The Importance of Early Detection in Glaucoma Treatment
Drs. Ike Ahmed and Anthony Realini discuss the importance of promptly diagnosing, managing, and treating glaucoma for better outcomes.
Ike Ahmed, M.D. FRCSC, Director, Alan S. Crandall Center for Glaucoma Innovation, University of Utah School of Medicine
Anthony
Realini, M.D., M.P.H. Professor, Vice Chair for Clinical Research, West Virginia
University Health Sciences Center
Where do you see the future of glaucoma care in the next decade?
Ike Ahmed: I’m excited about the ability to use at-home diagnostics or virtual diagnostics to detect early changes in the eye. Additionally, using gene therapy to change the way your genes are expressed in your eye to lower pressure and protect your nerve is critical.
We also have molecules being developed that may protect the eye from high pressure by preventing the nerve layer of the eye from degenerating. This practice is called neuroprotection, and in the future, we hope that we’re going to be able to use this mechanism.
What advice would you give to someone newly diagnosed with glaucoma to help them navigate their healthcare journey?
Antony Realini: The first thing I would say is that blindness from glaucoma is extraordinarily rare in people who regularly engage with their healthcare provider and stay on top of their own personal health. Under those conditions, if the treatment that they’re receiving isn’t working, the doctor will pick up on that through routine monitoring and adjust their therapy.
Most of the people who go blind from glaucoma are those who don’t know they have the disease. The biggest challenge healthcare practitioners face is convincing people that they have glaucoma in the early stages.
Read the full panel interview online at futureofpersonalhealth.com
Protecting Your Vision:
The Importance of Early Detection and Management of Glaucoma at All Ages
Often referred to as “the silent thief of sight,” glaucoma affects 80 million people each year — and as many as half have not yet been diagnosed.
Glaucoma is a group of chronic eye diseases that damage the optic nerve and lead to irreversible vision loss. It is the second leading cause of blindness in the world and there is no cure. In most cases, glaucoma is a result of increased intraocular pressure (IOP), and the goal of treatment is to maintain a safe IOP through medical and/or surgical therapy.
Most glaucomas progress slowly, but there are also cases of acute angle-closure glaucoma where symptoms will be abrupt and obvious. If you experience sudden blurred vision, severe eye pain, eye redness, decreased vision, headache, nausea, vomiting, or rainbow-colored rings or halos around lights, this is a medical emergency.
We often think of glaucoma as a disease of the old. If you are under the age of 40, you may not feel the need to have an eye exam today. However, the sooner glaucoma is detected, the better your prognosis.
You may be at higher risk for glaucoma if you are of African, Hispanic, or Asian heritage, or if you have a family history of glaucoma. However, glaucoma can affect anyone at any time. For the Black population, the disease is likely to occur 10 years earlier than in other ethnic populations. Close to 300,000 children worldwide have glaucoma.
Challenges of living with glaucoma
Regardless of the type of glaucoma you have, treatment will be lifelong and you will need to see your doctor regularly. Following an initial diagnosis, you may need to have your eye pressure checked every week or month until it is under control. Most patients will be prescribed a daily regimen of eyedrops, sometimes
to be taken several times a day. Adhering to your treatment is very important. There are also surgical interventions to treat glaucoma. If surgery is indicated, you will need additional pre- and post-op appointments with your doctor.
If you are experiencing low vision — vision that cannot be corrected with eyeglasses or contact lenses — you may benefit from low vision therapy to improve your ability to perform daily tasks and thrive in your home and work life. An optometrist might provide optical and electronic devices; an occupational therapist can introduce you to adaptive equipment and techniques; an orientation and mobility instructor can teach you how to navigate your space; and a psychologist can help if you’re struggling. Worrying about your eyesight, managing your medication, and getting to all of your appointments is stressful. The cost of treatment may be burdensome. If you are at a high risk for glaucoma, Medicare will cover some eye care. Tragically, it will not cover low vision rehabilitation. If you are underinsured, organizations like the Center for Vision Health, the American Glaucoma Society, Prevent Blindness, EyeCare America, and All Children See may be able to help.
The bottom line
Regular eye exams are vital to protect the health of your eyes. Be proactive. Develop a good working relationship with your doctor. Ask a lot of questions. Talk about your concerns. Together, you and your doctor can protect your eyesight.
Written by Cly Fowkes, Director of Special Projects, The Glaucoma Foundation
Publisher Kevin Walker Managing Director Gretchen Pancak Production Manager Dustin Brennan Creative Director Kylie Armishaw Client Success Manager Taylor Daniels
Doctor Eye Health Discusses Macular Degeneration
Dr. Joseph Allen, whose YouTube channel, Doctor Eye Health, has 1 million subscribers, shares the importance of prioritizing one’s eye health, and dives in on the details of macular degeneration.
What is age-related macular degeneration (AMD) and how does it affect a patient’s daily life?
