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Message weye to eye newsCONTINUED ON BACK PAGEMESSAGE FROM THE PRESIDENTDear Readers,The last few months have been evenul for the Foundaon. Leading o the good news is the announcement that TGF has received the largest individual gi in its 41-year history – a major endowment gi of $2.5 million from the Herbert Simon Family Foundaon. In June, we held the Foundaon’s 29th Opc Nerve Rescue and Restoraon Think Tank. Since 1995, this interdisciplinary conference has fostered creave thought and collaboraon among the world’s leading glaucoma experts, and specialists from other elds including engineering, neuroscience, genecs, biology, and immunology. Creave and novel ideas that originate in these discussions help to guide the course of future research with the goal of improving the lives of people with vision loss. This month, we are winding up our annual project to raise money for innovave research—VISIONS FOR VISION: The TGF Art Challenge to Celebrate Vision. We encourage you to visit our website to see the beauful painngs, drawings, photography, and sculptures by amateur and professional arsts, many of whom create with impaired sight. We hope you will make a gi in their honor.SEPT 2025Thank you for supporng The Glaucoma Foundaon.Your contribuons help us to improve life for people with glaucoma by raising awareness, funding cung-edge research, encouraging diversity in medicine, and educang physicians, paents, and the public.TGF’S ANNUAL BENEFIT GALAThis year, The Foundaon celebrated 41 years at our annual gala. More than 200 guests joined us at the Mandarin Oriental in NYC to honor Simi Ahuja, Kumar Mahadeva, David Fellows, and Helga Tan Fellows for their exceponal contribuons to the mission of TGF.L-R: Simi Ahuja, Kumar Mahadeva, Dr. Adriana Di Polo, Elena Sturman, Drs. Gregory Harmon and Jai Parekh.L-R: David Fellows, Helga Tan-Fellows, Hillary Golden, and Master of Ceremonies Jai Parekh

The Glaucoma Foundation | Page TwoIn terms of decisions about driving with vision loss, Dr. Marino stressed the importance of “useful eld of vision” and pointed out some of the most dicult condions, including dawn and dusk. She also provided a run-through of some new adapve technology that can help. Some cars can be ed with blind-spot monitoring that alerts you with audible alerts if you’re trying to make an unsafe lane change. Some cars have automac braking. There are also prism lenses that work by moving the image to correct alignment. Other aids include a myriad of magniers, text to speak opons for phones and tablets, wring guides, and much more.There’s also some cung edge new adapve technology. Just one example among several menoned was OrCam. These are devices designed for individuals with visual impairments or reading dicules. They ulize arcial intelligence to provide real-me assistance by reading text aloud, recognizing faces, and idenfying products. Studies show that more falls happen in the home than outdoors. Professional advice can be helpful in suggesng contrasng colors and special lighng. There are adaptable window shades to control how much sunlight is coming into the home at dierent mes of the day.Dr. Marino urged paents to tell their doctor if they are facing dicules. Ask for a referral to a low vision specialist, or a mobility specialist who, for example, can help with how to begin using a cane.eye to eye newsMAKING THE MOST OF YOUR SIGHTTGF’s June webinar, Low Vision and Glaucoma – Making the Most of Your Sight, was presented by Drs. Anu Laul and Rebecca Marino from the SUNY College of Optometry in New York.It focused on how glaucoma can impact your vision and your ability to complete everyday tasks, as well as what can be done to maximize your visual funcon. Dr. Laul began the presentaon by describing how visual acuity and visual eld loss from glaucoma can impact your ability to perform the everyday tasks of daily life. While loss usually begins in the periphery eld, he pointed out that dierent paerns of eld loss can aect places in one’s central vision. In one study, rather than reporng tunnel vision, paents spoke of missing spots, or blurred and fuzzy spots, which aected such tasks as reading, driving, walking, and shopping, and resulted in bumping into things and falling – surprisingly more oen at home than outdoors. Even some paents with 20/20 vision will read more slowly due to blurred or fuzzy spots. Shopping at the drug store and nding you bought condioner instead of shampoo can be very upseng. Enter the low vision specialist, whose role is to determine what devices and services can help. Dr. Marino explained that contrast loss, and glare sensivity, are primary decits in glaucoma. The contrast tesng and visual eld tests that she would do are dierent from what other eye doctors do; they are special tests that look for points of sensivity. Finding the right glasses is one of the rst tasks. There are many dierent nts and lenses available -- some for indoors and others for outdoor light.

