of intensity and perseverance. He never tried to “take over” but rather insisted that we stay true to the vision we had, one which would reunite, energize, and educate the 200 or so doctors the Glaucoma Service had trained.

Stan was dedicated to promoting education, especially within the Jewish communities in the United States and in Israel. He was also an indispensable help to the Glaucoma Service Foundation to Prevent Blindness. He was clear thinking, intense and vigorous, yet remarkably gentle. It is hard to visualize Stan participating in the D-Day invasions in Africa and Sicily, but he did. Perhaps it was at least partially the horror of those experiences that helped mold this lovely, sweet man, who knew what it meant to be a friend in the most profound sense.

Stan was devoted to his wife of many years, Edna. To hear him tell the story, Edna was the secret to his success in business. It was obvious that he respected and revered his wife. Clearly he deferred often to her wise advice. The Tuttlemans raised five children, who are continuing their parents’ good works.

As a result of Stan Tuttleman’s life, many people in many areas have benefited. Those who had the good fortune to have him as a friend were especially blessed.

Stan was a person of extraordinary generosity, courage, decisiveness, and vision, who will be truly missed.

An Interview with Chat Room Moderator Steve Beck

By Kathy Kuzmanich

To help make the Wednesday evening chat sessions on the Foundation’s website run smoothly, volunteers work in conjunction with the webmaster to organize and monitor questions being asked of the participating physician. In a recent issue of Searchlight on Glaucomawe highlighted the efforts of Ms. Norma Devine, editor of the chat highlights. We would now like to introduce you to Steve Beck, one of the moderators of the chat sessions.

Could you give us a synopsis of all the things you do in connection with the Glaucoma Service Foundation website?

Moderator Steve: These days, my contribution is mostly just helping moderate the Wednesday night chats. That means coordinating with the webmaster and other volunteers in order to have some on-topic questions ready to go for the chat.

During the physician chats, we moderators usually share duties; alternating tasks each week. That means that one of us “drives” as we call it; monitoring questions that are sent to the moderated queue, making sure things run smoothly for the doctor, sending appropriate questions to the room and to the doctor in an order that creates a nice flow to the chat.

The one who is not moderating takes care of the “flow”; greeting chatters who arrive after the moderated portion of chat has started, assisting them if they are first-timers in the chat room, monitoring the queue to see the “driver” is not being overwhelmed with questions, sending broadcast messages to the room if needed, sending additional questions to the queue, etc. It’s a good balance and we each enjoy what we do.

When were you were diagnosed with glaucoma?

Moderator Steve: In Nov. 1999 I went for an eye check-up because my vision had been getting worse. I’m rather myopic so I figured it was just time for a new prescription, or perhaps near-point vision age-related changes (even though I was only 46). Here I must confess that I was one of those people who had not had my eyes checked in years.To my shock, the optometrist said he thought I had glaucoma in my right eye and the pressure in that eye was quite elevated (33 with his pufftonometer). He scheduled me for a screening visual field test the next week, and even though the test did not show any glaucoma (the thresholds on the screening test were not as sensitive as the full Humphrey test) he was not satisfied and sent me to see a glaucoma specialist who confirmed the diagnosis. The complete visual field test did show glaucoma, although very mild, and I am ever grateful to the optometrist who trusted his instincts and observations over the results of the screening test. Living in Vancouver, BC, Canada, I have good access to excellent glaucoma specialists and with my glaucoma being caught early I have had no progression in the six and a half years since diagnosis.

It turns out my glaucoma (and also a subsequent cataract) was caused by severe trauma to the head I received at age 18.

How did you find the Glaucoma Service Foundation website?

Moderator Steve: I found the Glaucoma Service Foundation website between the time of becoming a glaucoma suspect and my visit with the specialist when I was doing research on the web about glaucoma. Like many, I knew virtually nothing about it before being diagnosed.

When did you start participating in the Wills Glaucoma Service chat room?

Moderator Steve: I began participating in the chats right away. It was the only place where one could ask live questions of a real glaucomaspecialist and have them answered. Everyone was very gracious, helpful, and supportive.

In those days, November/December 1999, the chat room was quite different —kind of like the Wild West. Everyone would be “talking” at once, posting questions to the doctor, comments, cross talking to each other. It was quite difficult for the doctor to keep track of questions, what he’d answered, what had been missed. It was pretty chaotic. Somehow, I just fell into trying to be helpful, keeping track of how many questions had been asked and answered, letting the doctor know where to look for the next question, and so on. Before long I was asked to help moderate, which in those days meant just that.

We then switched to a moderated chat. It is a much more productive use of the doctors’ generously donated time. The chat room has created a treasure trove of highlights that can answer almost any question a newly diagnosed person might have.

Why do you contribute so much of your time and energy supporting the GSF website/chat room?

Moderator Steve: My contribution is quite small compared to the doctor’s and the other volunteers. The Glaucoma Service Foundation website and the chat room were a great gift when I was first diagnosed. They provided information, support, and an on-line community of people who could understandglaucoma. I think a lot of people who find their way to the chat room don’t know anyone else who has glaucoma. While family and friends can be supportive, they don’t necessarily understand what it means to have a condition that will persist for life and require constant attention, vigilance, and possibly medication. It’s nice to find others who do know what it is like.

I’m extremely fortunate in that my glaucoma was caught relatively early as far as visual field damage. My case has been uncomplicated so far, and I have had no progression, so my need for personal support has been pretty minimal. But, I know that all those people are there for me when I do need support.

Is there anything else you would like to add?

Moderator Steve: Just a note of hope. With early detection and good treatment, progression of glaucoma can be slowed dramatically, and I am (so far, and touching wood notwithstanding) an example of that. Our health is our own responsibility - so do everything you can from your side. Be well informed; live a healthy lifestyle, which means eat well, get enough rest and exercise, make your doctor a partner in your health and take your drops! Count your blessings, enjoy life, and keep your sense of humor!

On behalf of the Glaucoma Service Foundation as well as the doctors on the Glaucoma Service, and countless glaucoma patients around the world, thank you Moderator Steve!

BOARD OF TRUSTEES

Stephen Harmelin, Esq.
Chairman

George L. Spaeth, MD
President

Richard P. Wilson, MD
Secretary/Treasurer

Judge Phyllis Beck
Charlotte Bonmartini
Francesco Bonmartini
Megan Brunner
Bonnie Carr Long
Louis Esposito
Jeffrey Henderer, MD
Thomas Henderer, Esq.
L. Jay Katz, MD
James Kim
Zeff Lazinger, DC
Hyman Lovitz, Esq.
Andrew Medcalf, PhD
Jonathan Myers, MD
George Strimel
Tricia Thomas, MD
Chris Urban
Joseph Watson