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Message January 2022 NEWSLETTERJANUARY IS GLAUCOMA AWARENESS MONTHDOCTOR, I HAVE A QUESTION : ADVANCES IN GLAUCOMALIVING WITH GLAUCOMA : TERRI ERICKSONCONTRAST SENSITIVITYNEW GLAUCOMA FELLOWSTGF NAMES NEW BOARD MEMBER
Newsletter January 2022MESSAGE FROM THE PRESIDENTDear Readers,TGF is ringing in 2022 with great enthusiasm, after saying farewell to a challenging but highly successful year. In recent months, we have continued to expand our Board, which now includes a diverse group of doctors, patients and caregivers. The newest member is Alon Harris, MS, PhD, FARVO, an internationally recognized expert and leader in the eld of ocular blood ow and glaucoma.Earlier, we announced that the Foundation, in a new partnership with Research to Prevent Blindness (RPB), was granting fellowships to young physicians specializing in glaucoma. Three winners have been selected; you can read about them in this newsletter. Together with RPB we also just granted a major career advancement award in glaucoma research to Matthew J. Van Hook, PhD, an assistant professor at the University of Nebraska whose work focuses on retinal synapses and function in neurodegenerative disease.We have other new partners and have made other new friends as well. As part of a twentieth anniversary celebration and its “year of giving back,” Endace, a company in New Zealand, supported The Glaucoma Foundation’s Art Challenge to Celebrate Vision with a corporate donation of $20,000 and made an additional gift of $5,000 on Giving Tuesday -- the global day of giving on which TGF raised more than $35,000 this year. And in just the last quarter, we had more than 1,000 rst-time donors! January is Glaucoma Awareness Month. We urge all our readers to heed its call and make an appointment to have your eyes examined. Early diagnosis and ongoing treatment can save your sight.In closing, we thank you for being a newsletter reader. We look forward to continuing answering questions and addressing subjects of importance to you. If there are topics you would like us to explore in future issues, let us know at info@glaucomafoundation.orgWith all best wishes for a healthy and happy year to come,Elena Sturman
Doctor, I Have a Question.What are some of the greatest advances in glaucoma treatment?Question answered by:Jerey M. Liebmann, MDDr, Liebmann is Shirlee and Bernard Brown Professor of Ophthalmology, Vice Chair, Department of Ophthalmology, and Director of the Glaucoma Divisionat Columbia University Irving Medical Center in New York City. In November, Dr. Liebmann, a member of the Foundation Board, presented a Zoom webinar on “New Horizons in Glaucoma Treatment.” This “Doctor, I Have a Question” column incorporates some highlights from that presentation. The entire webinar can be viewed on TGF’s website (insert link).As physicians, our goal is to preserve vision and quality of life for all our patients. Our populations are ageing and life expectancy is increasing, which means that there will be more people with glaucoma and they will have the disease for a longer period of time.Fortunately, we live in a world of rapidly changing paradigms in science. New advances in biotechnology and biological science occur every day. Our technology is rapidly improving. We have novel medical interventions, new surgical devices, and the future use of AI (articial intelligence) in glaucoma management will allow us to detect glaucoma earlier.What’s new in medicine and lasers? For the majority of patients, the current trend is to try to use as few eye drops as possible and expand use of laser trabeculoplasty much earlier in the course of the disease. Instead of eyedrops rst, many doctors will oer laser surgery rst. The goal is to try and minimize the medication burden - that’s a new treatment paradigm in our daily practice – and has been hugely advanced in the last 10 years. Patients may still be taking drops, but fewer times during the day. There are now three medications that are taken only once a day, and there are four combination drops on the market, This means that maximal eye drop therapy can be limited to just two times during the day for most patients.A new and important future option will be sustained drug delivery systems. Right now, only one device, Durysta, has been approved for use in the US. After placement inside the eye, the small implant releases medication very slowly over 4 to 6 months. To date, it has only been approved for a single, not repeated use, for an individual patient. Other ways to do this are in the pipeline – second generation implants, punctal plugs and injections to the back of the eye among them.In the realm of surgery, before the recent development of MIGS (minimally invasive glaucoma surgeries) there were only two main types of surgery for glaucoma – trabeculectomy and drainage device implantation. Today it’s a complex eld, with many dierent MIGS using dierent anatomic pathways to allow IOP to be lowered. Some of these less invasive procedures are done with cataract surgery; others alone. It is estimated that in 2022 ve percent of all glaucoma patients will have some kind of glaucoma procedure.
