Glaucoma Awareness – January 8, 2014

Glaucoma Awareness

Chat Highlights – January 8, 2014
Guest Speaker – Dr. Jillia Bird
Lorraine Miller – Editor, Chat Topic Researcher


Moderator:   Welcome to this evening’s chat on “Glaucoma Awareness” with our guest expert, Dr. Jillia Bird!  Dr. Bird is the current President of the World Glaucoma Patient Association.

P:   Dr. Bird, would you tell us a bit about yourself and your role in the glaucoma community?

Dr. Bird:  I am from Antigua. I am an optometrist who studied in New York and had my first job with the Barbados Eye Study in 1989.  It is a population study on glaucoma and the first of its kind exploring black eyes.

Moderator:  Dr.  Bird, tell us about your work with the World Glaucoma Patient Association?

Dr. Bird:  My passion to educate people about the silent nature of glaucoma began when I returned home to Antigua after two years with the Eye Study to find my mom with advanced undiagnosed glaucoma.

Dr. Bird:  When I was asked to head the World Glaucoma Patient Association, I didn’t hesitate.    It’s challenging to try to link populations across the globe with so many languages and cultures but we need to because glaucoma affects everybody.

Moderator:   Dr. Bird, will you share with us the most recent award you won at SUNY (The State University of New York at Stony Brook) in New York City?  What was if for?

Dr. Bird:   SUNY named me their Alumna of the Year because of my work that started at SUNY with the Stony Brook Eye study and continues with raising awareness all over the world with enthusiasm.

P:   January is Glaucoma Awareness Month. How many people are diagnosed with glaucoma?

Dr. Bird:  I don’t have numbers for the U.S. but I’ve heard several million.  Around the world, it’s touted as sixty-one million glaucoma sufferers and rising.

P:   How do I find out what activities are available in my area?

Dr. Bird:   You will probably see radio and television PSAs (Public Service Announcements) and maybe a few hospital-related programs.  We need to see more glaucoma patient support groups being formed out of doctor’s offices and hospitals.

P:   What type of glaucoma awareness programs should I see in my geographical area?

Dr. Bird:  Outreach and awareness is key to silent disorders like glaucoma.  Information or lack of information is the chief reason people present late in the disease.  Even more important or at least equally important, is that people understand what glaucoma is and come in for testing.

P:   If I have never had an eye exam, where should I go? Would it be acceptable to go to a department store’s optical department?

Dr. Bird:  You can certainly start at a department store.  Many qualified doctors work there but make sure to discuss eye disease.  Referrals are made for whatever tests are not available.

P:   Are any of the tests painful?

Dr. Bird:  Most tests for glaucoma are painless.  The Visual Field test is tiring but not painful.

P:   What tests are performed in a Glaucoma Awareness free screening hosted by a facility?

Dr. Bird:  I call “Screening” the S-word!  It is very dangerous to attempt screening for glaucoma in a public setting because more cases are missed than detected.   Gonioscopy involves a contact lens placed on the eye in which anesthetic has been used.  There is still no test sufficiently sensitive enough for glaucoma to make it effective in a public facility.

P:   Are there ever fees or co-pays for these events?

Dr. Bird:  Many screenings are free.  Please be advised that only a full dilated eye exam should be used to definitively diagnose glaucoma.   Glaucoma is easily missed if only eye pressures are screened.

P:   Is medication provided at a screening event?

Dr. Bird:    Medication is usually not provided at a screening event unless companies provide samples to encourage participation.

P:   At what type of facility should I look for information concerning Glaucoma Awareness Month?

Dr. Bird:  Check local hospitals and doctor’s websites.  Lions Clubs and other service organizations also might publicize information.  Stay tuned to the World Glaucoma Patient Association Facebook page.  We try to keep activities updated as information becomes available.

P:   Who can diagnosis glaucoma? Can my general practitioner?

Dr. Bird:  No, your general practitioner can do a risk factor analysis for you and calculate a risk for you getting glaucoma.   Only an ophthalmologist or optometrist diagnoses glaucoma after giving a battery of tests and analyzing the results.

