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Thursday, April 26, 2018

Women's Eye Health News, Issue 1, Volume 2, November 2014

NOTES FROM THE CHAIR

Our Committment to Women's Eye Health

I am happy to announce that the May 2014 launch of this publication, Women’s Eye Health News, was a great success. The publication has captured the interest and the support of the audiences we most want to reach—clinical and academic vision communities and, most importantly, women and the public.

We were particularly gratified that the newsletter was well received at the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), the largest and most respected society for eye and vision research in the world, which attracts an international membership and issues viagra without prescription india audience. In addition to launching the newsletter and exhibiting at ARVO, Women’s Eye Health (WEH) also held its Annual Meeting and Luncheon, featuring presentations by WEH chapters from Utah, as well as Shanghai, Beijing, and Hunan (China).

In this second issue, our featured article offers an in-depth look at glaucoma from the multiple perspectives of a patient, clinician and a researcher. The article presents not only early detection and treatment options but also current research efforts that one day may help advance treatments and cures for this disease, which is one of the leading causes of irreversible blindness.
In addition, you will read a brief interview featuring Dr. Paul Courtright, the epidemiologist, now based in South Africa, who authored the 2001 meta-analysis that revealed the fact that two-thirds of the world’s blind and visually impaired people are women. In his interview, he talks about steps being taken to improve this statistic.

While Women’s Eye Health News is our latest effort, it is only one way that WEH is keeping its commitment to spreading the word about women’s eye health.
This year, our new website has seen a 300-percent increase in unique visitors. In addition, we are gaining a stronger social media presence. Today, we have more than 5,000 likes on Facebook.

We continue to bring the message about women’s eye health to national and recipes generic propecia viagra international venues. In addition to ARVO, WEH maintained an information booth at the American Public Health Association Conference and the Unite for Sight Global Health Conference. More recently, we attended the Academy of Ophthalmology’s (AAO) annual meeting in Chicago.

We were also pleased and honored to attend the Women in Ophthalmology/Ophthalmic Women Leaders reception.

Looking forward, our goals include forging partnerships to support a national eye health awareness media campaign, and we continue to support an eye health public TV series in China.

We hope that Women’s Eye Health News will not only inform you, but also inspire you to be part of our organization. To volunteer or donate, contact us at This email address is being protected from spambots. You need JavaScript enabled to view it..">This email address is being protected from spambots. You need JavaScript enabled to view it..

Dong Feng Chen, MD, PhD, Chair
Associate Scientist, Schepens Eye Research Institute/Mass. Eye and Ear
Associate Professor of Ophthalmology, Harvard Medical School, Boston, MA

 

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GLAUCOMA

Silent But Not Golden

Glaucoma often remains undetected

“Fight to keep your independence,” is the advice Mary’s favorite aunt always gave her when she faced life’s challenges – advice the now retired nurse practitioner has always heeded during bumps in the road, including a brush with vision loss caused by glaucoma.

Lucy Shen Mass. Eye and Ear
Lucy Shen, MD 

Diagnosed with elevated intraocular pressure nine years ago, it wasn’t until she was treated for an unrelated retinal issue that her case was referred to a specialist – Lucy Shen, MD, Assistant Professor of Ophthalmology at Harvard Medical School (HMS), and a glaucoma specialist at Massachusetts Eye and Ear in Boston, Mass.

When Mary presented to Dr. Shen’s office, she was already on medical therapy and had undergone laser treatment but her peripheral vision continued to shrink. Dr. Shen recommended surgery. “I am so grateful for Dr. Shen’s expertise and proactive approach,” says the 67-year-old patient, who knows that severe vision loss as she ages would dramatically affect her independence and quality of life. Now, with her central vision preserved, she continues follow-up care with Dr. Shen as recommended.