AMD is one of the more prominent blinding eye diseases that occur in people over the age of 50. This is where the retinal cells in the back of the eye begin to slowly die off and stop functioning. The exact cause of macular degeneration is not fully understood yet, but we know that risk factors such as aging, smoking, obesity, and diet all play a role.
Early on, people may not know they have a problem unless they’re seeing their eye doctor on a regular basis. It may be slowly developing without true vision loss, but the earliest sign that people may have is reduced vision at nighttime or in low-light situations. As macular degeneration slowly starts getting worse, it affects your central vision, so things like reading or recognizing faces become extremely difficult.
Macular degeneration is called age-related macular degeneration because it specifically affects the central bullseye in the back of the eye called the macula, which provides your sharp reading ability and color vision.
What advice would you give to someone who is newly diagnosed with an eye disease? Following up with your doctor and listening
closely to their recommendations is critical. Not being afraid to ask questions about your condition and being proactive about the disease is also very important. These small habits can have ripple effects and help improve other aspects of a patient’s life. As a doctor, I want all my patients to advocate for their health so I can do everything possible to help them live better lives.
How has your YouTube channel and following played a role in advocating for different eye diseases and in your life as a doctor?
I originally started just because there wasn’t very much about eye health on YouTube at the time. It has been validating to see that not just eye doctors are interested in this content. A lot of people are struggling with their eye health and are unable to receive the proper healthcare.
My goal with the YouTube channel is to provide answers to the most pressing questions regarding eye health. I want to encourage people to take good care of their health while delivering true information.
YouTube has made me a better doctor because it’s pushed me to become a better speaker in front of patients. This channel has also motivated me to research even more because I want to provide information and data from the most recent publications.
Why Increased Funding for Vision Research Is Vital for an Aging America
Each day, 10,000 Americans turn 65 and will be at the greatest risk of age-related eye disease.
The prevalence of eye diseases like age-related macular degeneration (AMD), glaucoma, diabetic retinopathy, and cataracts is expected to rise significantly. This surge underscores the urgent need for increased funding and research to develop better treatments and improve the quality of life for millions of Americans.
Vision impairment and blindness lead to increased healthcare costs, loss of productivity, and a greater need for social services. Only through dedicated research can we develop effective prevention strategies, innovative treatments, and cures that will mitigate these expenses. Vision research is not just a medical necessity; it is an economic imperative to reduce the financial strain on our healthcare system and society at large.
National Alliance for Eye and Vision Research (NAEVR) plays a pivotal role in advocating for increased funding and providing educational resources. Vision impairment and blindness pose significant challenges to an aging population. Increased funding for the National Eye Institute and other research institutions is essential to develop new treatments, improve existing ones, and ultimately find cures for these debilitating eye diseases.
By prioritizing funding, we can support the scientific advancements necessary to tackle the growing prevalence of eye diseases and ensure that our aging population can maintain their vision and quality of life.
WRITTEN BY Dan Ignaszewski Executive Director, National Alliance for Eye and Vision Research
Dr. Joseph Allen
Low-Vision Resources to Start Using Today
When it comes to vision loss, it’s smart to keep one eye on the future. But what about the low-vision tools available right now?
Modern accessibility features, online resources, and community programs improve communication and quality of life for people with low vision.
Get the most out of your smartphone
Most smart devices let you change settings like color contrast and text size without downloading extra apps. Many newer phones also offer built-in low-vision accessibility tools like screen readers and magnifiers.
Apps like Be My Eyes connect people who have vision disabilities with sighted assistants who can help with anything from ordering dinner to picking out a suit.
Check out funding opportunities
Find out if you qualify for state and federal funding programs like Medicare and Medicaid. Even if you don’t need assistance yet, you can save yourself a lot of future stress by researching your options now.
Even if you’re just starting to experience vision loss, it can get much harder to find low-vision resources as time goes on. Organizations like Ability Central are here to help you make the most of your independence while you navigate your changing world.
Written by Ability Central
Age-Related Macular Degeneration: Knowing the Risks, Protecting Your Vision
Never take your vision for granted. Your ability to see the world in all its wonder — the deep blue sky, the smiling faces of loved ones, or a great touchdown catch — is truly magical.
That magic is made possible by our retinas, the thin layers of powerful tissue lining the backs of our eyes. Retinas work like film or digital sensors in a camera to capture light, converting it into signals that our brain processes to create the images we see.
If you are fortunate, you will never have to worry about your retinas. If you eat a healthy diet, don’t smoke, and have good genetic luck, your retinas have a good chance of lasting a lifetime.
However, there’s one major risk factor for the health of your retinas that you can’t control: getting older. Once you reach 55, your risk for a retinal condition called age-related macular degeneration (AMD) begins to increase. The older you get, the greater your risk for AMD. About 200 million people around the world, including 10 million in the United States, have the condition. It’s the leading cause of blindness in developed countries.
Causes of AMD
In AMD, fatty deposits called drusen accumulate underneath the retina and can lead to the degeneration of the cells called photoreceptors that make vision possible. The center of your retina, the macula, is most affected by AMD.
