Wednesday, July 30, 2014

Dr. Prem Subramanian a neuro-ophthalmologist volunteers for Vietnam eye conference


To, 

Dr. Prem Subramanian,
 neuro-ophthalmologist,
The Wilmer Eye Institute
Johns Hopkins Hospital
600 N. Wolfe St.
Baltimore, MD 21287
wilmerinfo@jhmi.edu

Respected Sir, 

Attention :Dr. Prem Subramanian,

I hv by now about 90% vision loss in my right eye due Right eye optic neuritis. 
Initially when I went to local eye clinics in Mumbai one after another none cud diagnose the problem and wound up saying it may be due to onset of cataract. Finally after lot of hunting and several tests and finally MRI the conclusion was that it is Right eye optic neuritis. 

I vigorously hunted for neuro-ophthalmologist in Mumbai but none of the even leading eye hospital and multispeciality hospitals had neuro-ophthalmologist in Mumbai. Many hospitals and eye specialist did not know that there is a super super speciality field like neuro-ophthalmology.

Finally net search gave me list of some neuro-ophthalmologist at Sankara Netralaya. That is an excellent hospital but they also did not have any solutions for me. 

My request is : 

1. Pl. give me your personal  email id.

2. Pl. have similar programme in Mumbai / India as you had in Vietnam. I know the initiative was from Vietnamese and v lack here such initiatives from health ministry, NGOs. , Eye doctors associations and hospitals. But if you try then some thing may come up in near future or else Indians suffering  here will be deprived for right diagnosis and treatment for decades. 

3. for my personal issues which id I must write and what will be expense if I plan to visit and consult yourgoodself. 

4. I tried to enroll on your eye hospitals newsletter but it allows only US citizens to enroll. Pl. allow other country specialists and citizens to also enroll and get deeper insight. 

It is hearty to note that you went at your own expense to share your valuable knowledge in the field of  neuro-ophthalmology all the way to Vietnam. We are proud of you rather our newspapers must cover proudly this yeomen service of yours and expect same for your countrymen too. 


Alok Tholiya 
+919324225699
atholiya@gmail.com 
Mumbai, India







The four-day conference was held by the nonprofit Hawaiian Eye Foundation in partnership with Hue Central Hospital, the foundation said in a press release.


Dr. Prem Subramanian of Silver Spring, a neuro-ophthalmologist with the Wilmer Eye Institute, was part of a volunteer faculty group that took part in the Imperial City Eye Meeting in Hue, Vietnam, in April.
Almost 300 ophthalmology students and practicing ophthalmologists from throughout Vietnam participated.
Subramanian and other faculty members traveled to Vietnam at their own expense.
“It was a tremendous opportunity to teach our Vietnamese colleagues about neuro-ophthalmology, since there are no neuro-ophthalmologists in Vietnam,” Subramanian said in the press release. “The knowledge they gained will help them to care for challenging eye problems in their patients.”


