Return to flip book view

Message March, 2021 NEWSLETTERAddressing Disparities in HealthcareTwo Forms of GlaucomaLiving With Glaucoma : Bonnie Jo Lobosco

Newsletter March, 2021Addressing Disparities in HealthcareDisparities in healthcare in the U.S. are long-standing and reach beyond individuals to aect their children, communities, and our entire society. In a major study reported in 2012, the prevalence of yearly eye examinations among visually impaired US residents aged 40 or older varied signicantly by race/ethnicity, income, and education, both overall and within states. Discrimination, social constructs, lack of access to care, economics, and environment all play a part. The new generation of medical professionals are poised to play a major role in addressing the health inequities that drive disparities. TGF hopes to keep their role at the forefront of this national discussion by encouraging awareness of these complex issues and supporting young ophthalmologists from underrepresented minorities in their contributions to the profession.In the spring of 2020, the Foundation established The Patricia Hill-Dr. Sanford Eisenberg Fellowships in Glaucoma to support women and minorities in the study of glaucoma. This year, in a new partnership with Research to Prevent Blindness, TGF will be co-funding ve new $10,000 supplemental fellowships targeted to under-represented minorities who are fellows in Departments of Ophthalmology engaged in substantive glaucoma research. The rst two recipients of the Hill-Eisenberg awards are currently completing their glaucoma fellowships at Columbia University Medical Center. One of them is Dr. Jessica Alana Scott, a Black woman and the daughter of an ophthalmologist. She points out that only 5% of U.S. physicians are Black and that “diversity in medicine does not only foster a rich, collaborative team environment with dierence in opinions and experience, but is also benecial for patient care.” TGF agrees. Among African Americans, glaucoma occurs about ve times more often than in other groups, and blindness from the disease is six times more common. Not only is the overall prevalence higher in African Americans, but the disease begins at an earlier age and progresses faster. Genetics appear to play a role; access to healthcare or lack of insurance are also factors. Monitoring the disease is crucial. The Los Angeles Latino Eye Study (LALES) reported an overall prevalence of open-angle glaucoma among the Hispanic/Latino community at nearly 5 percent — similar to what has been reported for Black Americans. But in this population the risk increases over age 60. Some chronic conditions, such as diabetes and high blood pressure, put Hispanics and Latinos at higher risk for vision loss -- they are almost 2.5 times more likely to have diabetes, compared to non-Hispanic whites. According to the CDC, Hispanic Americans are less likely to have an eye exam or access to health and eye care services because of language barriers and/or health insurance coverage. It’s estimated that by 2050, half the people living in the United States with glaucoma will be Hispanic or Latino.

Two Forms of GlaucomaChildhood GlaucomaBonnie Jo Lobosco, proled in this issue, and Jahkori Dopwell Hall, who gave a patient perspective at the recent TGF webinar, both were diagnosed with glaucoma at a very young age. Childhood glaucoma is unusual but is a signicant cause of childhood blindness. It is caused by a disease-related increase in IOP. The multiple potential causes fall into one of two categories and may be primary or secondary to some other disease process. Primary congenital glaucoma results from abnormal development of the ocular drainage system. It occurs in about 1 out of 10,000 births in the United States and is the most common form of glaucoma in infants. Secondary glaucomas result from disorders of the body or eye and may or may not be genetic. Both types may be associated with other medical diseases. Ten percent of primary congenital glaucomas are present at birth, and 80 percent are diagnosed during the rst year of life. The pediatrician or family rst notices eye signs of glaucoma, including clouding and/or enlargement of the cornea. The elevated IOP can cause the eyeball itself to enlarge and injure the cornea. Important early symptoms of glaucoma in infants and children are poor vision, light sensitivity, tearing, and blinking. Both medication and surgery are required in some cases.Normal-Tension GlaucomaChristine Di Somma, another patient participant at the February seminar, was diagnosed with advanced normal-tension glaucoma three years ago. This form of the disease, also known as low-tension glaucoma, is characterized by progressive optic nerve damage and visual eld loss with IOP levels that are usually considered to be within the normal range (10-21 mm Hg). It should be noted that the level of IOP often does not correlate with the degree of optic nerve damage or visual eld abnormality, but the higher the IOP, the greater the risk of damage, even within this so-called normal range. Normal-tension glaucoma is increasingly being diagnosed and may account for as many as one-third of all cases of open-angle glaucoma in the United States. It is thought to be related, in part, to poor blood ow to the optic nerve, which leads to death of the cells which carry impulses from the retina to the brain. In addition, these eyes appear to be susceptible to pressure-related damage even in the high normal range, and therefore a pressure lower than normal is often necessary to prevent further visual loss. Studies suggest that sleep apnea and low blood pressure at night might be additional risk factors for normal tension glaucoma. Research is ongoing in the eld of optic nerve blood ow and its role in glaucoma.