The Glaucoma Foundation | Page Threeeye to eye news“Be curious about your disease; invest in your own glaucoma journey.” That’s advice from Judy Huang, a successful business woman in Columbus, Ohio, who was diagnosed during a roune eye exam in her 30s, some 20 years ago. Judy’s treatment began with two SLT laser surgeries and several eye drops. Beta Blockers were problemac as they can lower blood pressure, and she already had low blood pressure. Low blood pressure and high IOP at night Is not a good combinaon. Next, she went to Canada to get a surgery that was not approved in the US, but it was not successful. Then she saw a dierent doctor for a successful surgery – conrming her belief in geng a second, or even a third opinion. That worked for about a year. Ulmately Judy had tradional trabeculectomy. She also tried treatments at the Sevir Center, Magdeburg, Germany, that is now conducng clinical trials in the U.S.“I’m stable right now, but in those earlier mes when my eyesight was declining, I felt I was at the mercy of my docs. As a believing Chrisan in Jesus, my faith carried me through that me and every day. That’s also when I got more involved and became more personally invested in my own care. I went online to see what I could nd. I began going to events and listening to webinars. I learned about new technology and which specic doctors were doing promising research and involved in interesng clinical trials.”“I have been a parcipant in the clinical trial out of Stanford University that is tesng Insulin as an eye drop. I hope to connue in that trial’s third stage and have also volunteered for another trial, involving CNTF. Paents interested in clinical trials should take a look at clinicaltrials.gov to begin their search and learn more about what’s happening. Since glaucoma is a chronic disease, it’s important to keep the faith and hope in whatever is coming up.” What other advice would Judy like to share? “Be proacve. Maybe invest in your own care by renng an iCare tonometer to measure your pressures at home so that you can nd out what your IOP is at various mes of the day. Be your own advocate. Don’t let your doctor’s oce dictate what eye surgery you should have. They do their best, but many do not know about the latest research/trials; oen you do. Do not hesitate to get a 2nd or 3rd opinion.“It’s not only about IOP – it’s about lifestyle too, about what you eat, your stress level, the kind of exercise you do. Glaucoma requires a holisc outlook -- mental health, physical health, faith. I don’t drink much anymore, I work with a nutrionist and eat healthy (most of the me) and I certainly don’t smoke. Sll, there might be degeneraon taking place.“Connue to be grateful for what you are seeing. I can’t think about what my eyes used to see, because that’s already gone. I’m just very grateful for the vision I have right now.”LIVING WITH GLAUCOMA. Meet Judy Huang

The Glaucoma Foundation | Page Foureye to eye news eye to eye newsTHE GLAUCOMA FOUNDATION’S 29TH SCIENTIFIC THINK TANK NYC JUNE 20 AND 21, 2025On June 20th and 21st, TGF held our annual scienc Think Tank, a pivotal forum for the exchange of ideas among leading sciensts in diverse elds to bring their knowledge to bear on the challenges of glaucoma. This year, presentaons and discussion were on the topic of “The Future of Glaucoma: Harnessing Data, AI, and Precision Medicine for Paent-Centered Care.” This year’s experts came from Columbia University, Harvard University, Icahn School of Medicine at Mount Sinai, Johns Hopkins Wilmer Eye Instute, University of California Davis School of Medicine, University of California at San Diego, University of Michigan, University of Miami Leonard M. Miller School of Medicine, Baylor College of Medicine, University College of London, and Microso Corporaon. Sixty parcipants aended in person, and more than 100 invited guests joined us virtually on Zoom.The underlying theme presented in the talks and discussions was what one speaker termed “a poorly accessible explosion of available data and the challenge that data integraon presents.”“AI oers a huge opportunity to leverage the wealth of data available on glaucoma paents, but we have yet to translate that data into a beer understanding of the disease or its treatment,” said Dr. Louis Pasquale.The opening speaker, Dr. James David Brandt of UC Davis, spoke about the challenge of glaucoma data integraon for researchers and clinicians. As he said, “…all this crucial data is hidden in plain sight – siloed in ways that make it dicult to connect the dots in real me for the paent sing in the clinician’s oce.” The rst day of the conference dealt with data science, issues and uses of integrang glaucoma, impacts of AI on glaucoma, building inclusive genomic and clinical datasets, AI applicaons in ophthalmic surgery, and integrang AI into randomized clinical trials.On day two, Michael F. Chiang, Director of the Naonal Eye Instute at the Naonal Instutes of Health, spoke on “Vistas to Data Integraon in Ophthalmology.” His talk addressed promises and challenges regarding informaon technology, data science, and collaboraon, and iniaves at the NEI intended to address those challenges in areas such as imaging, arcial intelligence, data standards, and the promoon of team science.Michael F. Chiang, Director of the Naonal Eye Instute

