Alpha-CARE - the online Blog of GLAUCOMA PATIENTS ASSOCIATION (SINGAPORE)

18 Oct 2008: Talk on Coping with Glaucoma

2008-10-02T06:36:00.004+08:00

Join us at our Glaucoma Patient Forum on:

Coping with Glaucoma - You are not alone!

at:

Tan Tock Seng Hospital
Conference Room 1 & 2 (Level 1)

Date: 18 October 2008 (Saturday)
Time: 2pm to 4pm

For more details see: FORUM

Yahoo! Search on the top 10 Hits: The World's most talked about events at the moment.

COPING WITH GLAUCOMA
An important element in coping with glaucoma is learning techniques you can do for yourself. ... Author, Coping With Glaucoma ...www.therubins.com/illness/glaucoma.htm - Cached
Edith Marks and Jason Marks, Authors
Coping with Glaucoma ... Reviews: COPING WITH GLAUCOMA " ... Coping With Glaucoma....contains a wealth of information, both basic and ...www.booksbymarks.com/edith/glaucoma.htm - Cached
Glaucoma Service Foundation: Coping With Glaucoma Chat Highlights
Glaucoma Service Foundation to Prevent Blindness provides glaucoma information on diagnosing, testing and treating ... "Coping ... Coping with Glaucoma by ...www.willsglaucoma.org/supportgroup/20021218.php - Cached
Glaucoma Support Group : Glaucoma Service Foundation to Prevent ...
Glaucoma Service Foundation to Prevent Blindness provides glaucoma information on ... GlaucoMates share tips about living and coping with glaucoma. Need help? ...www.willsglaucoma.org/support.htm - Cached
Coping with Glaucoma
Coping with Glaucoma. Author: Edith Marks and Rita Mountauredes. ISBN: 089529804X ... book highlights medications and procedures used to treat and diagnose glaucoma. ...www.healthywomen.org/resources/books/dbbooks/copingwithglaucoma - 88k - Cached
[PDF]
Coping with glaucoma - you are not alone!
248k - Adobe PDF - View as html
A patient forum in English on. Coping with glaucoma - you are not alone! ... glaucoma patients & caregivers. PLACE: Conference Rooms 1 & 2 (next to. Theatrette) ...www.singapore-glaucoma.org/ftp/18Oct_final.pdf
Welcome to Glaucoma Patients Association (Singapore)
Singapore Glaucoma Patients Association ... organising a glaucoma patient forum, Theme: Coping with glaucoma - you are not alone! ...www.singapore-glaucoma.org - Cached
NIHSeniorHealth: Coping with Glaucoma
Video: "Coping with Glaucoma" A man with glaucoma is able to preserve much of his vision ... Video: "Coping with Glaucoma" A man with glaucoma is able to ...nihseniorhealth.gov/glaucoma/treatment/video/glauc2.html - Cached
MEDICARE EYE SURGERY GLAUCOMA GLAUCOMA SURGERY GLAOCOMA ...
Why wait for Cataract,Glaucoma, Lens Implants or laser eye surgery when ... "Coping with Glaucoma" discusses the different types of glaucoma, the connections ...www.icaremedicare.com/glaucoma.htm - Cached
Glaucoma: Symptoms - MayoClinic.com
Glaucoma — Comprehensive overview covers symptoms, causes, treatment of this eye condition that threatens vision. ... Coping and support. Prevention. Symptoms ...www.mayoclinic.com/health/glaucoma/DS00283/DSECTION=symptoms - Cached

quarter of a million people with undiagnosed Glaucoma in the UK

2008-04-02T18:53:00.000+08:00

Letter to Editors from Sir Trevor McDonald OBE
Are You 1 in Half a Million?
There are half a million people in the UK with Glaucoma, half of
whom don't know they have the condition and are at risk of losing
their sight unnecessarily. Untreated, Glaucoma leads to
irreversible sight loss; if caught early enough Glaucoma can be
treated, preventing sight loss.
Thursday 6th March is the first World Glaucoma Day. Organisations
such as the Glaucoma Alliance UK are raising awareness of
Glaucoma, what it does to sight and how it might affect you.
So, are you one of the quarter of a million people with
undiagnosed Glaucoma in the UK? Without an eye test you won't
find out until it's too late, Glaucoma doesn't have any symptoms in
its early stages; people can lose up to 40% of their sight before
they realise they have a problem.
Many people are entitled to receive free eye tests. People who are
over 40 and have a close relative with Glaucoma, have diabetes,
are aged 60 or over, who live in Scotland or who themselves or
their partner receive benefits, family credit, pension credit, are all
entitled.
Don't delay, make 6th March, World Glaucoma Day, the day that
you find out if you are 1 in half a million, get an eye test.
Yours faithfully,
Sir Trevor McDonald OBE