According to Dr. Shen, glaucoma is a leading cause of irreversible blindness in adults worldwide. It often develops when fluid builds up in the eye because the drainage system is impaired. The fluid buildup, in turn, elevates eye pressure and slowly cuts off nutrition, compressing and killing the optic nerve, which interprets and transfers visual information to the brain. There is no cure for glaucoma and vision loss caused by the disease is not reversible. However, there are effective treatment options that can prevent further damage.
“Without the surgery, Mary would have lost more of her vision,” says Dr. Shen, who found high eye pressure and optic nerve damage in Mary’s eye. She adds that the surgery opened up a new pathway to allow fluid to drain and relieve the pressure.

In most cases, surgery is not the first defense against glaucoma, notes Dr. Shen. “First we prescribe one of several different kinds of daily eye drops that help to decrease the pressure. Some drops prevent fluid production, while others create new ways for the eye to release the fluid. There is also laser therapy, which can lower the pressure in the eye.”
Dr. Shen emphasizes that without treatment the optic nerve will continue to die. “As it dies, it will first destroy peripheral (side) vision, leaving the patient with a narrow visual field called ‘tunnel vision.’ Ultimately it can cause total blindness,” she says.

Louis Pasquale, MD
Louis Pasquale, MD

Silence is glaucoma’s secret weapon; the disease is often called the silent thief of sight. “Patients don’t feel the pressure and don’t have obvious visual symptoms until the disease is advanced,” says Louis Pasquale, MD, Associate Professor of Ophthalmology at HMS, and director of the Mass. Eye and Ear’s Glaucoma Service. “That’s why regular glaucoma screening is essential,” he says.

Screening is simple, according to Dr. Shen. “First we measure eye pressure with a special instrument called a tonometer. Next, we check the drain of the eye for any visible blockage and dilate the patient’s eyes for evaluation of the health of the optic nerve. Finally, we use an instrument to map the patient’s peripheral vision and assess the extent of vision loss.” The entire examination is painless and non-invasive. Note that high eye pressure alone doesn’t necessarily mean you have glaucoma.

“Each step in the evaluation is important and contributes to our final diagnosis,” says Dr. Pasquale. “We don’t want to miss any of the signs.”

Glaucoma

Eighty percent of glaucoma sufferers have primary open-angle glaucoma (POAG), where the angle between the iris (the colored center of the eye) and the cornea (the clear lens that covers the eye) is open and so are the drains that release excess fluid. However, microscopic debris can build up in the drain, compromising its function. In the second-most-common type, closed angle glaucoma (COG), the angle between the iris and the cornea is very narrow if not closed, and so the drains are compromised. In COG, the pressure and damage develop more rapidly than in POAG and may require more immediate interventions to release the pressure and save vision.

Glaucoma is a disease primarily of the aging eye, and the most common form seems to affect both men and women equally as they age. However, statistics show that some types of glaucoma are more prevalent in women than men, such as closed angle glaucoma (COG).

For unknown reasons, those of African descent have higher incidences of POAG and often develop the disease at a younger age. Those with a family history of glaucoma are also more likely to develop the disease. Therefore, the National Eye Institute (part of the National Institutes of Health) recommends that these populations get screened for glaucoma starting at age 40 as opposed to age 60.

“If glaucoma is caught in time, we can usually treat glaucoma symptoms and prevent further vision loss but the real hope for a cure is advancing research,” notes Dr. Pasquale, who is studying the genetics and etiology of the disease. After observing that retinal ganglion (nerve) cells, whose axons comprise the optic nerve, contain estrogen receptors, he has been investigating the role that hormones play in the onset of the disease in women.

Damage repair through nerve regeneration is the focus of Dong Feng Chen, MD, PhD, Associate Professor of Ophthalmology at HMS and a neuroscientist at Schepens Eye Research Institute/Mass. Eye and Ear. Dr. Chen has had some success in turning on genes that contain the power to repair damaged optic nerves and simultaneously, she is also working on stimulating retinal stem cells to replace essential nerve cells lost in the disease process.

While the future holds great promise, Dr. Shen encourages everyone to remember that, “early detection, treatment, and regular surveillance is the best way to keep the disease at bay.” The older you are, the higher risk you have of developing glaucoma.

Eye care professionals recommend that everyone over age 60 have a comprehensive eye exam at least every two years.

