Senior Physicians Speaker Series : Glaucoma - Why Is It Important ?
by KATHRYN VANCE
Dr . Sam Yared , Senior Physicians Speaker Series Chair , introduced Dr . Joern Soltau on Tuesday , May 7 . Dr . Soltau is a professor and the Chair of the University of Louisville Department of Ophthalmology , Director of Glaucoma Services . He received his medical degree from the University of Heidelberg in Germany , and later came to the U . S . where he completed his ophthalmology residency at Washington University in St . Louis , Missouri . He also completed a fellowship in glaucoma at Bascom Palmer Eye Institute in Miami , Florida before joining us in Louisville .
The optic nerve is comprised of millions of nerve fibers that carry signals of what we see , running from the eye to the brain . He compared this to how images on a camera can be transmitted through a cable to a computer screen . In glaucoma , the pressure inside the eye is elevated , and progressively damages the optic nerve , like a camera cable that becomes progressively frayed over time . Put simply , Dr . Soltau said that patients with advanced glaucoma only see a part of the whole picture . As the disease progresses , the area that they can see becomes progressively smaller , and they eventually go blind .
Glaucoma is the number one cause of preventable , irreversible blindness . This is in contrast to Dr . Soltau ’ s presentation in January 2023 on cataracts , which is the top cause of reversible blindness . Unfortunately , he said , glaucoma is often undetected until there is extensive visual field loss , by which time it is too late .
In order to test for glaucoma , they measure intraocular pressure ( IOP ) and corneal thickness . They are also able to do imaging of the optic nerve and measure the nerve fiber layer ( ocular coherence tomography ), in addition to checking peripheral vision fields .
Glaucoma treatment aims to reduce the risk of further optic nerve damage by reducing eye pressure and can include medical , laser and surgical therapy . The mainstay of treatment is drops , drops and more drops , he said , with many different classes of medications . The most important part of treatment is compliance , both in that patients remember to do their eye drops , but also that they apply them properly , which can be challenging for patients for a variety of reasons such as rheumatoid arthritis , stiff neck , tremors or lack of hand eye coordination . There are several types of devices that can help deliver the drops effectively that may help patients who need it .
The goal of treatment is to reduce IOP by about 30 %. Standing the test of time , the first line therapy is prostaglandins and drops , but more and more lately , laser treatment has become a go-to option , which also helps with compliance . Laser treatment doesn ’ t last forever but can lower pressure for about three to five years , sometimes longer . Other options include MIGS ( microinvasive glaucoma surgery ) or filtering surgery as well as drainage implant devices and cyclodestructive procedures .
This is a summary of the Senior Physicians Speaker Series presentation . For a link to view the full presentation , please email foundation @ glms . org .
Kathryn Vance is the Communications and Event Coordinator at the Greater Louisville Medical Society .
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