The Glaucoma Foundation | Page Fiveeye to eye newsA panel following Dr. Chiang’s talk addressed some important quesons, among them: Why aren’t there standard denions for glaucoma in 2025, and how can we develop them?What can NIH and the glaucoma community do to beer promote standards and interoperability in glaucoma imaging, devices, and Electronic Health Records data?How might the glaucoma community lead innovaon in synthesizing discrete published ndings into high-level knowledge, or developing new paradigms for collaborave discovery of “truth”?There was a general consensus about the need for universally accepted denions of glaucoma, which are now inconsistent, and aer that, trying to get all the dierent plaorms where data is collected into the same DICOM-compable modality.Among data standards that are hard to leverage is IOP. The queson is how is IOP measured? There are dierent tools to do that – from tonopens to iCare rebound tonometers, to Glaucoma paents/advocates Hillary A. Golden and Patricia Lee Cauleld on the panel for the nal session.Goldmann Applanaon – but variable operator technique, data acquision methods, and paent cooperaon raise quesons regarding what standard approaches can be used to integrate such data in meaningful ways. This is an example of data that is readily extractable from the electronic medical record that is considerably “noisy” because it’s measured in dierent ways, by dierent people. Where ocular imaging is concerned, DICOM global standards exist for most imaging devices, but adopon remains oponal and low despite years of eort.The amount of published data is becoming unmanageable. AI presents a great opportunity to leverage that data, but what’s important is data standards and diagnosc criteria for the disease.A nal live-streamed session on the glaucoma paent perspecve featured one presentaon on glaucoma coaching from the doctor’s perspecve, and two talks by paents – one of whom is a professional glaucoma coach and another who oered a perspecve on taking ownership of the disease. Dr. Aakri Garg Shukla of New York Presbyterian Hospital described glaucoma coaching as a developing technique that shis the focus from one-sided informaon delivery in healthcare sengs to an interacve conversaon that includes movaon, personalizaon, and goal seng. Unlike tradional paent educaon, coaching emphasizes behavior change and paent autonomy, empowering individuals to manage their chronic condions.

The Glaucoma Foundation | Page Six The Glaucoma Foundaon has received a major endowment gi of $2.5 million from the Herbert Simon Family Foundaon to establish the Herbert Simon Chair in Glaucoma Research and Innovaon. The endowment will support the work of Alon Harris, MS, PhD, FARVO, an internaonally renowned leading clinical scienst in the eld of ophthalmology and glaucoma.eye to eye newsDr. Harris’s work extends from the development of novel diagnosc and monitoring approaches for managing glaucoma to artificial intelligence and digital twin applicaons that are enhancing our understanding of disease progression. He serves as Co-Director of the Barry Family Center for Ophthalmic Arcial Intelligence & Human Health and Vice Chair of Internaonal Research and Academic Aairs at Mount Sinai Hospital. In addion, he is the Director of the Ophthalmic Vascular Diagnosc and Research Program, and holds dual professorships in Ophthalmology and Arcial Intelligence and Human Health at the Icahn School of Medicine at Mount Sinai. “Glaucoma has touched my family in a personal way and I know how crical early detecon and innovave treatment can be,” explained Herbert Simon. “Supporng Dr. Alon Harris’s work is not just an investment in science – it’s a commitment to saving sight and improving lives. I’m proud that our family’s name will be ed to someone whose passion and impact are so profound.”Acknowledging the new endowment gi, Elena Sturman, the Glaucoma Foundaon’s President and CEO said: “We are thrilled to receive this transformave gi – the largest individual gi in TGF’s 41-year history. It not only recognizes the impact that Dr. Harris’s work has had on the eld of glaucoma research, but assures that his innovave work will connue to shape future direcons in the ght against this devastang disease.”“I extend my sincere thanks and gratude to the Simon family for their most generous support of my work going forward,” says Dr. Harris. “I am honored that they have entrusted me to carry out our shared commitment to research and innovaon that can save sight and improve lives.”