About the Wilmer Eye Institute

Select Staff, Unique Setting
The Wilmer Eye Institute has long been recognized for bringing together ophthalmologists and optometrists consistently ranked by their peers as among the finest internationally, supported by a well-trained and highly-experienced team of physician assistants, nurses, technicians, and staff cited by patients for their knowledge, responsiveness, and sensitivity. Since 1925, they have established and refined a flexible approach for delivering state-of-the-art ophthalmic care at The Johns Hopkins Hospital and eight convenient satellite locations across central Maryland. With the completion of The Robert H. and Clarice Smith Building and adjoining Maurice Bendann Surgical Pavilion in 2009, the Institute has established a preeminent vision research center and one of the most modern ophthalmic surgical facilities in the world.
Individual Attention to Our Patients' Needs
Wilmer's goal is to provide comprehensive, high-quality, responsibly-priced, and state-of-the-art eye care in an accessible, supportive, caring, and user-friendly environment; resulting in superior outcomes and a high level of satisfaction for patients. Through use of innovative methods, Wilmer ophthalmologists, optometrists, nurses, and staff operate with exceptional efficiency. Wilmer also provides a level of individual attention highly valued by our patients, whether they are visiting us for a routine checkup, outpatient consultation, procedure, extended care, or emergency care. For the convenience of our patients and referring providers, the Wilmer Call Center is available Monday through Friday, 8:30 am - 5:00 pm, to schedule appointments and provide general assistance in a friendly and professional manner. From arrival to checkout, we strive to maximize the experience for patients and visitors aloi.
Convenient and Comprehensive Outpatient Care
Wilmer sites at the Johns Hopkins Hospital and surrounding counties combine the expert care of Wilmer ophthalmologists and optometrists, who are equipped with the latest in diagnostic and surgical technologies, with the ease and convenience of an efficient outpatient facility. Clinical eye services include medical and surgical evaluation and management of a wide range of conditions and diseases.  Wilmer's surgeons also offer the latest refractive technologies designed to reduce dependence on eyeglasses, including Lasik and use of deluxe intraocular lenses in cataract surgery. Complete pre-operative and post-operative care and patient education are provided by our skilled and professional physician assistants and nursing staff. Specialized ophthalmic medications are formulated on-site at the Johns Hopkins Hospital Pharmacy.
Wilmer also offers state-of-the-art Low Vision evaluation and management for patients who have lost vision as a result of trauma or chronic eye disease. Additionally, at all of Wilmer's outpatient locations, our providers offer expert routine and general/comprehensive eye care for adults and children. Appointments for non-urgent conditions are generally available within two weeks.
At many of our locations, a convenient Wilmer Optical Shoppe provides patients and families the opportunity to fill prescriptions for eyeglasses and contact lenses right on the premises. Operated by Wilmer Eye Institute managers and staff, patients will experience our signature optical expertise, a wide selection of options, and high-quality workmanship.
Maryland Eye Trauma Center
As the only designated eye trauma center of the Maryland Institute for Emergency Medical Services Systems, Wilmer's Eye Emergency Service, located in the Johns Hopkins Hospital Adult and Pediatric Emergency Rooms, delivers 24-hour-a-day care for blunt and penetrating injuries, chemical burns, and other eye or orbital trauma. Wilmer physicians consult with neurologists, plastic surgeons, otolaryngologists, and social workers to address the patient's complete needs during episodes of acute care.
Inpatient Services
When the patient's condition calls for extended overnight observation and treatment, Wilmer Eye Institute ophthalmologists and Johns Hopkins surgical care units have forged a collaborative partnership, ensuring a smooth and efficient patient transfer to an inpatient room. As always, the full resources of the Johns Hopkins Hospital and its specialists are available for the patient as required.
About the Wilmer Dome
The Robert H. and Clarice Smith Building and Maurice Bendann Surgical Pavilion were designed to mirror the octagonal Wilmer Dome atop our historic Johns Hopkins Hospital location. The Dome, located on the third floor of the Wilmer building, remains open to public viewing of displayed historical interest items, including the portrait of founding director William H. Wilmer, M.D.; early ophthalmic instruments; the "President's Chair" used by Dr. Wilmer to examine eight Presidents of the United States; and a selection of photography from the Wilmer Eye Institute archives. Formerly the surgical suite prior to the opening of the Bendann Pavilion, the space is now the home of Wilmer's Central Surgical Scheduling unit.
Contact Us
Make An Appointment:
(410) 955-5080
1-800-21JOHNS (1-800-215-6467) - Toll Free
General Questions:
wilmerinfo@jhmi.edu
Reach Us By Mail:
The Wilmer Eye Institute
Johns Hopkins Hospital
600 N. Wolfe St.
Baltimore, MD 21287

Dr. Prem Subramanian a neuro-ophthalmologist volunteers for Vietnam eye conference


To, 

Dr. Prem Subramanian,
 neuro-ophthalmologist,
The Wilmer Eye Institute
Johns Hopkins Hospital
600 N. Wolfe St.
Baltimore, MD 21287
wilmerinfo@jhmi.edu

Respected Sir, 

Attention :Dr. Prem Subramanian,

I hv by now about 90% vision loss in my right eye due Right eye optic neuritis. 
Initially when I went to local eye clinics in Mumbai one after another none cud diagnose the problem and wound up saying it may be due to onset of cataract. Finally after lot of hunting and several tests and finally MRI the conclusion was that it is Right eye optic neuritis. 

I vigorously hunted for neuro-ophthalmologist in Mumbai but none of the even leading eye hospital and multispeciality hospitals had neuro-ophthalmologist in Mumbai. Many hospitals and eye specialist did not know that there is a super super speciality field like neuro-ophthalmology.

