Exciting New Treatments For GlaucomaAnyone who has glaucoma knows there’s no cure for it and no way to reverse the damage to the optic nerve or the resulting vision loss. Dr. Norm Zabriskie, a glaucoma specialist at the Moran Eye…
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February 25, 2015
Vision Interviewer: What's the future of glaucoma treatment? We'll examine that next on The Scope. Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. Interviewer: Dr. Norm Zabriskie is a glaucoma expert at the Moran Eye Center, and if you know somebody who has glaucoma or been diagnosed yourself, you know that you can't necessarily cure it right now. All you can do is treat it, and manage it, and keep it from getting worse. But is there something in the future that might change that? What is the future of glaucoma treatment? Is it always going to be about managing or are there some cure possibilities in the future? Dr. Zabriskie: Well, we sure hope there are, and we would love to be able to talk with patients about reversing their disease, or even maybe making it where they didn't have to take drops every day. Interviewer: Yeah Dr. Zabriskie: So to talk about the first of those, and that is what would make just what we do now easier? There are a number of, for example, extended drug delivery mechanisms and instruments that are being developed right now. For example, maybe an implantable drug that would be good for six months or something like that. Interviewer: So you don't have to do those daily drops, yeah. Dr. Zabriskie: So you don't have to do a drop every day. So that's one part of it that is very, very important. And I see some of those things being relatively near in the future, where either you could put a little plug into your tear duct or you could maybe inject a little medicine that would be good for six months and you wouldn't have to worry about drops for six months. Interviewer: That would be awesome, wouldn't it? Dr. Zabriskie: And come back and do it again and you're good to go. Interviewer: Yeah. Dr. Zabriskie: That would be great. And I think those are pretty near in the future, actually. The other part of that equation is really what we would like to talk about, and that is somehow, someway, reversing or improving damage that has already been done, basically regenerating the optic nerve. And that's really the Holy Grail, not only of glaucoma but of spinal cord injury, of stroke, all of those things are kind of in the same basket, so to speak. Interviewer: Yeah, meaning once the damage is done . . . Dr. Zabriskie: Yeah, that's right. How do you get it back? But all of the research, in my opinion, all of the research that's being done in all of those areas will all be cross-applicable. You know, if the spinal cord injury problem is solved, potentially the glaucoma problem will be solved as well because it's all involving the regeneration of nervous tissue. Interviewer: What about even before that, preventing that pressure from even happening? I mean, are there people looking at that? Dr. Zabriskie: Sure, that's another important thing of looking at what it is in the processes of the eye and the balance of pressure that caused the pressure to go up in the first place. Interviewer: Which is the cause, that's the thing that makes it all happen. Dr. Zabriskie: In many instances, but yet we know, see, we know that there's probably 25%, 30% even of people that never have a high pressure and yet have severe glaucoma. So we know there's like this black box of other factors, be it genetic susceptibility, something about that optic nerve that just makes it susceptible to damage, maybe blood flow, maybe other factors that we don't even know about yet that are damaging the optic nerve other than pressure. But certainly, pressure is what we concentrate on the most now, because that's what we can treat. And as I mentioned, it has been proven now that lowering the pressure is absolutely beneficial. I don't think there's any doubt about that. Interviewer: But as far as figuring out a way for those instances where pressure is the cause, how do you prevent that pressure from happening in the first place? Not quite sure at this point yet? Dr. Zabriskie: Don't have that yet, yeah. You know, a way to actually go into the system, the drainage system itself. Interviewer: Yeah, and figure out what's happening. Dr. Zabriskie: And clear it out or drain it out. Again, some of our surgeries are designed a little bit to try to do that. But as far as a drop or something that really gets at that issue, don't have anything that's super effective in that regard. Announcer: TheScopeRadio.com is University of Utah Health Sciences radio. If you like what you've heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |
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I Have Glaucoma – Now What?You just learned you have glaucoma and your eyesight is at risk. While there is no cure for glaucoma, there are several ways to slow its progression. Dr. Norm Zabriskie, glaucoma expert at the Moran…
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February 10, 2015