WGD: Posters Display

2008-03-15T13:54:00.011+08:00

WGD: Glaucoma Vision

2008-03-15T09:42:00.003+08:00

An eye-catching simulation of vision through an eye with advanced, early, or no defects from glaucoma, together with a short explanation of the brain's visual processes leading to these perceptions (submitted by Dr A. Hoste from Belgium and prof. A. Safran from Switzerland)

Glaucoma Vision
A short explanation on the way the brain perceives images from eyes with glaucomatous damage
The images represent the visual field of a left eye. The corresponding results of the visual field test (where blind areas are represented in black) are embedded in the images. A normal test always shows one blind spot: where the optic nerve is attached to the back of the eye, there is no retina and consequently no light perception. Yet, we do not perceive this blind spot because our brain is able to fill it in with colours and patterns from the surrounding areas. The brain uses visual information received from adjacent parts of the image to achieve this.
In the same way, the brain conceals damage caused by glaucoma. In the image representing an early stage of glaucoma, the eye looks to the fixation point in the centre. It does not see the children because they are practically completely located in the blind area. Still you are unaware of any visual problem, due to the filling-in process. Even in a later stage of the disease, the brain is still able to compose a plausible image. The deformations in the periphery remain unnoticed because you are unable to fix your eye on them. You are always looking at the centre of the image, and when you shift your gaze to the periphery, the deformations move with it.

References
Safran AB, Landis T. Plasticity in the adult visual cortex: implications for the diagnosis of visual field defects and visual rehabilitation. Curr Opin Ophthalmol 1996; 7:53-64.
Ramachandran VS, Gregory RL. Perceptual filling in of artificially induced scotomas in human vision.
Nature 350:699-702, 1991.
Das A, Gilbert CD. Long-range horizontal connections and their role in cortical reorganization revealed by optical recording of cat primary visual cortex. Nature 375:780-4, 1995.

Prissy Place: iprissy.com

2008-03-15T07:21:00.003+08:00

Great!, everybody is wrting about the 1st World Glaucoma Day in Singapore. Generating increased awareness in glaucoma is the way ...... thank you.

http://iprissy.com/lifestyle/world-glaucoma-day-6-march-2008/

World Glaucoma Day: Glaucoma among Malays, Chinese among the highest in the world

2008-03-15T05:47:00.004+08:00

ChannelNewsAsia: World Glaucoma Day in Singapore - Glaucoma among Malays, Chinese among the highest in the world

http://asia.news.yahoo.com/080306/5/singapore333338.html

Tan Tock Seng Hospital/SAVH: "Dining in the Dark" raises public awareness, provides work opportunities for the blind

2008-03-14T16:15:00.003+08:00

"Dining in the Dark" raises public awareness, provides work opportunities for the blind

Glaucoma is among the top three causes of blindness in Singapore, so the SAVH is running a shorter version of the "Dining in the Dark" programme at Tan Tock Seng Hospital on Saturday as part of World Glaucoma Day.

http://www.channelnewsasia.com/stories/singaporelocalnews/view/332890/1/.html

Glaucoma rate among Malays, Chinese among highest in the world

2008-03-14T16:08:00.003+08:00

SINGAPORE : The prevalence of glaucoma among Malays and Chinese here is among the highest in the world. A survey found that it affects 3.2 percent of Chinese and 3.4 percent of Malay Singaporeans, aged 40 and above.

http://www.channelnewsasia.com/stories/singaporelocalnews/view/333338/1/.html

AsiaOne Health: How glaucoma can make you blind in as little as 2 weeks

2008-03-14T09:53:00.008+08:00

NUH-GPAS World Glaucoma Day: Public Forum at the Central on 8th March 2008
350 people attended the 2 sessions held in English and Mandarin

The Forum Program

Q&A Session at NUH-GPAS WGD Public Forum on 8 March

What an audience!, some standing for 2 hours to learn more.