Finally net search gave me list of some neuro-ophthalmologist at Sankara Netralaya. That is an excellent hospital but they also did not have any solutions for me. 

My request is : 

1. Pl. give me your personal  email id.

2. Pl. have similar programme in Mumbai / India as you had in Vietnam. I know the initiative was from Vietnamese and v lack here such initiatives from health ministry, NGOs. , Eye doctors associations and hospitals. But if you try then some thing may come up in near future or else Indians suffering  here will be deprived for right diagnosis and treatment for decades. 

3. for my personal issues which id I must write and what will be expense if I plan to visit and consult yourgoodself. 

4. I tried to enroll on your eye hospitals newsletter but it allows only US citizens to enroll. Pl. allow other country specialists and citizens to also enroll and get deeper insight. 

It is hearty to note that you went at your own expense to share your valuable knowledge in the field of  neuro-ophthalmology all the way to Vietnam. We are proud of you rather our newspapers must cover proudly this yeomen service of yours and expect same for your countrymen too. 


Alok Tholiya 
+919324225699
atholiya@gmail.com 
Mumbai, India







The four-day conference was held by the nonprofit Hawaiian Eye Foundation in partnership with Hue Central Hospital, the foundation said in a press release.


Dr. Prem Subramanian of Silver Spring, a neuro-ophthalmologist with the Wilmer Eye Institute, was part of a volunteer faculty group that took part in the Imperial City Eye Meeting in Hue, Vietnam, in April.
Almost 300 ophthalmology students and practicing ophthalmologists from throughout Vietnam participated.
Subramanian and other faculty members traveled to Vietnam at their own expense.
“It was a tremendous opportunity to teach our Vietnamese colleagues about neuro-ophthalmology, since there are no neuro-ophthalmologists in Vietnam,” Subramanian said in the press release. “The knowledge they gained will help them to care for challenging eye problems in their patients.”


