Chat Highlights
Glaucoma Awareness
January 10, 2001

Norma Devine, Editor

On Wednesday, January 10, 2001, Dr. Rick Wilson, a glaucoma specialist at Wills, and the glaucoma chat group discussed "Glaucoma Awareness." 

Moderator:  Hello Dr. Wilson.  Welcome.  

Dr. Wilson:  Hello, gang. 

Moderator:  The topic tonight is Raising Glaucoma Awareness.

Dr. Wilson:  Great topic.

P:  I've raised my family's awareness since I've been grumbling about my leaking bleb!

P:  I wrote to Rosie O'Donnell today and begged her to let me appear on the show. 

Moderator:  Really?  Why?  

P:  To tell everyone this is Glaucoma Awareness Month.  

P:   Maybe try Oprah, too.  There's a high percentage of African Americans at risk and undetected.

P:  That is a great idea to get some attention on glaucoma.  

Moderator:  Dr. Rick, we were just talking about not having seen or heard anything about this being National Glaucoma Awareness Month.  

P:  Unfortunately, it's not glaucoma awareness month in Canada. 

P:  I remember that glaucoma got some media play when an athlete was hit in the eye.  

Moderator:  That was Kirby Puckett, the baseball Hall of Famer.

P:  Unfortunately, a celebrity is probably needed to call attention to glaucoma. 

Dr. Wilson:  The American Academy of Ophthalmology Foundation has raised a lot of money to increase awareness and promote screening for glaucoma.  The Prevent Blindness America Foundation and the Congressional Glaucoma Caucus are also working on these issues.

P:  Is a glaucoma check a routine check now with every eye exam?  It is so easy and takes so little time.

P:  I know that some optometrists do not check the intraocular pressure when people go in for glasses. 

P:  What do you consider a glaucoma check?  Just measuring the intraocular pressure? 

P:  Well, yes, that was what I was thinking.  I know the optic nerve tells the tale, but I thought that checking IOP would catch a lot of people.

P:   Dr. Rick, a lot of people with glaucoma would be missed if IOP only were checked.  About what percent? 

Dr. Wilson:  That depends on who you read, but many more people would be labeled suspicious than would be detected.  Checking for glaucoma with just pressure is akin to seeing if a patient has kidney disease by looking at the iris.

Dr. Wilson:  Let me give you a list of the risk factors:  

1. Age: Less than 50 years old (no points).
2. Age: 50 to 64 years old (1 point).
3. Age: 65 to 74 years old (2 points).
4. Age: over 75 years of age (3 points).
5. Ethnic heritage, African American (2 points).

Family history:

6. None of my immediate family (i.e., parents or siblings) have glaucoma (0 points).
7. One or both of my parents have glaucoma (2 points).
8. One or more of my siblings have glaucoma (3 points).
9. One or both of my parents and one or more of my siblings have glaucoma (3 points).
10. My last medical eye examination was:
    1. within the past two years (0 points).
    2. two to five years ago (1 point).
    3. more than 5 years ago (2 points).

Add up your score:  more than four points is a high risk; three is moderate risk; two or less is low risk.   All relatives of  glaucoma patients should have this information.

P:  My score was one.  I just had a trabeculectomy.  Nothing helped.  Not drops of any kind nor the laser surgery.  Now I am going to my doctor tomorrow because the eye is very red.  I'm afraid of  what this is going to be.  I guess this disease is just never ending.

Dr. Wilson:  Unfortunately, you're right.  A lot of people in the chat room can sympathize with you.  

P:  I guess the checklist was accurate in predicting my being diagnosed with glaucoma. I was 61 years old,  had two siblings and an 88-year-old mother on drops. That was four years ago. Since then,  two more siblings, ages 53 and 54,  have been diagnosed.  That's not a very good outlook for my two sons, I guess. 

P:  I got a zero!

P:   I got 0 points, too.  So how did I  end up with glaucoma?

P:   I got a 0.

P:  So did I get a 0.  

Moderator:  Me, too.  

P:  I got 10 points.

P:  I  had glaucoma before my parent did. 

P:  So did I!  Mother wanted to know if you could catch glaucoma  from your daughter!

P:  I have no one in my family with glaucoma that I know of.  It seems there are lots of others the same way.  We have to watch our family now.

P:  What about such things as low blood pressure, nearsightedness, high blood-clotting factor?

Dr. Wilson:  Those are all minor risk factors compared to the ones I listed.

P:  Should doctors still be using the air-puff tonometer to check intraocular pressure?

Dr. Wilson:  Only optometrists checked the eye pressure with the puff when they were not allowed to use a topical anesthetic.  Now everyone should use the blue light or, at the very least, the tonopen.

P:  It's surprising that many people still think if their IOP is normal, they don't have glaucoma.

P:  Given that it is inherently difficult to get regular folks to go get checked for something obscure like glaucoma, why isn't it made a part of a regular physical exam?  When I have a physical exam they (to quote Guthrie) "check every single part of me" and leave "no part untouched."  Why not the eyes, too?

Dr. Wilson:  You're right.  They should check the eyes, too.  A lot of the  executive physicals do check the eyes.  I see the "rejected" executives.

P:  Glaucoma awareness should go on TV  as a public service announcement.  Public service announcements are free.  The problem is there are fewer and fewer of those announcements because all the stations want to do is make money.  

P:  I've  heard people mention glaucoma dismissively:  "Oh, they have drops for that."  Some of the well-intended education probably invites the idea that there's a medicine one can take. That's not the whole story!

P:  My local newspaper usually runs an article in its Health section on the "disease of the month" and has covered glaucoma before.  Does anyone read newspapers any more?

P:  Maybe Kirby Puckett could talk someone into doing a show?

Dr. Wilson:  Harry Belafonte is the American Academy of Ophthalmology's spokesperson for glaucoma awareness.  I met with him at our Eyecare America meeting and he was a wonderful gentleman.

P:   Has Belafonte had trabeculectomies?  

Dr. Wilson:  Belafonte has had cataract extractions and a retinal procedure.  He does not have glaucoma, but is an excellent person to reach out to the minority community.

P:  We need more people like Belafonte.  I am convinced that celebrities bring the public's attention to diseases.  Look at AIDS. 

On January 17, Dr. Wilson discussed Nutrition and Glaucoma in the Chat room. Click here for highlights of that meeting.

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