For people diagnosed with glaucoma, the choice is simple: Either get treatment or go blind.
According to the Glaucoma Research Foundation, almost three million Americans have the disease but only about half of them know it. That means 1.5 million U.S. citizens are at serious risk of losing their eyesight to this disease.
Here in the Vero area, several local physicians and ophthalmologists treat glaucoma. New Vision Eye Center, the Florida Eye Institute and Monnett Eye and Surgery Center, for example, all offer excellent care, and now there’s a newcomer in town making a key contribution in the fight against glaucoma.
Dr. Sarah Khodadadeh, a former clinical instructor at Yale University’s Eye Center in New Haven, CT and a protégé of Dr. James Tsai, president of the Mount Sinai Eye and Ear Infirmary in New York, recently joined the staff at Vero’s Center for Advanced Eye Care, where she is performing a type of eye surgery not previously available in Indian River County.
Procedures to treat glaucoma can range from a relatively simple course of medication in the form of eye drops to a variety of laser-based treatments to a surgical procedure known as a trabeculectomy that reduces pressure in the eye, which Dr. Khodadadeh now offers at the Center for Advanced Eye Care. In some cases, a combination of all of three may be required. Still, while these treatments may save a patient’s remaining vision, they cannot improve or restore sight already lost to the disease.
The term glaucoma is actually something of a “catch-all” phrase in that it includes several different types of eye degeneration. All forms of the disease damage the eye’s optic nerve and can result in vision loss and blindness. Types of glaucoma include open-angle, low-tension or normal-tension, angle-closure, congenital, neovascular, pigmentary and pseudoexfoliation glaucoma. The earlier any of these diseases are detected and treated, the more of a patient’s remaining sight can be saved.
Sadly, most types of glaucoma do not announce themselves with easily recognizable symptoms. That said, the presence of the following warning signs may indicate the need for an immediate and thorough eye examination: unusual trouble adjusting to dark rooms; difficulty focusing on near or distant objects; squinting or blinking due to unusual sensitivity to light or glare; a change in the color of the eye’s iris; red-rimmed, encrusted or swollen eyelids; recurring pain in or around eyes; double vision; dark spots appearing at the center of a patient’s field of view; lines and edges that appear distorted or wavy; excessive tearing or watery eyes; dry eyes with itching or burning and seeing spots or ghost-like images.
The most common form of the disease is open-angle glaucoma. It accounts for about 90 percent of all cases and is most frequently found in people over 60, so it’s important to see an eye doctor or ophthalmologist at least once a year if you’re 60 or over. Those with a family history of glaucoma or other health problems, such as diabetes, may want to see an eye doctor more frequently.
Basically, glaucoma damages the optic nerve behind the eyeball and if left untreated it leads to blindness. Glaucoma is, in fact, the second-leading cause of blindness in the world.
Misconceptions about the disease are common. Many people think high levels of pressure within the eye (intraocular pressure) is the one definitive sign of glaucoma but, in fact, many people with fairly high intraocular pressure do not have the disease at all while others with seemingly normal intraocular pressure do. Every individual is different. Getting tested is the only reliable way to know if the disease is present. Head and eye trauma from falls, car accidents and similar events are also potential triggers for developing glaucoma.
One of the most effective ways of dealing with glaucoma is the trabeculectomy procedure and Dr. Khodadadeh says she is the only board-certified ophthalmologist currently doing that procedure locally.
What is a trabeculectomy? In a nutshell, a trabeculectomy, (sometimes called a filtration surgery), reduces pressure on the optic nerve by removing a piece of tissue in the drainage angle of the eyeball and creating an opening that allows any excess fluid in the eye to drain out.
Having the procedure available here, says Khodadadeh, means much more than just a shorter drive for local eye patients going to and from their surgery. Those who might previously have gone to Boynton Beach, West Palm or Melbourne for this procedure faced another problem. Dr. Bill Mallon, also of the Center for Advanced Eye Care says “the post-operative care is really where the challenges are in glaucoma surgery.” He says he has sent many Vero area patients to surgeons in Boynton Beach, but the hour-and-a-half drive each way posed a significant burden on those patients. That’s because proper post-op care usually requires two or more follow-up exams per week for the first couple weeks after surgery with more visits thereafter and that meant a lot of miles on the patient’s odometer.
Like any surgery, there can be side effects from a trabeculectomy including inflammation and infection inside the eye. For the best possible results, frequent follow-ups are the recommended course of action. Not having to spend multiple hours on the road to and from Boynton Beach or West Palm for those visits helps make the recovery period easier on the patient as well as for whoever is driving them, and makes it less likely patients will miss critical aftercare.
Khodadadeh puts it this way: “Because the patients are complex and the healing process is complex, post-operative management is what makes these surgeries a success.”
Apparently, a substantial number of Vero area residents agree. Even the gregarious Khodadadeh admits she’s a little surprised at the steady stream of patients she’s been seeing after just four months. “I didn’t expect to be this busy so early on,” she says, “I’m already seeing 25 to 30 patients a day and 90 to 95 percent of the patients I do see are for glaucoma.”
Whichever course of treatment glaucoma patients decide on, there’s now one odd, high-tech footnote to add.
Earlier this month researchers in England announced that – thanks to advances in eye-tracking computer software – it may someday be possible to forego annual eye exams and simply have patients watch a movie or TV show on their ipads. The device’s software would then track the viewer’s eye movements looking for symptoms or signs of glaucoma.
Until that time, however, the best bet is to continue with those regular eye exams. The earlier glaucoma is diagnosed, the better the odds are of saving your sight.
Dr. Sarah Khodadadeh is with the Center for Advanced Eye Care at 772-299-1404. New Vision Eye Center can be reached at 772-257-8700. The Florida Eye Institute can be reached at 772-569-9500 and the Monnett Eye and Surgery Center is at 772-589-9111.