About the Wilmer Eye Institute

Select Staff, Unique Setting
The Wilmer Eye Institute has long been recognized for bringing together ophthalmologists and optometrists consistently ranked by their peers as among the finest internationally, supported by a well-trained and highly-experienced team of physician assistants, nurses, technicians, and staff cited by patients for their knowledge, responsiveness, and sensitivity. Since 1925, they have established and refined a flexible approach for delivering state-of-the-art ophthalmic care at The Johns Hopkins Hospital and eight convenient satellite locations across central Maryland. With the completion of The Robert H. and Clarice Smith Building and adjoining Maurice Bendann Surgical Pavilion in 2009, the Institute has established a preeminent vision research center and one of the most modern ophthalmic surgical facilities in the world.
Individual Attention to Our Patients' Needs
Wilmer's goal is to provide comprehensive, high-quality, responsibly-priced, and state-of-the-art eye care in an accessible, supportive, caring, and user-friendly environment; resulting in superior outcomes and a high level of satisfaction for patients. Through use of innovative methods, Wilmer ophthalmologists, optometrists, nurses, and staff operate with exceptional efficiency. Wilmer also provides a level of individual attention highly valued by our patients, whether they are visiting us for a routine checkup, outpatient consultation, procedure, extended care, or emergency care. For the convenience of our patients and referring providers, the Wilmer Call Center is available Monday through Friday, 8:30 am - 5:00 pm, to schedule appointments and provide general assistance in a friendly and professional manner. From arrival to checkout, we strive to maximize the experience for patients and visitors aloi.
Convenient and Comprehensive Outpatient Care
Wilmer sites at the Johns Hopkins Hospital and surrounding counties combine the expert care of Wilmer ophthalmologists and optometrists, who are equipped with the latest in diagnostic and surgical technologies, with the ease and convenience of an efficient outpatient facility. Clinical eye services include medical and surgical evaluation and management of a wide range of conditions and diseases.  Wilmer's surgeons also offer the latest refractive technologies designed to reduce dependence on eyeglasses, including Lasik and use of deluxe intraocular lenses in cataract surgery. Complete pre-operative and post-operative care and patient education are provided by our skilled and professional physician assistants and nursing staff. Specialized ophthalmic medications are formulated on-site at the Johns Hopkins Hospital Pharmacy.
Wilmer also offers state-of-the-art Low Vision evaluation and management for patients who have lost vision as a result of trauma or chronic eye disease. Additionally, at all of Wilmer's outpatient locations, our providers offer expert routine and general/comprehensive eye care for adults and children. Appointments for non-urgent conditions are generally available within two weeks.
At many of our locations, a convenient Wilmer Optical Shoppe provides patients and families the opportunity to fill prescriptions for eyeglasses and contact lenses right on the premises. Operated by Wilmer Eye Institute managers and staff, patients will experience our signature optical expertise, a wide selection of options, and high-quality workmanship.
Maryland Eye Trauma Center
As the only designated eye trauma center of the Maryland Institute for Emergency Medical Services Systems, Wilmer's Eye Emergency Service, located in the Johns Hopkins Hospital Adult and Pediatric Emergency Rooms, delivers 24-hour-a-day care for blunt and penetrating injuries, chemical burns, and other eye or orbital trauma. Wilmer physicians consult with neurologists, plastic surgeons, otolaryngologists, and social workers to address the patient's complete needs during episodes of acute care.
Inpatient Services
When the patient's condition calls for extended overnight observation and treatment, Wilmer Eye Institute ophthalmologists and Johns Hopkins surgical care units have forged a collaborative partnership, ensuring a smooth and efficient patient transfer to an inpatient room. As always, the full resources of the Johns Hopkins Hospital and its specialists are available for the patient as required.
About the Wilmer Dome
The Robert H. and Clarice Smith Building and Maurice Bendann Surgical Pavilion were designed to mirror the octagonal Wilmer Dome atop our historic Johns Hopkins Hospital location. The Dome, located on the third floor of the Wilmer building, remains open to public viewing of displayed historical interest items, including the portrait of founding director William H. Wilmer, M.D.; early ophthalmic instruments; the "President's Chair" used by Dr. Wilmer to examine eight Presidents of the United States; and a selection of photography from the Wilmer Eye Institute archives. Formerly the surgical suite prior to the opening of the Bendann Pavilion, the space is now the home of Wilmer's Central Surgical Scheduling unit.
Contact Us
Make An Appointment:
(410) 955-5080
1-800-21JOHNS (1-800-215-6467) - Toll Free
General Questions:
wilmerinfo@jhmi.edu
Reach Us By Mail:
The Wilmer Eye Institute
Johns Hopkins Hospital
600 N. Wolfe St.
Baltimore, MD 21287

Tuesday, March 25, 2014

Johns Hopkins-trained doctor now in the Philippines

“I knew even before I went to the US to train that I was going back here,” shared Dr. Franz Marie Cruz, the first Filipina to graduate from a neuro-ophthalmology fellowship at the prestigious Johns Hopkins University in the United States. “For one, my family is here. Plus, there are only about 30 neuro-ophthalmologists in the country, not enough to serve over 90 million Filipinos. Mas kailangan ako dito (I am more needed here),” she added.
Cruz, a doctor at PELI, is one of the
few neuro-opthalmologists in the
country.
Cruz is a neuro-ophthalmologistat the Pacific Eye and Laser Institute, one of the emerging premier eye-care centers in Asia. She also specializes in treating patients with uveitis, medical retina and cataract. She pursued a career in neuro- ophthalmology after receiving a medical degree from the University of the Philippines and completing her three-year residency at the Department of Ophthalmology and Visual Sciences of the UP-Philippine General Hospital.
According to Cruz, neurosurgery, neurology and neuro-ophthalmology are related in that they deal with brain diseases. She said eye health issues such as vision loss, double vision and having problems in one’s peripheral fields may be symptoms of more serious health risks, such as multiple sclerosis, myasthenia gravis and brain tumors. “There are brain tumors that affect vision or eye movement,” she shared. “Neuro-ophthalmologists are trained to find out whether a patient’s eye problems are linked with brain disorders.”
Cruz stressed the importance of undergoing routine eye exams as it determines not only a patient’s prescription for eyeglasses or contact lenses, but also checks the eyes for common diseases and evaluates them as an indicator of one’s overall health.
“A patient went here to make sure he was wearing the right prescription glasses. During my examination, I suspected he had a problem with his brain,” she shared. “We did an MRI and found out that he indeed had a tumor. Luckily, we discovered it early. He came back to thank me and said that I saved his life.”
Cruz also shared the story of one young patient who had fever for three weeks. Her parents brought her to different doctors and had her checked for dengue, UTI and other illnesses, to no avail. “The patient also complained of blurred vision in one eye. When her parents brought her to me, I saw that the optic nerve was swollen. We found out that she was scratched by a cat one week before she became sick.”
Cruz said there aren't enough neuro-ophthalmologists practicing in the country.
"Filipino eye doctors are probably among the best cataract surgeons in the world. However the challenge is to improve our clinical eye in detecting neuro-ophthalmologic diseases in their early stages before they cause more serious illness,” she said.
Cruz is doing her share by working part-time as a faculty member of the San Beda University College of Medicine.
Pacific Eye and Laser Institute Surgicenter is located at 50 Jupiter Street, Bel-Air, Makati City. The center also has clinics in Quezon City and Binondo, Manila. For more information about its services and to find out more about neuro-opthalmology, visit www.pacificeye.com.ph.
http://manilastandardtoday.com/2014/03/24/johns-hopkins-trained-doctor-now-in-the-philippines/