Joyce was a hit with the audience of 200 people (Mandarin session)

The GPAS committee beneath a WGD Poster as backdrop

"If detected early, and controlled, it should not affect a person's work life," said Prof Aung.
The lack of public education has prompted organisers of the first World Glaucoma Day, held worldwide tomorrow, to reach out to the public, with talks at venues such as the Alexandra and National University hospitals and the SNEC.

http://health.asiaone.com/Health/News/Story/A1Story20080305-52808.html

The NUH-GPAS World Glaucoma Day Public Forum at the Central on 8th March 2008 which attracted close to 350 people is one such collaborative efforts between hospitals and patient support groups for increasing awareness of glaucoma to the public and sufferers.
On 29th March 2008 the Glaucoma Patients Association will assist the National University Hospital, Department of Ophthalmology where over 250 pairs of eyes would be screened.

Another hospital, the Tan Tock Seng Hospital collaborated with the Glaucoma Society (Singapore) where 325 people were screened for signs of glaucoma.

Other talks and eye screenings were conducted by the Singapore National Eye Centre, Alexandra Hospital and the Jurong Medical Centre.

AsiaOne Health: You don't have to go blind

2008-03-14T09:49:00.004+08:00

The common causes of avoidable blindness include cataracts, glaucoma, diabetic retinopathy and age-related macular degeneration.

http://health.asiaone.com/Health/Wellness%2B%2540%2BWork/Story/A1Story20080109-44265.html

AsiaOne Health: No pain, no symptoms, then you get Blind

2008-03-13T11:33:00.003+08:00

Angle closure glaucoma

Chinese women who are gettting older may also be at a higher risk compared to their male counterparts, said Dr Jovina See, a consultant ophthalmologist and head of glaucoma services at the National University Hospital.

http://www.asiaone.com/Health/News/Story/A1Story20080305-52803.html

Public Forum on 8 March @ Central: FULL HOUSE

2008-03-07T07:11:00.009+08:00

submitted by Dr M Javier Gonzalez Rodriguez from Vigo (Spain)

NUH-GPAS World Glaucoma Day Public Forum:
8 March 2008 at The Central

We like to thank the public for their overwhelming support of our Event this Saturday on 8th March at the Central.

All seats for the forum in both the English & Mandarin Sessions have been taken up.

We will not be able to accept any walk-in participants on the day itself.

NUH-GPAS World Glaucoma Day Public Forum at The Central on 8 March 2008

2008-03-05T08:13:00.002+08:00

PLEASE REGISTER AS SOON AS POSSIBLE AS REMAINING SEATS ARE VERY FEW (LESS THAN 30 SEATS ARE AVAILABLE) - 5TH mARCH 2008

A partnership with Allergan: DON'T TURN A BLIND EYE TO GLAUCOMA - Detection is your best protection

2008-03-01T08:25:00.002+08:00

SAVH joins in the World Glaucoma Day Event [Click Here]

2008-02-26T05:34:00.006+08:00

SAVH joins in the World Glaucoma Day Event

In conjunction with World Glaucoma Day 2008

8 March 2008 (Saturday)

In Singapore, Glaucoma is one of the top 3 causes of blindness in adults over 40 years of age.

The key to prevention of blindness is Early Detection.

Eye screening, Talks will be conducted at Tan Tock Seng Hospital by our Eye Specialists. In addition, come join us to experience what is it like to be visually handicapped at our “Dine in the Dark” segment!

WGD Newsletter - 6th Feb 2008 ...[click here]

2008-02-26T02:38:00.006+08:00

Local Events Highlight

In Singapore, the GPAS (Glaucoma Patient Association of Singapore)and the Singapore WGD Committee are organizing an impressive number of activities: Screening events at four different Hospitals, some for the entire week; a high-visibility event at the Health Promotion Board; fliers, posters, banners to be distributed nation-wide in Singapore. Find out more from the Guide to WGD Events in Singapore on the GPAS website

First World Glaucoma Day Observance Ceremony on 6th March 2008

2008-02-24T08:39:00.001+08:00

Members who are interested to attend please R.S.V.P by fax or email by 29 February 2008
Fax: 6227-7290 or Email: ravi.chandran@snec.com.sg

World Glaucoma Day - Participating Countries

2008-02-17T08:29:00.002+08:00

TTSH Public Forum on 8 March 2008

2008-02-06T23:31:00.000+08:00

TTSH Public Forum on 8 March 2008

Time Activity

8.30 am Start of Screening

9.30 am – 10.15am Public Talk 1 (details to refer to point 3)
- Patient Experience Sharing (10mins)
- 2 topics to be delivered by 2 doctors (10mins each)
- Q & A (15 mins)

