WGD likely to become annual event, Dr. Ritch says

March 6, 2008

Ophthalmology Times interviewed Robert Ritch, MD, holder of the Shelley and Steven Einhorn Distinguished Chair in Ophthalmology at the New York Eye and Ear Infirmary, who is one of four specialists coordinating the WGD activities.

He-along with Scott R. Christensen, president and chief executive officer of the Glaucoma Foundation and president of the World Glaucoma Patient Association, Ivan Goldberg, MD, clinical associate professor, University of Sydney, Sydney, Australia, and director, Eye Associates, Glaucoma Services, Sydney Eye Hospital; and George N. Lambrou, MD, PhD of the Athens (Greece) Institute of Ophthalmology-have worked to draw attention to the need for early detection and treatment of glaucoma by organizing and focusing events on March 6.

What do you hope to achieve with WGD?

It's a push. Let's see what it does. In some of these countries in which awareness is still low, such as Nepal, they're doing a lot of things. The response in Antigua has been enormous, including radio, TV and newspaper announcements, glaucoma T-shirts, screening, fund-raising, and a march for glaucoma with the prime minister leading the parade holding a banner, and the government is issuing a postage stamp. We're hoping all of these events will make a difference and reduce the problems both of blindness and all the other socioeconomic and quality of life issues that go along with it.

Will it become an annual event?

Yes. It has just been the three of us (plus myself) getting all this started, with no staff. We finally reached a critical mass and then it became a chain reaction. You can see what's going on at the Web site, http://www.wgday.net. We have learned a lot and have a lot to build on for next year. We have gotten a great response.

Glaucoma has been called the second-leading cause of preventable blindness. Why does that number continue to grow?

Half the people with glaucoma who are legally blind have not been declared legally blind. If they were, it would make glaucoma the leading cause of blindness. People come in with 10-degree fields-if you tell them they're blind, they're afraid they're going to lose their driver's license. If we (in the United States) don't declare a lot of people blind based on visual field, what's going on in the rest of the world? We'd double the number of people (who are legally blind).

In addition, as the population continues both to grow and age, particularly in developing nations, we can expect the number of cases of glaucoma to grow concomitantly.

What can be done to lower the number of glaucoma cases?

People don't think about glaucoma. The older you get, the more you think of these things. If people don't have eye problems, they don't go to an eye doctor. They don't get their vision checked. It would be great if primary-care physicians could check glaucoma because everybody goes to a primary-care physician. But not everyone goes to an ophthalmologist every year. You just have to make people aware of it. If they're aware of the risk factors, they'll hopefully be more inspired to get checked.

People also don't realize that glaucoma can be a disease of younger people, particularly pigmentary glaucoma. More than 2% of the Caucasian population has the gene for this and about 10% to 15% develop glaucoma, which strikes patients in their 20s and 30s. That amounts to about 400,000 people in the United States with this condition. African-Americans, particularly those with myopia, are also prone to develop glaucoma at younger ages.

Is there a way in which primary-care physicians can help detect glaucoma earlier?

It would be great if primary-care doctors could detect glaucoma, but they don't take IOPs, and we don't expect them to. And we don't expect them to recognize glaucomatous disks, and we don't expect them to do visual field examinations. The best way to do it is to keep creating awareness of the most important risk factors and hope that people get complete eye examinations. People with a history of glaucoma in a first-degree relative are at the most risk. Patients with glaucoma don't always notify their families about this. It would also be useful to have information about glaucoma in the offices of primary-care physicians.