Monday, March 17, 2014

Vision lost in glaucoma cannot be reversed

My mail sparked conversation on Glaucoma. With the following findings/ discussion/  I feel it is important for all primary eye specialists to look for early detection of Glaucoma. Health ministry and social orgs. must make it mandatory to look for Glaucoma even in routine check up and avoid permanent loss of vision. 
Alok Tholiya



Corres_2nd Floor

Mar 15 (2 days ago)


to me
Dear Sir

Thank you for your mail. Yes, as rightly pointed out, glaucoma cannot be cured but can be controlled with medicines or surgery. Vision lost in glaucoma cannot be reversed, the purpose of treatment is to preserve existing vision.
regards,

Dr. Manish Panday



From: "Corres_2nd Floor" <corres2@snmail.org>
To: "Dr.Dr Manish Panday" <drmpy@snmail.org>
Sent: Monday, March 10, 2014 9:56:40 AM
Subject: Fwd: steroid-induced Glaucoma stealing sight in young


Dear Sir
Forwarding this mail for your opinion please
P Rekha

From: "Dr.Tarun Sharma" <drts@snmail.org>
To: "corres2" <corres2@snmail.org>
Sent: Monday, March 10, 2014 9:24:10 AM
Subject: Fwd: steroid-induced Glaucoma stealing sight in young


any glaucome consultant opinion

Dr. Tarun Sharma, MD, FRCSEd, MBA
Director, Shri Bhagwan Mahavir Vitreoretinal Services
Sankara Nethralaya, Chennai, India
Please visit:
www.sankaranethralaya.org
www.omtrust.org
www.supportsankaranethralaya.org

From: "Alok Tholiya" <atholiya@gmail.com>
Sent: Monday, March 10, 2014 2:54:08 AM
Subject: steroid-induced Glaucoma stealing sight in young

NEW DELHI: A few weeks ago, 27-year-old Ajit (name changed) consulted an eye specialist because of poor vision. His examination showed that he had lost 70% of his sight in one eye and 10%-15% in another eye due to Glaucoma, a disease associated with old age. As he had no family history of glaucoma, it was hard to explain the cause for his illness till he informed doctors about the eye drop he had been using to treat an infection.

"It was a steroid-based eye drop. He had been prescribed the medicine long ago for allergic conjunctivitis. He, however, used it indiscriminately for all eye problems as the medicine was effective. He had a steroid-induced glaucoma, but by the time he came to us it was too late," says Dr Mahipal Sachdev, chairman and medical director, Centre for Sight Group of Eye Hospitals.

These days, doctors prescribe steroid-based medicines for a lot of conditions like asthma, skin allergies and post-surgery problems. Ophthalmologists say these medicines should be taken under supervision, and patients should undergo a glaucoma test two to three weeks after the course is over. "It is important to get eyesight tested in these cases as loss of vision in Glaucoma is gradual. Patients don't notice it as the peripheral vision is affected first," said Sachdev. Doctors see an increase in young patients.