Vision Interviewer: Your eye doctor says you have glaucoma. Now what? We'll talk about that next on The Scope. Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. Interviewer: Dr. Norm Zabriskie is a glaucoma expert at the Moran Eye Center. So Dr. Zabriskie, I've gotten the diagnosis. My optometrist told me that I have glaucoma. I want to take it seriously because I know it can make me blind and it's irreversible. What next? Dr. Zabriskie: You bet. Well, treatment for glaucoma, first off, I think this is a very important point. For many years now, we didn't know for sure that our treatment was even that effective, and treatment consists fundamentally of lowering the eye pressure. Within the last 10 to 15 years, there have been multiple, very large, very well-designed and well-conducted studies both in the United States and in Europe and elsewhere, that in my opinion have fundamentally proven that lowering intraocular pressure, though not a cure, is absolutely beneficial in terms of either stopping or at least delaying the progression of glaucoma. So I am absolutely 100% an advocate of treatment which consists of lowering the intraocular pressure. Interviewer: All right. But it's not a cure. It can only slow or stop . . . Dr. Zabriskie: It's not a cure. It does not cure disease nor does it reverse damage that has been done. It just slows down or stops the progression. So then we look at, what are the options for lowering the intraocular pressure? And they really consist of three things. One is medicines which is usually topical medicines given in the form of eyedrops. The second is laser treatment, and the third is surgical treatment when required. Interviewer: Is that always the first thing that you try to do, the least invasive, the drops first? Dr. Zabriskie: Yeah, in almost all instances we try drops first. Now there might be some circumstances where, say, laser was used first and we also have good literature, good studies that support the use of laser first. But if you just look at the practice trends in the United States, most of the time drops are initiated first. And part of the reason is that I think we have very good drops, very good medicines for treating glaucoma. Interviewer: And they get to see for the rest . . . Dr. Zabriskie: They get to see. Interviewer: I mean, that's a fair trade-off, right? Dr. Zabriskie: And then things are well-maintained. Absolutely. Interviewer: Even if I'm the kind of person hates putting drops in my eyes, that's kind of a good balance or payoff to . . . Dr. Zabriskie: Absolutely, absolutely. Now if drops for whatever reason either prove ineffective or poorly tolerated, then we can moved on and a laser treatment that we have available to us, I think is also an excellent option. The laser is great in that it is non-invasive, okay, so we're not making surgical wound, we're using a laser to treat the eye. It tends to be quite effective. It doesn't last forever but we can oftentimes get several years of pressure lowering from a single laser treatment, and in some instances that laser can be repeated down the line which can give us yet another boost of pressure lowering. So I think laser is a very, very good option when needed. Interviewer: But the important thing to remember is when you get a treatment, especially the drops, you've got to do it. Otherwise it doesn't do any good. Dr. Zabriskie: That's exactly right. You have to take the drops everyday or it doesn't help, it doesn't work. And here's the thing. Why it can be difficult for a glaucoma patient to take their drops is that so often they are taking a medicine to treat a disease that is really not causing them any problems. They still see fine, they feel like they're doing fine, and yet I'm telling them, "You have glaucoma. Thankfully it's early and I need you to take this eye drop to keep it in this early phase." Interviewer: So the important thing to remember here is that if you are diagnosed with glaucoma, there are some excellent treatments out there. Dr. Zabriskie: There are. Interviewer: Most likely starting with eye drops and moving on. Dr. Zabriskie: Correct. Interviewer: Any final thoughts for somebody that just had that diagnosis and they're a little frightened, scared? Dr. Zabriskie: Absolutely. It is a scary diagnosis but my counsel is to realize that many, many, many patients, if not by far the majority of patients, if they take their drops or whatever treatment is recommended to them by their doctor and they're faithful about it and compliant about it, most of them do well. And they live the rest of their life with good vision and functioning very, very well. Announcer: TheScopeRadio.com is University of Utah Health Sciences radio. If you like what you've heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |
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Learn the Basics of Glaucoma to Prevent Future BlindnessGlaucoma is an eye condition commonly discussed, yet often underestimated. If left untreated, glaucoma can inflict on your vision, leading to irreversible damage and potential complete blindness.…
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