DOCTOR, I HAVE A QUESTION.WHAT ARE THE CONSIDERATIONS WHEN A PATIENT HAS CATARACTS AND GLAUCOMA? Queson answered by:Gregory K. Harmon, MDChairman of the Board of The Glaucoma FoundaonDr. Harmon is in private pracce, specializing in glaucoma and cataract surgery.Cataracts occur when the eye’s naturally clear lens becomes cloudy, usually with age. In cataracts, the proteins in your eye’s lens start to break down around age 40. But you typically won’t noce symptoms unl age 60 or later. Certain medical condions, like diabetes, steroid usage and trauma to the eye may cause you to have symptoms sooner. Glaucoma, like cataracts, is a disease more common as people grow older. Elevated eye pressure (IOP) inside the eye is the greatest risk factor for glaucoma. The goal of almost all glaucoma treatment is to lower eye pressure to prevent or limit damage to the opc nerve. If a cataract makes it harder to see clearly and your eye pressure is not as it should be in spite of medicaons or laser treatment, your doctor may suggest treang both surgically at the same me.Today there are numerous newer surgical glaucoma procedures that do not require as much cung into the eye and involve less risk than tradional surgeries. These are called MIGS, meaning minimally invasive glaucoma The Glaucoma Foundation | Page Sevensurgeries. Even if your IOP is controlled on medications, an extra step (MIGS) during cataract surgery usually results in beer eye pressure control, oen reducing the need for glaucoma medicaons.MIGS can be combined with cataract surgery for paents with mild to moderate open-angle glaucoma. In fact, some MIGS are FDA approved only for use with cataract surgery. Most use the same ny incision used during cataract surgery.There are several types of intraocular lenses (IOLs) doctors use in cataract surgery. And if there is coexisng glaucoma, there are several consideraons for your doctor in choosing which type of lens to recommend.One key fact is that contrast sensivity is reduced in glaucoma and worsens as glaucoma advances. It therefore is contraindicated to use a mulfocal lens or an extended depth of eld lens with paents who have moderate or advanced glaucoma because these types of lenses also reduce contrast sensivity - especially under low light condions. Monofocal lenses and Toric intraocular lenses can be used safely in paents with glaucoma. Another issue that is important relates to exfoliave glaucoma, or pseudo exfoliave glaucoma. In this type of glaucoma, there is a signicant risk of the paent having weakness in the Zonules – the ny bers that hold the natural lens in place. Certain techniques are required to minimize the chance of the zonules breaking during the surgery and the paent’s natural lens falling into the back of the eye, near the rena. For this reason, femtosecond eye to eye newsCONTINUED ON BACK PAGE

eye to eye newsMESSAGE FROM THE PRESIDENTconnued from page 1CATARACTS AND GLAUCOMAconnued from page 7The Glaucoma Foundation | Page Eightlaser is the preferred method of removing the cataract for most surgeons that deal with this type of higher risk glaucoma paent. In fact, many surgeons believe that it is helpful to perform femtosecond laser in all glaucoma paents having cataract surgery because it can minimize inammaon and, in some paents, result in more speedy recovery.While MIGS procedures will not replace or eliminate traditional glaucoma surgery, they provide a lower threshold for surgical intervenon with the goal of beer IOP control. In fact, for many surgeons, it is considered a missed opportunity to not do a MIGS procedure at the same me you are removing a cataract from an individual who has coexistent glaucoma. Some MIGS opons include • Hydrus Microstent (Ivans/Alcon) • iStent (Glaukos) • Kahook Dual Blade (New World Medical) • XEN Gel Stent (Allergan) • Sion goniotomy (Sight Sciences) • OMNI (Sight Sciences) • and Trabectome (MicroSurgical Technology)In planning cataract surgery in the presence of glaucoma, your doctor will consider if your current meds are suciently lowering your eye pressure and if you are tolerang the side eects of your meds. A discussion with your eye doctor about all the treatment opons, risks and benets of various MIGS is important in order to determine and recommend the best opon for you.TGF webinars are an important element of our educaonal programs. This issue has an arcle about a recent webinar on low vision and making the most of your sight. In August we aired “Do I Have the Right Doctor,” with Drs. John Berdahl and Murray Fingeret, and glaucoma paent and advocate Patricia Lee Cauleld. These and other webinars can be viewed on TGF’s YouTube Channel: youtube.com/@theglaucomafoundaonWe look forward to connuing answering quesons 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@glaucomafoundaon.org.Thank you,Elena SturmanJoin us for September’s webinar