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Message JANUARY 2024 NEWSLETTERJANUARY IS GLAUCOMA AWARENESS MONTHMYTHS VS FACTSDOCTOR, I HAVE A QUESTION ABOUT CHILDHOOD GLAUCOMALIVING WITH GLAUCOMA- ATHLETE COLLEEN SILVEIRA WINTER WEATHER AND YOUR EYESTHE NEW GLAUCOMA FELLOWS AND CAREER ADVANCEMENT WINNER
Newsletter January, 2024Message From The PresidentHappy New Year to Our Readers,TGF is marking the arrival of 2024 with great enthusiasm and a busy agenda, beginning with the January observance of Glaucoma Awareness Month. Increasing awareness remains critical with glaucoma still the leading cause of preventative blindness. We urge you and your family to make that call for an appointment to have your eyes examined. It could save your sight!To help spread this vital message, we have placed a series of public service announcements on WCBS and 1010 WINS news radio stations and launched a campaign on social media.We are also excited to announce that on January 28, TGF grantee and member of our Scientic Advisory Board Dr. Thomas V. Johnson of the Wilmer Eye Institute at Johns Hopkins and I will be featured as guests in a segment on glaucoma on the rst show of the inaugural season of “Health Uncensored with Dr. Drew” on Fox Business Network. The show will air at 5:30 pm on January 28.And there’s more for January. We’re ringing in the new year with a new webinar on January 11 for patients, a discussion and Q&A titled ‘I’ve Been Diagnosed with Glaucoma. Now What?’ This program, with Dr. Constance Okeke, MD, MSCE, a renowned cataract surgeon and pioneer in micro-invasive glaucoma surgery (MIGS), is tailored to guide individuals navigating a glaucoma diagnosis, oering a comprehensive discussion on pivotal topics. We hope you’ll register for this January 11th webinar or view a recording on our website beginning a few days later.Looking ahead, we hope you will save the date of April 18 for a spectacular TGF 40th Anniversary Gala at CURRENT on the Hudson River in Manhattan. I’m thrilled to announce that among the awards bestowed that night, The Chairman’s Spotlight Award will be presented to David Letterman. In closing, we thank you for being a newsletter reader and a supporter of TGF’s eorts. In the year ahead, we look forward to answering questions and addressing subjects of importance to you. If there are topics you would like us to explore in future issues, please let us know at info@glaucomafoundation.org.With all best wishes for a happy and healthy year to come,Elena Sturman
January is Glaucoma Awareness MonthLet’s Dispel Some MythsHave you made a resolution to have your eyes checked for the new year? Early diagnosis and treatment are key to controlling this “sneak thief of sight.” The notion that people can tell if they’re developing glaucoma is one dangerous myth about the disease. Here are some others.Myth 1: Your vision will deteriorate or blur if you are developing the disease.Most forms of glaucoma have no symptoms or cause no change in vision until later in the course of the disease. Once vision has been lost to glaucoma, permanent damage has already been done to the optic nerve and sight cannot be restored.Myth 2: Only old people get glaucoma.Though frequency increases with age, glaucoma can strike at any time in a person’s life. Approximately one in 10,000 babies is born with glaucoma. Myth 3: Glaucoma is always inherited?Family history is a strong risk factor for glaucoma but an absence of family history does not mean a person is risk-free. If there is a family history, everyone in the family should be tested.Myth 4: Ethnicity has nothing to do with glaucoma risk.Blacks and Asians are at particularly high risk for developing glaucoma. Researchers have also recently discovered that glaucoma is far more common among U.S. Hispanics than originally thought. African Americans are six times more likely to suer from glaucoma than Caucasian Americans, develop the disease years earlier, often with a greater rate o vision loss.Myth 5: All people with glaucoma have elevated intraocular eye pressure.Elevated eye pressure (IOP) is a risk factor for glaucoma and is not the disease itself. There are more than 40 dierent types of glaucoma, and not all are associated with elevated IOP. Glaucoma specialists believe that some forms of glaucoma are strongly related to vascular changes and impaired “nutrition” (poor blood ow) to the optic nerve. The common thread among all glaucoma is damage to the optic nerve rather than elevated IOP.Myth 6: If you don’t have high blood pressure, you cannot have high eye pressure.Blood pressure and eye pressure vary independently. Controlling blood pressure does not mean IOP is controlled. However, high blood pressure is often – but not always – associated with elevated IOP. Interestingly, low blood pressure is strongly associated with some forms of glaucoma such as normal-tension glaucomaMyth 7: Glaucoma always leads to blindness.This is one of the most dangerous myths of all. Some 90 percent of all glaucoma-related blindness could have been prevented with proper treatment. If fact, glaucoma is the leading cause of preventable blindness. But you can’t get treated unless you know you have a problem! Make an appointment to have your eyes checked today.