10.30am Opening Ceremony - Opening Address by CEO / CMB (5mins)
- Patient Experience Sharing (10mins)

11.30am – 12.15pm Public Talk 2
- Patient Experience Sharing (10mins)
- 2 topics to be delivered by 2 doctors (10mins each)
- Q & A (15 mins)

12.30pm End of whole event

World Glaucoma Day Public Forum - 8 March 2008

2008-02-02T06:59:00.001+08:00

For on-line registration : http://www.singapore-glaucoma.org/files/WGD2008/NUH_GPAS_Forum.html 8 /NUH_GPAS_Forum.html

GPAS Support Group Session on 16 February 2008

2008-01-19T10:09:00.000+08:00

first ever World Glaucoma Day

2008-01-16T16:06:00.000+08:00

March 6th, 2008 will be the first ever World Glaucoma Day (WGD), a joint global initiative of the World Glaucoma Association (WGA) & the World Glaucoma Patient Association (WGPA).

Because glaucoma is a progressive disease causing irreversible visual loss, usually without warning until relatively advanced, and because 50% of affected people in the developed world (up to 90% in developing countries) do not know that they have the disease and are therefore not on treatment, community awareness needs to be significantly increased. This includes awareness of the disease and of the need to have regular eye checks, thereby permitting earlier detection and avoidance of what should be preventable visual disability.

This is the ultimate Goal of the World Glaucoma Day: To enhance global glaucoma awareness through novel as well as through traditional or novel communication strategies and events.

Rather than have a single large event held in conjunction with a major Ophthalmic conference, World Glaucoma Day was designed to be the sum total of local activities aiming at increasing glaucoma awareness, such as newspaper articles, radio and television coverage, public glaucoma "screening" campaigns in public places and "open-door" days at glaucoma clinics and departments of ophthalmology. Hundreds of activities have been planned around the World.

World Glaucoma Day - 6 March 2008 (click)

2007-12-27T06:06:00.000+08:00

World Glaucoma Day in Singapore

GPAS will observe with their partners the 1st World Glaucoma Day on 6th March 2008 at The Giving Place (NVPC- National Volunteer & Philantropy Centre), The Central #04-88, Clarke Quay. The observation ceremony will start at 6.00pm.

A week-long poster exhibition on Glaucoma starting 3rd March till 8th March will be displayed at the Level 4 Gallery of the Giving Place.

Talks on glaucoma are scheduled for:

6th March 2008 6pm to 8pm - Opening Ceremony: Observation of World Glaucoma Day in Singapore - invited guests, media representatives and glaucoma-related industries & organisations (there are limited seats for public attendance)

8th March 2008 10am to 12 noon - Talks on glaucoma in English (open to public - 150 seats available)

8th March 2008 2pm to 4pm - Talks on glaucoma in Mandarin (open to public - 150 seats available)

Location Plan of the Giving Place

By the side of the Singapore River

The beautiful facade of The Central

See you at the World Glaucoma Day in Singapore

GPAS launched on November 24, 2007

2007-12-01T20:51:00.001+08:00

More photos: click title header

GPAS Launch on November 24

2007-10-16T13:23:00.000+08:00

The GLAUCOMA PATIENTS ASSOCIATION (SINGAPORE) will be launched on

November 24, 2007
8.30 to 11.30am
National University Hospital Auditorium

for details see: http://www.singapore-glaucoma.org/Forums/GPAS_Launch.html

GPAS at the Total Eyecare Festival - 11 to 14 Oct 2007

2007-10-16T13:10:00.000+08:00

The Glaucoma Patients Association (Singapore) made full use of the space at the Festival to bring awareness of glaucoma to some 50,000 visitors to the event. Almost 1000 pairs of eyes were screened for eye diseases. Talks from eye professionals and specialists gave talks on glaucoma, macular degeneration, diabetic retinopathy, use of eye glasses, myopia.

GPAS had the opportunity of meeting various professionals in the eyecare community - from ophthalmologists, community leaders, optometrists, nurses etc.

http://www.singapore-glaucoma.org/Forums/AlconTEF_Oct07.html

GPAS - Our 1st 40 days

2007-10-08T06:20:00.000+08:00

Oct 10, 2007

Our 1st 40 DAYS

Dear Friends,

During the first 40 days since our inception on Aug 30, 2007, my Committee and I have worked relentlessly to get the support of our glaucoma patients and the related local and international groups.

