Ophthalmologists are 'public health ambassadors for glaucoma'

Ophthalmologists are "public health ambassadors for glaucoma" in their professional and academic lives and as such have a responsibility to take specific actions, said Anne L. Coleman, MD, PhD, delivering the 9th annual Clinician-Scientist Lecture during the annual meeting of the American Glaucoma Society (AGS).

Dr. Coleman, the Frances and Ray Stark Professor of Ophthalmology and a professor of epidemiology at the University of California, Los Angeles (UCLA), said that ophthalmologists must:

• Tell patients with glaucoma that their family members are at increased risk for the disease.
• Diagnose glaucoma accurately.
• Educate patients.
• Follow and treat patients responsibly.
• Interface with other medical professionals.

"We provide an important service to society and the public's health," she said, encouraging audience members to remember their "public health duty."

In their professional lives, Dr. Coleman said, ophthalmologists must educate society and government officials about glaucoma. Examples of education efforts include the AGS' first advocacy day, held March 6, as well as participation in World Glaucoma Day activities that day and participation in the American Academy of Ophthalmology's EyeCare America program.

Ophthalmologists also should participate in the training of medical students, other eye physicians, and glaucoma specialists, Dr. Coleman said.

"We carry the public health message in our academic lives as well," she said, by interacting with colleagues in other disciplines; conducting research on the scope, pathophysiology, diagnosis, prevention, and treatment of glaucoma; and sharing the results of such research with colleagues, students, and society.

Dr. Coleman described a Jan. 18 strategic planning meeting at the Braille Institute in Los Angeles that was attended by representatives of the National Education Program for National Hispanic Association for Elders; the Southern California College of Optometry; the University of Southern California Department of Ophthalmology; the American Diabetes Association; QueensCare parish nurses, who serve low-income, uninsured people in Los Angeles County; UCLA; and other groups. Attendees discussed ways to address the high rate of visual impairment and blindness in the city, she said, and concluded that screening and education are disservices because no place exists to which to refer people for exams and care.

"In Los Angeles, we have free clinics where individuals can go. In addition, we have the EyeCare America program . . . but they clearly are not enough," she said. County hospitals are overwhelmed with patients, she added.

Despite the planning committee's recommendation, screening and education related to visual impairment and blindness remain important because they allow patients to seek or plan for care if it becomes available, Dr. Coleman said.

"It's still important to educate society so they can make decisions for themselves," she said.

"We can't take care of the uninsured and low-income [people] if we do not at least acknowledge that they are there. They are the elephant in the room," Dr. Coleman concluded.