In India, lack of awareness about the disease and its prevention are the main reasons for delayed diagnosis. Though people know about glaucoma or kala motia, as it is commonly referred to in large parts of India, eye doctors find that most cases come at a later stage when the damage is done. And this year's World Glaucoma Week's theme-Beat Invisible Glaucoma-is about early diagnosis. It starts from March 9.

Unlike cataract, the harm done by glaucoma is irreversible as it damages the optic nerve. "Nearly 20% of the patients are blind in one eye by the time they take help. We can prevent blindness in glaucoma patients. We now have the technology to treat the disease but it requires routine tests," said Dr Ramanjit Sihota, professor and head of the glaucoma centre at AIIMS.

"A simple test of field of vision, intraocular pressure test and gonioscopy- a method to find the type of glaucoma - is enough for the diagnosis. One should undergo the test once a year. In case of medical history, patients should take doctors' advice,'' said Dr Kenshuk Marwa, consultant, Rockland Hospital. Dr Parul Sharma, head of ophthalmology at Max Healthcare, said, "Most doctors routinely check for glaucoma in all patients. The eye pressure can be controlled by medicines."

With technical advances, doctors say it is much easier to manage the disease. Though the damaged portion can't be revived, further harm is prevented. "In extreme cases, we implant valves to create a drainage channel. We use laser to pull open the trabecular mesh in the drainage area. This reduces the pressure inside the eye,'' said Dr Harsh Kumar, former president of Glaucoma Society of India.

Tuesday, January 28, 2014

just for ur info .....Neuro-ophthalmology

Neuro-ophthalmology 

Typically, patient care is multidisciplinary. Specialist diagnostic and follow-up clinics are provided within the Eye Clinic, these are most often used for patients who develop visual problems in association with neurological disease, for example idiopathic intracranial hypertension, pituitary tumours, epilepsy, multiple sclerosis and cerebrovascular disease. There are additional facilites for EMG-guided orbital botulinum therapies and pupillometry, and there are close links with the UCL Institutes of Neurology and Ophthalmology, and with Moorfields Eye Hospital.
Mr Fion Bremner
Consultant
Mr James Acheson
Consultant
Dr Gordon Plant
Consultant
Mr Fion BremnerNeuro-ophthalmology, Ophthalmology
Mr James AchesonNeuro-ophthalmology, Neurology and neurosurgery
Dr Gordon PlantNeuro-ophthalmology, Neurology and neurosurgery


































​Elsewhere ​there r specialised neurology and nuero surgery hospitals like we have heart institutes. So focus and facilities are much highre level then in a general hospitals. Neuroopthalmolgy is a french and latin in most part of India except Sankar netralaya , Chennai . 


Sunday, January 19, 2014

Glaucoma is the eye disease that goes unnoticed

Daily Checkup: Glaucoma is the eye disease that goes unnoticed

Half of Americans over 40 with the disease don't know they have it, which makes eye exams vital



Dr. Janet Serle of Mount Sinai says, "For the majority of patients this disease can be held in check."


THE SPECIALIST: Dr. Janet Serle
A professor of ophthalmology at Mount Sinai, Dr. Janet Serle exclusively treats patients with glaucoma. January is Glaucoma Awareness Month.

WHO’S AT RISK
While doctors estimate that 2.7 million Americans over the age of 40 have glaucoma, it’s believed that half of those patients don’t even know they have it.
“Glaucoma is a chronic disease that causes damage to the optic nerve that connects the back part of the eye to the brain,” says Serle. “If inadequately treated, glaucoma can lead to blindness, which is why it’s so important to see an eye doctor regularly and get diagnosed quickly if glaucoma does develop.”
The optic nerve is located at the back of the eye, surrounded by the retina. “The optic nerve is like a telephone wire that contains 1 million fibers. If they get damaged, the visual information can’t travel from eye to brain,” says Serle. “Typically, patients lose central nerve fibers last, so they can see well straight ahead after the peripheral vision goes, though some patients don’t fit this pattern and may lose central vision early in the course of the disease.”
Doctors have yet to identify the underlying cause of glaucoma. “We assume there are genetic and environmental factors, and we have defined several genes that are more common in many patients with glaucoma,” says Serle.
“You’re more likely to develop the disease if you’re African-American or Latino, or if you have a family history of the disease, diabetes, thin corneas, optic nerve cupping, or are a chronic user of steroid pills or steroid eye drops,” says Serle. “A general rule of thumb is that the higher your eye pressure, the higher your risk, but 50% of patients don’t actually have high eye pressure, so the diagnosis of glaucoma can never be solely based on high eye pressure.”
While it is possible for patients to develop glaucoma at any stage of life — some babies are even born with glaucoma — the risk does increase with age. “In whites and Latinos, your risk of glaucoma starts going up after age 50, but for African-Americans risk goes up starting at 40,” says Serle. “If you have any risk factors, you need to be monitored as early as your teens and 20s.”