For more information about glaucoma, visit:
http://w-e-h.org/glaucoma.html
http://www.nei.nih.gov/health/glaucoma
http://www.glaucomafoundation.org

 

News & Updates


A Conversation with Paul Courtright, DrPH

Director, Kilimanjaro Centre for Community Ophthalmology, Africa

“Without a gender-sensitive approach, we will not succeed in reaching our targets,” said Dr. Paul Courtright speaking about the World Health Organization’s mission to meet the goals of Vision 2020 – a global campaign to eliminate the avoidable causes of blindness by the year 2020. 


(L to R) Dr. Paul Courtright, his wife Dr. Susan
Lewallen and Dr. Ilene Gipson

He made this statement to continue calling attention to the disproportionate toll vision loss has on the lives of women throughout the world. It was Courtright’s review of 70 vision surveys published in the journal Ophthalmic Epidemiology in 2001 that first described the blindness gender gap. His finding that two-thirds of the world’s blind are women inspired the formation of WEH by founding chair, Ilene Gipson.

Today, Courtright lives and works in South Africa where he continues to increase access to and advocate for education about vision care in general and women’s vision care in particular as Director of the Kilimanjaro Centre for Community Ophthalmology (KCCO).

According to the KCCO website, “In Africa, the gender imbalance is especially pronounced, as women do not enjoy high levels of financial independence, decision-making power, nor social support to get even routine eye care.”

Dr. Gipson recently visited with Dr. Courtright who shared his current perspective on the issue of blindness and gender.

Since your 2001 publication, have you continued your efforts to mitigate the blindness gender gap?

PC: Yes, we have continued to work on this issue. It was clear that just publishing the findings on gender inequity would not lead to any changes. We had to explore the possible reasons for the findings. We decided to undertake both programs and research to determine if addressing the barriers to eye care could make an impact. This work is still ongoing.
A major event in 2009 was getting the IAPB (International Agency for the Prevention of Blindness, an alliance of civil society organizations, corporates and professional bodies promoting eye health through advocacy, knowledge and partnerships) to dedicate World Sight Day to gender and blindness. This enabled KCCO to compile evidence from around the world with significant impact.

Our current focus is working through micro-finance organizations to see how they can take the lead at the community level to encourage utilization of eye care services by women. The advocacy work of these organizations, which are trained to identify and refer patients in need of eye care services, has led to a notable increase in the number of female patient referrals to outreach clinics and regional hospitals.

We also have been working with groups (researchers and others) in India, Egypt, China, Ethiopia, and Nepal to expand their work on the topic of women’s eye health.

Would you say that the statistic – two-thirds of the world’s blind and visually impaired are women – is still true?

PC: While there have been changes, they have not been across-the-board. Changes do not happen rapidly. They happen one place at a time. For example, international Rapid Assessment of Avoidable Blindness (RAAB) surveys show better equality in cataract surgical coverage in some places (which translates to better equality in blindness figures), which is a good sign. What makes it happen? Leadership and commitment!!

Are you aware of changes that have occurred because of your research, particularly in women's eye health issues in Africa?

PC: Definitely. There are a number of people in Africa who continue to make this topic part of their work. Eye care is not going to generate the level of interest/funding like Ebola, HIV/AIDS, malaria, and the like; eye care providers there often do not have the clout needed to make change.

What can WEH do to help spread the word?

PC: I think WEH has a very important role to play that I can imagine easily expanding in the coming years. With its education and awareness mission, WEH can increasingly take advantage of the speed and access afforded by the social media to spread the message to women and their families the world over.

WEH can also, through its deep connections to the scientific and medical communities, continue to advocate for funds for research and services to women. I would say, keep expanding your reach and engaging more women in helping one another. Women who have power must advocate for those who don’t.

For more information on KCCO, go to www.KCCO.net.

Issue 1, Volume 2, November 2014

Women's Eye Health News is published by:
Women's Eye Health.org based at 
Schepens Eye Research Institute/Mass. Eye and Ear, 20 Staniford Street, Boston, MA 02114
Sponsored by Harvard Medical School Department of Ophthalmology

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