Newsletter January 2022What about the future? Neuroprotection refers to the ability to protect optic nerve cells directly. If we could strengthen the nerve cells from dying, that would be the holy grail of glaucoma therapy. It is a eld of active ongoing research. Glaucoma, like Alzheimer’s and Parkinson’s, is a neuro degenerative disease and glaucoma will benet from all the research into these other diseases as well.The future also looks bright for the eld of precision medicine and precision ophthalmology, which uses genetics to transform the diagnosis and treatment of disease. There’s a worldwide eort to use the power or genetics to help us diagnose the disease and to develop new treatments and care for our patients. Applied genetics uses this information to provide each patient with a genetic diagnosis of their ophthalmic condition so we can pinpoint the diseases with great accuracy. In 2017, in a “rst” for the U.S., the FDA approved a gene therapy to treat patients with a rare form of inherited vision loss in children that can lead to blindness.LIVING WITH GLAUCOMAMeet Terri Kirby Ericksonward-winning poet Terri Kirby Erickson, a North Carolinian, launched her sixth published collection of poetry, winner of an International Book Award in Poetry, in late 2020. She also has the unique distinction that her “Poem by a Woman with Glaucoma” was just published in the Journal of the American Medical Association (JAMA) in their Poetry and Medicine section. Terri has always actively marketed her work and TGF learned about her when she contacted several ophthalmologists and organizations like TGF about the poem. “As a poet,” she says, “you just want to have your work read and hope that people will be moved by something that you write.”Terri doesn’t just have glaucoma – she’s had her fair share of medical issues and thinks it’s important for medical journals to get some perspective from patients and not just healthcare workers. “It’s so necessary that people feel they are not alone with their aictions. A poem can go straight to a person’s heart in a way no other kind of writing can do,” she has said. “Poems unite and connect us to one another’s humanity. Every poem is another little light in the darkness, telling us that we are not alone.” Although Terri’s been writing since the 5th grade and worked in the elds of editing and writing for years, it was when her daughter left home, “a strange time for a parent,” that she started to think about what her new passion might be. Attending a performance at Salem College by former US Poet Laureate Rita Dove, she says she knew “this is it – it’s what I want to do.” “That’s when I got started. I just started writing and writing and actually self-published my rst book. I was teaching a course at Salem College for adult students in poetry and ended up doing an interview on the local NPR station that came to the attention of Press 53 – the press that has published ve of my collections.”
“I just love her way of describing things,” said Kevin Morgan Watson, publisher and editor in chief of Press 53. “When you’re reading her poems, you feel like you’re there. You can taste the air. You can smell the owers. You can hear the birds ying overhead. It really is amazing. She is the queen of metaphor and simile.”Terri also has Crohn’s disease and her rst diagnosed eye disease was Fuchs endothelial corneal dystrophy, which aects the thin layer of cells that line the back part of the cornea. “My corneas are like lace doilies and can tear easily.” “I’ve had several laser surgeries for my open angle glaucoma and have spent a lot of time in doctors’ waiting rooms. But I’m lucky that everything was caught early. As a writer and someone who is very visual, the idea of having a disease that could lead to partial or full blindness was truly scary. I just feel extremely grateful and happy that I was able to nd success doing the thing i I decided that I really wanted to do, and that I had a passion to do. I plan to live my life to the fullest – hopefully for a long time.”The Ophthalmology Specialists’ Secondary Waiting Room by Terri Kirby EricksonLight is gentle here, and scarce—a roomdesigned for dilated pupils, for patientswith glaucoma, cataracts, and maculardegeneration—people whose eyes havesomehow failed them. Several wear darksunglasses. Others blink and blot theireyes with tissues. At various times, everychair is taken. Then, a name is called, andafter that, another. But no seat is vacantfor long. There are so many of us, and sofew hours left in the day. While we wait,some engage in whispered conversations.We compare eye pressures, past surgeries,and treatments, share stories like cowboysgathered around a circle of slowly-dyingembers—though most people sit in stoicsilence, watching the wall-mounted TV,checking their cell phones, or staring intospace. One elderly woman leans over herwalker and shouts, She, pointing to hermiddle-aged daughter, keeps shushing me.And when her daughter says, with harriedaection, Shhh, most can’t help but smile,faces illuminated like priceless paintings bythe faintest, yet unbearably beautiful, light.