P:   How many people have glaucoma and don’t know it?

Dr. Bird:  It’s estimated that 50% of those with glaucoma in your part of the world don’t know they have it and that rises to 95% in the so-called developing world.  It is a terrible state of affairs and why we need to bind together to change this information deficit.

P:   How is glaucoma detected in individuals in the rural communities of the world?

Dr. Bird:  Many organizations try to reach rural communities but they are very under-served in some sections of the world.

P:   Is word spread differently in other cultures or do we educate the same no matter where the individual resides?

Dr. Bird:  We feel awareness can be changed by mobilizing people to get proactive and seek care no matter how far from home they must travel.  On my island, we do marches in the streets in a carnival-like atmosphere with music bands, banners, and youth groups and it is working!   You can start activities in your own neighborhood or church.  You can just start small and grow the awareness right in your own small circle of friends and family.

P:   Is there a blood test to diagnosis glaucoma?

Dr. Bird:  There is no blood test available but work has been underway in laboratories resulting in some gene markers being identified for certain types of glaucoma.

P:   Are there preventative measures that a patient can follow to avoid glaucoma?

Dr. Bird:  We try to encourage general wellness as the way to meet glaucoma head on but there aren’t any preventive measures other than early detection and proper lifelong treatment.  It helps to know your family history and get tested in your youth and regularly thereafter.

P:   Medication for glaucoma is expensive in the United States.  If glaucoma is diagnosed in another country, how is the medication affordable?

Dr. Bird:  The government of Antigua provides glaucoma medication free of charge since it is one of our covered diseases like hypertension and diabetes.  The situation is different in other countries.

P:   Here in Brazil, our government only covers timolol.  If a different medication is required, you need to buy it, but fortunately our prices are less than in the U.S.  My government is not interested in glaucoma, maybe because it is very expensive for our public health system to detect and treat the disease.

Dr. Bird:  I hope the government of Brazil can look to change that and expand the coverage because your population makeup is very similar to ours and glaucoma is very prevalent.

P:   Are the same medications and procedures available in Antigua and Brazil as in the U.S.?

Dr. Bird:  Yes, for the most part.  We still don’t have OCT and other ocular imaging techniques available here but many nearby islands do have up-to-date technology.  Brazil has most of the up-to-date technology available today.

P:   Dr. Bird, what are some causes of angle closure glaucoma in people with no family history?

Dr. Bird:  Angle closure glaucoma is an anatomical disease.  People without any family history could possibly be born with that shape to their eyes.  Because you do not have family history doesn’t not mean there isn’t one.  Many individuals can die with glaucoma undetected.

P:  Are there any known ties between migraines or thyroid disease and angle closure glaucoma?

Dr. Bird:  Migraine and glaucoma have been linked mainly due to a vascular spasm theory rather than to the anatomy of the angle.  Speculative links between thyroid disease and glaucoma have also been made, again not anatomically, but due to hormones and other imbalances in the body.

P:   Is an open angle glaucoma and migraine correlation more likely?

Dr. Bird:  Yes, it is more likely.

P:   Doctor, what message would you like to send to not only the participants in the chat tonight but also to the many that will read the chat highlights in years to come?

Dr. Bird:  Advocacy and awareness are key to silent and blinding diseases like glaucoma.  Both are useless unless the populations are educated and made aware, and then mobilized to change their behaviors, get tested, and adhere to treatment regimens.

P:   What areas of research will you pursue in the future?

Dr. Bird:  I am very interested in the association between poor circulation and normal tension glaucoma.  In particular, sleep apnea, over-treated hypertension, and the worsening of glaucoma.  I hope to raise more awareness of these things in my population.  Know your family history!  Start today to find out!

Moderator:  Our time is up for this evening.  Our thanks to Dr. Jillia Bird for joining us tonight and educating us on your passion!


About the Author:

The Glaucoma Service Foundation’s mission is to preserve or enhance the health of all people with glaucoma and to provide a model of medical care by supporting the educational and research efforts of the physicians on the Wills Eye Institute Glaucoma Service, the largest glaucoma diagnosis and treatment center in the country.
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