Newsletter January, 2024 DOCTOR, I HAVE A QUESTIONAs a pregnant woman with some history of glaucoma in my family, I want to better understand what childhood glaucoma is all about. What should I know? Dr. PanarelliQuestion answered by Dr. Joseph F. Panarelli, MDDirector of Glaucoma Services, NYU LangoneProfessor, Dept. of Ophthalmology at NYU Grossman School of Medicine The rst thing to know about pediatric glaucoma is that these cases are complex. We’re a small eld - none of us comes out of our training really prepared to handle these complex cases right away. But it becomes a passion – something you want to be involved in.It’s a very complicated disease process and it comes in dierent forms. Primary congenital glaucoma is probably the most recognizable to pediatricians and pediatric ophthalmologists. And for the specialist who is taking care of these infants it is the one that’s probably most amenable to surgical treatment. These kids often do well if diagnosed early enough.Then there are a host of secondary glaucomas that are often associated either with systemic conditions or may be genetically acquired. These are very dicult to treat because the anatomy is often distorted. These children often require multiple surgical procedures because it is a more complicated disease process.When an infant is born, the main thing the obstetrician has to look for is a good red reex – a test to detect abnormalities of the eye that need to be addressed. Congenital glaucoma is often picked up by a pediatrician, pediatric ophthalmologist or often by a parent. The classic triad of symptoms are tearing, constant blinking and aversion to light. They may notice that the front of the eye looks hazy. They may also notice that the eye starts getting large - children have elastic tissue – pressure may make their eyes larger. While this may look adorable, to the clinician it’s a sign that the child may have glaucoma.A problem is that as these children’s eyes grow larger, they grow asymmetric and develop amblyopia (lazy eye) and the brain doesn’t develop good usable vision. So, the important thing for me is to work very closely as a team with the pediatric ophthalmologist. I can do a great job xing the glaucoma but if we are not managing the lazy eye, we’re not doing the best for this child. As children grow older, make sure you get them to an eye doctor if they have any visual complaints. One of the challenges I often face is children with juvenile glaucoma, often diagnosed between the ages of 5 and 15. Because we don’t have great warning signs for that condition, in a lot of cases we don’t notice it until it’s late in the disease course.
Routine eye examinations are very important and anytime a child has a complaint, make sure it’s addressed. If there’s any family history of ocular issues, I think children should be examined once a year.There are a number of us who are very passionate about pediatric glaucoma, and we’ve organized a North American Pediatric Glaucoma Society. We want to make sure that we train a future generation to adequately manage this specialty. Pediatric glaucoma is not something I learned overnight – it took years to learn the craft. Our job as teachers is to pass this on so that children all over the country – and all over the world – will be able to get the care they need. LIVING WITH GLAUCOMAColleen Silveira Colleen Silveira personies the message that a glaucoma diagnosis doesn’t mean you should give up on what brings you joy and happiness. Look forward, not backwards, she says, and live your life to the fullest. She’s done just that! A competitive athlete all her life, Colleen was diagnosed with Pigmentary Dispersion Glaucoma 12 years ago when she was 35. Early on, when she went monthly to get her pressures checked, doctors said her type of glaucoma seemed to be exertion-based. “That really freaked me out! I didn’t want my life scaled back to just walking and yoga. I’m an endurance athlete! That’s part of my wellbeing for my mind and my body. Because I was training for Iron Man at that time, I asked my doctor if I could do a two-hour run and just run right in to the oce for a pressure test. I thought that was the most accurate way to see if exertion was a factor in my eye pressure. We did this for about a year and found that my pressure never went up. That was a very interesting nd for my doctors and a very happy moment for me.” “Testing to get data is the only way to understand glaucoma better and seeing my doctor once every four months for pressure checks does not seem like good data. I was hoping something could be developed for us to use at home like diabetics had – to see what would, every day, aect our own pressures like food, time of day, lack of sleep or exercise. That was my number one concern – to understand what makes our own pressures go up or down.” “I’ve been in the health care/wellness eld and believe that food and nutrition can help change the trajectory of our lives. So, I started researching what foods could possibly help my eyesight. I would tell my doctor, I’m doing this, and trying this, and she would say, let’s see what happens. From drops and dietary ideas, I have been at a lower glaucoma pressure point in the last three years than earlier on my glaucoma journey.” “One of my passions is international travel. I don’t do Iron Man anymore, but in my 30s I started to indulge in hiking. I wanted to see how other people lived and the way to meet indigenous people is hiking through their lands with them as guides. It’s beautiful and humbling. Now my husband is into that as well. It’s really a fun thing for us to do together – his rst climb with me was Kilimanjaro!”