Newsletter March, 2021 LIVING WITH GLAUCOMAMeet Bonnie Jo LoboscoBonnie Jo Lobosco has faced many challenges and ultimate sacrices. A multi-talented 71-year-old who lives in Pennsylvania, Bonnie Jo is a Gold Star mother, whose son, a Green Beret, was killed in action in Afghanistan in 2009. Her ex-husband, who she remarried shortly thereafter, died suddenly. And, yes, she lost sight in one eye from glaucoma when she was just a toddler! Bonnie Jo has been through a lot, but she’s been creating a new life. “The need to give back is inbred in all of us,” she says. “You just have to nd it.” And that’s what Bonnie Jo has been doing! “People need support; sharing is important,” she says. In 2012 Bonnie Jo wrote a book entitled Marla-boro, about her 45-year struggle with cigarette addiction - she’s now free of smoking.Today Bonnie Jo is a mentor and writer for TAPS (Tragedy Assistance Program for Survivors), which supports families aected by a death in the armed services. She also works with an organization aiding retirees. Another of Bonnie Jo’s causes is spreading awareness about glaucoma and urging others to get tested early. “I’m proof that glaucoma is not just a disease of old people,” she says emphatically. Bonnie was diagnosed with glaucoma before she was one year old. While learning to crawl, she kept bumping into corners to on her left side. She had already lost vision; her rst battle was to save the eye itself.As a child, in the 1950s, doctors had few options for relieving eye pressure. Each time her pressure spiked, she underwent a procedure – she estimates a total of 40 – removing a small piece of her eye. This resulted in a badly deformed eye.

At the age of 19, when the pressure spiked again, badly, her specialist broke the news that her eye would have to be removed. “I remember it well. Being at Columbia Presbyterian Hospital alone because of problems with my parents, but old enough to sign the necessary papers myself. As the attendant wheeled me down the hall he asked, ‘we are removing your left eye, right?’ I said ‘right’, and he ipped out, ‘right or left?’ That is all I remember until I woke up.”Today, the good news is that pressure in her remaining right eye is under control. She faithfully uses eye drops and has her pressure measured carefully.Bonnie Jo’s message: “Be proactive, make sure your children’s eyes are checked at birth. And don’t neglect having your own precious eyes checked regularly, especially as you age.”Her glaucoma advocacy goes beyond her mission of spreading awareness. “It’s my honor and my duty to support research on this disease.” She began making small contributions at her rst job when AT&T employees were asked to select a charity for regular donations. And she’s kept it up, most recently with an ongoing commitment to nding a cure.Just last week, the driver of a car service taking Bonnie Jo to a medical appointment told her that she thought she, too, had glaucoma. “From what she told me about her pressures, it sounded like she did. I think my conversation with her – she said she would call to make an appointment that day – may save her sight. That’s what this is all about, saving your own sight and others if you can.”“We all really have to do whatever it takes to open up people’s eyes…and to further the research,” she says. .

Thank you for being a TGF newsletter reader.Let us know what’s on your mind.info@glaucomafoundation.orgCopyright © 2024 The Glaucoma Foundation, All rights reserved.You are receiving this email as a friend of The Glaucoma Foundation.Our mailing address is:The Glaucoma Foundation80 Maiden Lane, Suite 700New York, NY 10038