SIGNS AND SYMPTOMS
One of the problems with treating glaucoma is that it can slide under the radar for years. “Most patients’ glaucoma is completely asymptomatic, which means that it is usually detected during a routine eye exam,” says Serle. “The doctor either finds high eye pressure and explores further, or looks in and visually sees the damage in the optic nerve.” The doctor then performs a series of tests to confirm the diagnosis.

TRADITIONAL TREATMENT
Upon being diagnosed with glaucoma, the first step is to assess the intraocular pressure. “One test isn’t enough — we usually need to do several readings over a few days,” says Serle. “Then, our initial treatment is medications like topical drops to lower eye pressure by 30%, which may or may not be enough.” How and when you apply the drops is vital to maximize their effect.
Although several states have legalized medical marijuana for glaucoma patients, it is not a good treatment option. “When it does reduce eye pressure, the duration of effect is very short, typically 3 to 4 hours, whereas the eye drops we use lower pressure from 6 to 24 hours,” says Serle. “In order for marijuana to effectively reduce eye pressure, it would need to be smoked round the clock, interfering with a patient’s daily activities, due to the common side effects.”
If eye drops don’t work, the next option is laser surgery. “The goal is to enhance the flow of fluid out of the eye and thus decrease the eye pressure. We apply 50-100 shots of the laser to the angle of the eye,” says Serle. “Laser surgery basically buys us time before a more invasive surgery. It’s a temporary measure that usually works for anywhere from a few weeks to a few years.”
Laser surgery can only be performed three times, and the efficacy usually decreases each time.
Surgery is the final option. “There are two traditional surgical approaches: one puts a hole in the eye and one puts a tube in the eye, in both cases to drain fluid out,” says Serle. “There are also newer procedures, like MIGS [minimally invasive glaucoma surgery], in which we put little devices in the angle of the eye.” The traditional surgeries are the most effective, but even they sometimes need to be repeated years down the road.
While glaucoma can have dire consequences if left untreated, the current treatment options are highly effective. “For the majority of patients this disease can be held in check,” says Serle. “The key is to take your meds religiously and come back for your eye exams.”

RESEARCH BREAKTHROUGHS
Promising new medications are currently under clinical investigation. “It’s exciting to have three potential new meds to lower eye pressure, all of them working with different mechanisms,” says Serle. “We haven’t had a new drug to treat glaucoma since 1995, so it’s time.”

QUESTIONS FOR YOUR DOCTOR
A good leadoff question for everyone is, “What is my eye pressure?” If it turns out to be over 21, then ask, “Am I at risk of glaucoma?” Follow up by asking, “Do I have any suspicious findings on my eye exam?” and “Should I see a specialist?”
“Sometimes you have to push your doctor a little bit,” says Serle. “But it’s worth doing, because early detection and intervention is so essential for treating glaucoma.”

WHAT YOU CAN DO
Get informed. There are many glaucoma-focused websites; Serle recommends starting with the American Academy of Ophthalmology (aao.org) and Mount Sinai (mountsinai.org/eyecare).
Don’t skip eye checkups. The checkup schedule depends on your age. Newborns with any risk factor should be checked on the first day of life; schoolchildren should be checked once; teens to thirtysomethings should be checked every 2-4 years; patients in their 40s and 50s should be checked every one to three years; and patients over 60 should be checked annually.
Comply with your prescription. If you have glaucoma, one of the most important things you can do is to be vigilant about taking your meds are prescribed. “Enlist a spouse or caregiver to help with the eye drops, which can be hard to instill,” says Serle.

Read more: http://www.nydailynews.com/life-style/health/daily-checkup-glaucoma-unnoticed-article-1.1580972#ixzz2qsfRlJ4e