Newsletter January, 2024“I had never thought about altitude and IOP. Would my pressures go up climbing a 19,000 ft mountain? I asked my doctor, but again there was no data. Recently, when I was planning a September trip to Morocco to climb Mt. Toubkai in the Atlas Mountains, I was so thrilled that the home tonometer was now available and that I was able to get one. I took the tonometer with me to Morocco, tested every day, and found I was getting a little bit of an elevated pressure with elevation gains.” “I just think it is so important when as glaucoma patients we can be in the driver’s seat in some of this. When we can take some power into our own wellness it gives us more of a sense of purpose in understanding this disease better.” “I love going to unique places -- 13 countries in Africa so far. Most recently my husband and I headed to Ethiopia, Rwanda and Uganda. I was so thrilled to nally see these places, especially hiking to see the mountain gorillas! I went to the Ellen DeGeneres Conservatory where the good work of saving the gorillas will continue from Diane Fossey’s earlier work. Next year we’ll be going to Nepal. I’ll have my tonometer with me – 17,000 feet -- and I will be able to test every night because we’ll be in a cabin setting and it’s just a gradual incline. It will be a perfect way to pressure test. My passion for seeing the world is still there. I really hope that my eyes continue to do well so I can see everything. Every time I attend a conference about glaucoma, I see a huge change with new developments…we’re getting there. Have patience, keep informed, and enjoy your life in the meantime.” WINTER CAN WREAK HAVOC ON YOUR EYESFortunately, following a few tips can help keep your eyes safe.Heaters and dry wind can aggravate dry eyes during the winter months. Dry eye syndrome, particularly common among older adults, is mostly caused by a deciency in the tear glands, and a common preservative in many glaucoma medications can worsen the symptoms. The main treatment for relief is the use of lubricating articial tears, preferably with no preservatives. Leave at least fteen minutes between applications of glaucoma eye drops and the articial tears to keep from washing the glaucoma drop out of the eye. For more severe cases, a thicker gel or ointment can be used at night or a prescriptive eye drop is available. Using a humidier in your home may also be helpful. It’s important to wear sunglasses in the winter to protect your eyes from dry, cold conditions and from the sunlight that reects o of snow and ice. Look for a label that says “100% protection against both UVA and UVB” or “100% protection against UV 400.” Choose larger frames. Frames that wrap around the sides of the face oer the greatest protection. Also, note that cost, lens color or tint, lens darkness, mirror-coating and polarization do not play a role in UV protection.If you participate in ice skating, skiing and snowboarding, consider wearing special goggles that can provide even more protection. It’s also a good idea to wear a hat to help deect the sun’s rays and, if possible, to avoid skiing or hiking behind other people to help cut down on the amount of snow and debris that can y into your face.
FELLOWSHIPS FOR 2024 ANNOUNCEDSince 2021, TGF (sponsored by Patricia Hill) has been co-funding up to ve annual $10,000 supplemental fellowships with Research to Prevent Blindness (RPB). These fellowships are targeted to Under-Represented Minorities (URMs) as dened by the NIH, who are fellows in Departments of Ophthalmology, and engaged in substantive glaucoma research as part of their fellowships. To date, 14 fellows have been funded. TGF and RPB are also co-funding a $150,000 RPB/ Glaucoma Foundation Career Advancement Award in Glaucoma Research, which is available to assistant professors, helping to advance their research and career.Dr. Ayellet V. SegréWinner of the Fall 2023 Career Advancement Award is Ayellet V. Segré, MSc, PhD, Harvard Medical School. She is working on a study that is expected to identify new biological insights into neuroprotective mechanisms of glaucoma and to suggest new therapeutic targets.The ve winners of the supplemental fellowships to under-represented minorities engaged in substantive glaucoma research as part of their fellowships are:Viviana Barquet, MD, Washington University in St. Louis School of Medicine. Dr. Barquet is involved in a study evaluating how the social determinants of health inuenced appointment adherence and impact on disease in patients with glaucoma before, during, and following the COVID-19 pandemic.Leangelo Hall, MD, Wills Eye Hospital. This funding will allow Dr. Hall to study and help improve the ability of articial intelligence technology to identify referable glaucoma in the hopes of increasing access, detection, and ultimately treatment of glaucoma for medically underserved, high-risk individuals. Alanna Elise James, MD, University of Southern California. She is using this grant to assist in the study of conversion of glaucoma suspects to manifest glaucoma, which they believe will indicate suboptimal resource utilization in glaucoma care. If true, this could drive reallocation of many of those resources towards areas in need.Giselle N. Lynch, MD, Columbia University Dept of Ophthalmology. The Manhattan Vision Screening and Follow-up Study (NYC-SIGHT) aims to investigate whether innovative community-based eye health screenings can improve early detection and management of glaucoma and other eye diseases among high-risk populations living in Upper Manhattan neighborhoods of Harlem and Washington Heights.Anthony Mukwaya, MD, Harvard Medical School. This supplemental fellowship will be used to procure reagents and supplies required to perform planned single cell RNA sequencing experiments to understand how retinal microenvironment contributes to glaucoma disease development and progression.
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