People with advanced AMD can lose their central vision — the ability to read, drive, and recognize the faces of friends and loved ones. Sometimes, the fatty deposits alone are the culprit — they cause the dry form of AMD. In other cases, vision-robbing, leaky
blood vessels also grow underneath the retina, leading to wet AMD.
Minimizing your risk
What can you do to minimize your risk? Well, it gets back to healthy living. Doctors often say that what’s good for your heart is good for your eyes and retinas. So, don’t smoke, eat healthy, and exercise. Also, if you are over age 55, see your eye doctor every year to address any issues that may be developing. Many eye conditions, including AMD, are silent but can be treated if addressed early.
There’s also great research underway to improve the efficacy and convenience of treating AMD. Scientists are working on innovative approaches for preventing vision loss from ever occurring. New drugs, gene therapies, and stem cell treatments are being developed to save and restore vision for people with AMD.
These emerging techniques also show great promise to help people with inherited retinal diseases like retinitis pigmentosa, Stargardt disease, and Usher syndrome. While these genetic conditions are less common, they are often diagnosed in children and are progressive, leading to blindness by adulthood.
Written by Ben Shaberman, Vice President, Science Communications, Foundation Fighting Blindness
Learn more about AMD, inherited retinal diseases, and cutting-edge research by visiting FightingBlindness.org
Clear Eyes: How the Light Adjustable Lens Has Revolutionized Cataract Surgery
“This is unlike anything we have seen in ophthalmology,” said Kenneth King, O.D., a bright-eyed optometrist at the Alliance Vision Institute in Fort Worth, TX. He’s referring to a particularly ingenious type of artificial intraocular lens (IOL) that’s changing the game in cataract surgery.
When you think of cataracts — a clouding of the lens of the eye — you may picture an elderly person suffering from the disorder. And while over half of all Americans age 80 or older have cataracts or have had surgery to eliminate them, according to the National Eye Institute (NEI), the CDC reports that about “20.5 million (17.2%) Americans aged 40 years and older have [cataracts] in one or both eyes, and 6.1 million (5.1%) have had their lens removed by surgery.”
The good news is that surgery options are considered safe, with the NEI stating that 9 out of 10 people “can see better” afterward. Cataracts may hamper everyday activities, and the CDC says they’re one of the leading causes of vision loss in the United States.
A fine-tuned solution
Commercialized by RxSight® — an ophthalmic medical technology corporation based in Aliso Viejo, California — the Light Adjustable Lens™ (LAL®/LAL+™) is the only FDA-approved IOL that can be adjusted and customized in the eye, after cataract surgery. At the forefront of these surgeries is Taylor Strange, D.O., a board-certified ophthalmologist who specializes in laser vision-correction surgery and vision-enhancement procedures.
So, what makes the Light Adjustable Lens so unique? As explained by Dr. Strange, it’s “made of a special photosensitive material that can be modified by a specific wavelength of light. After the lens is implanted, we’re able to use a special light delivery device to make very specific, fine-tuned adjustments to the patient’s visual outcome by correcting any residual refractive errors.”
Currently, no other intraocular lens on the market has this ability, which makes the LAL quite remarkable. It allows for more precision, true adjustability, and freedom of choice in the patient’s vision, post-surgery — allowing them to go through a trial-run of how they see
the world with the new lens, then modifying as needed or desired.
A team effort
To date, Dr. Strange has performed more than 750 Light Adjustable Lens surgeries. He partners with Dr. King, who specializes in preand post-surgery treatments (among other specialties) and works on the light-treatment portion as part of the overall procedure.
“The lens requires surgical expertise on the front end and extensive attention to detail on the back end,” Dr. King pointed out. “So, we quickly divided the care of the patients into surgical care and post-op care. Dr. Strange handles the surgery and I handle the adjustments. It also became obvious that extra time must be spent with patients to understand their needs and expectations for their vision, pre- and post-operatively.”
Recently, Dr. King decided to enhance his vision by choosing the Light Adjustable Lens for himself. Naturally, Dr. Strange performed the surgery.
“The surgery was very easy,” Dr. King recalled. “There was no pain. In fact, I don’t remember much — just some green lights. And I could actually see on my way home. I went to work taking care of patients the next day and could read charts and see faces down the hallway! After healing for a few weeks, we did my first adjustment and that improved my vision even more. I was then able to ‘lock in’ what would be my final vision. The adjustments on the machine were a bit bright, but I had no pain at all.”
Moving forward, what makes Dr. Strange optimistic about the future of this technology?
“It’s all about the power of adjustability,” he said. “That’s what gives the Light Adjustable Lens the advantage for truly customized vision after cataract surgery. The lenses can even be adjusted up to three times, if necessary, to meet the patient’s lifestyle.”
Written by Omar Sommereyns
To learn more, visit allianceeyes.com and rxsight.com
INTERVIEW WITH Taylor Strange (left), D.O., Board-Certified Ophthalmologist & Kenneth King, O.D., Optometrist Photo courtesy of RxSight®