Newsletter January 2022Do You Have a Problem with Contrast Sensitivity?You’re not alone. Loss of contrast sensitivity is an extremely common condition associated with aging – and a common problem for people with glaucoma. Contrast sensitivity is what allows us to detect things like dierent shades of the same color. It refers to the dierence in luminance or color that makes an object distinguishable. Loss of contrast sensitivity can hamper many daily activities. For example, patients may notice some signs when they have diculty with: --Driving at night, or in foggy, rainy or glare conditions, and accurately determining distances, the position of the lanes and the presence of other cars. (An article on driving with glaucoma will appear in the next newsletter issue.)--Reading a newspaper or magazine where the print contrast against the paper background is poor and tight line spacing may confound.--Distinguishing objects when they are similar in color to their background, like nding a black wallet in a black purse; or pouring coee into a dark colored mug.The threshold at which you see the target when taking a visual eld test is one indication of your threshold sensitivity. There is also a contrast sensitivity gradient which your doctor can administer to assess your level. You may be able to improve contrast sensitivity with the use of various tinted glasses, working with your doctor or low vision specialist. Also, when you can control it, use good lighting.
THREE NEW FELLOWS NAMEDThe Glaucoma Foundation (sponsored by Patricia Hill) - Research to Prevent Blindness Fellowship in Glaucoma is a one-year $10,000 supplemental fellowship targeted to under-represented racial and ethnic minorities, as dened by the NIH, who are fellows in departments of ophthalmology engaged in substantive glaucoma research. Three awardees were selected in December.Carlos Alberto Parra, PhD, is a postdoctoral fellow in brain mapping in the Department of Ophthalmology at New York University’s Grossman School of Medicine. His current research is on the neurodegenerative eects of glaucoma on visual pathway structures. With the support of the TGF-RPR Glaucoma Fellowship, he will continue his research on the detection and quantication of the eects of glaucoma on the microstructure of the visual pathways, both in humans and in animal models.Joah F. Allancy, MD, at the University of Michigan’s Kellogg Eye Center, came to the U.S. from the Caribbean as a child. As a Resident, he spent considerable time working with patients of Dominican and West African descent, where he witnessed the most notable progressive glaucoma. Dr. Allancy is currently a visiting lecturer and curriculum developer for the department of ophthalmology at the Hôpital de l’Université d’État d’Haiti. This summer he will be helping with education and surgical training for the hospital’s rst glaucoma/anterior segment fellowship.Ndidi-Amaka Onyekaba, MD, Duke University, wants to make a global impact in ophthalmology, especially in her country of origin, Nigeria. She has always been interested in that which disproportionately aects those of African descent. Her primary research focuses on examining healthcare disparities in the eld of ophthalmology. She hopes to collaborate with researchers in the VIP Lab to develop machine learning algorithms to help identify those at risk of glaucoma and blindness. January is Glaucoma Awareness MonthHave you scheduled your annual eye examination? While there is no cure for glaucoma, early treatment can often stop the damage and protect your vision. In the New York area, TGF is spreading the word in a PSA announcement on 1010 WINS Radio and in selected print media throughout the month. Glaucoma is a leading cause of vision loss and blindness in the United States. Glaucoma has no early symptoms — that’s why half the people with glaucoma don’t know they have it. The only way to nd out if you have glaucoma is to get a comprehensive dilated eye exam. Anyone can get glaucoma, but those at higher risk include: • Everyone over age 60, especially Hispanics/Latinos • African Americans over age 40 • People with a family history of glaucoma
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