Welcome back to healthy life, in production, Timothy Johnson, I’m Dr. Naina Sinha. Glaucoma is a disease that can cause blindness if left untreated. However, there is a new treatment that may offer hope for people suffering from glaucoma complications; it’s called canaloplasty. And here today to tell is about this new procedure is Dr. Bradford Shingleton, a surgical ophthalmologist.
“Welcome Dr. Shingleton.”
“Is a pleasure to be here.”
“I guess we should start with ‘what is glaucoma, what is the definition of that disease’.”
“Oh that’s so important. Glaucoma is very much like hypertension. Just like we have a blood pressure, we have an eye pressure. If the blood pressure goes up, it’s hypertension; if the eye pressure goes up, it’s glaucoma. But the key thing, if the eye pressure goes up with glaucoma, it damages the optic nerve. The optic nerve is part of the brain and if there’s damage to the brain and optic nerve, that can lead to irreversible blindness. But just like blood hypertension, unfortunately glaucoma for the vast majority of people is silent. It can grow very slowly and silently and people can actually loss vision and not know it’s happening.”
“Ok. Are there certain groups of people that are higher risk for developing glaucoma? Is family history of glaucoma important?”
“Absolutely, family history is very important. And very much directly related to age, the older people get the more common glaucoma is. But age is an issue; there are certain associated findings such as diabetes and other changes in the eyes, so it’s critical that patient be seen by their ophthalmologist to check for the possibility of glaucoma particularly if they have a family history of glaucoma.”
‘”Now, is there a cure for this disease or are they really just persistent treatment?”
“Just like hypertension, there is no cure, but it’s so critical to prevent problems with glaucoma because as I mentioned the damage is permanent, so that’s why it’s so critical to catch it early on, this disease. And that’s where, in terms of a surgical approach where we typically use medicines or lasers and then surgery; canaloplasty may be a very effective surgical approach earlier on.”
“Sir, can you sort of go thru with us the major types of treatments that are currently available; what we usually start out with; how it progresses?”
“Great. For majority of people we use medications, and this controls glaucoma for most people. The issue with medication is, you may guess, they can be irritating to the eye, they’re costly and if anybody’s like me, then we tend to forget putting the medicine in. That’s a problem with compliance, so that’s an issue.
The next stage of treatment tends to be laser therapy and this has been very effective. The problem with laser therapy is, it does tend to be temporary. When medicines and lasers don’t work, we do surgery and typically our surgery in the past is actually been sort of a minor modification on surgery that was done literally a hundred years ago in southern India by a Dr. Iliad. We haven’t had dramatic changes since that time. And we actually make a hole in the eye to bypass the normal channel and that controls the pressure for many people. The problem with that conventional type of surgery is that it can be associated a pressure that’s too low, a pressure that’s too high; there can be scarring, leakage, infection, and that’s the problem. And the canaloplasty may be an advance over that traditional type of surgical treatment.”