GPAS is pleased to advise you that our Association is on the AIGPO International Listing (Association of International Glaucoma Patient Organisations). The AIGPO was recently renamed World Glaucoma Patient Association (WGPA). The listing is significantly beneficial to us as 6.5% of our total website traffic originated from the AIGPO website. This augers well for the interest shown to GPAS internationally. Our Mission of: Building support to maintain quality and independent living for those with glaucoma is in total agreement with the WGPA's Mission of: Working to better the lives of glaucoma patients worldwide.

Locally we are on the NVPC Listing in Singapore.

We are profoundly encouraged by the strong endorsements the international community have shown to GPAS .....

WGPA Exec. Vice-Chair Prof. George Lambrou messaged us: "Let me send you my best wishes for a thriving GPAS that will make a difference in the well-being and sight preservation of its members."

WGA President, Prof. Ivan Goldberg responded: "Yes indeed, Sam - congratulations and well done.You're moving ahead very nicely. Good luck!"

From Wills Glaucoma, Prof. Richard Wilson: " Congratulations, Sam. That is great news and Dr. Chew will be an excellent and wise advocate for you. Rick Wilson."

GPAS made her first public appearance at the NUH EYE CARE SEMINAR on Sep 29 where we had a booth to showcase our Association.

GPAS look forward to welcome you at the Total Eye Care Festival from 11 to 14 October 2007 at Marina Square Linkbridge Atrium from 11am to 9pm daily. GPAS will bring awareness of glaucoma message to the participating public. A walk through traffic of close to 50,000 can be expected for the 4-day festival.

Again, we hope to see you at the MDS Public Forum on EYE ALERT: What You Know May Save Your Sight on Oct 27 at Alexandra Hospital Auditorium. This is a collaborative effort of MDS & GPAS.

Next month, we will be celebrating the official GPAS Launch and Patient Forum on November 24 at National University Hospital Auditorium. All glaucoma patients and their caregivers are welcome. The membership fees for all eligible persons are waived till December 31, 2008.

All these events are on our website: www.singapore-glaucoma.org and more events will be added before the year ends.

Visit us daily - our website is on the move and seldom static!

We are looking forward to a great year in 2008!

Best regards,

Sam Fong
President
Glaucoma Patients Association (Singapore)
website: http://www.singapore-glaucoma.org
email: glaucoma.patients@gmail.com

Alpha-C Support Group: Sam to retire to lead Glaucoma Patients Association (Singapore)

2007-09-02T17:05:00.000+08:00

Dear Alphacians and friends,

I like to inform you that a Glaucoma Patients Association (Singapore)
has been registered on Aug 30, 2007 and that I am the founding
president of this association.

It was exactly a year ago in August 2006 that Alpha-C Support Group
was formed. In September 2006 Dr Jovina See became our first guest
speaker to share with us and was followed by other guests speakers
such as Mr Kua Cheng Hock, Dr. Sharon Siddique and we also conducted
our own in-house sessions. All in all we conducted 8 sharing sessions
and participated at the TTSH Public Forum, the National Eye Care Day
and the SNEC Support Group launch.

All our activities were self-funded by well-wishers from within
Alpha-C Support Group and as such we were able to include other
glaucoma patients not affiliated to any societies to participate in
our group activities free of charge. 12 months seems a short time but
Alpha-C Support Group became the catalyst to many patient groups to
emerge this year. In a small way we provided the impetus for SNEC
Glaucoma Support Group to revitalize itself. The executive committee
of the Macular Degeneration Society launched in June 2007 acknowledged
that Alpha-C will be the early model it will adopt before evolving its
own model. The Alpha-C experiment has paid dividend again with the
formation of the Glaucoma Patients Association (Singapore) on August
18, 2007 and approved by ROS on Aug 30, 2007.

Having lead Alpha-C Support Group for 12 months, I have decided to
allow myself to retire as there is now a patients association
dedicated to cater for the needs of the glaucoma sufferers. As I am
president of GPAS there is duplication in conducting sharing sessions
for both groups. As GPAS will outgrow Alpha-C Support Group (it being
a cell group) I welcome alphacians to attend our sharing sessions in
the interim until they are able to find suitable alternative
arrangements which they feel comfortable with. If there is a member
who like to continue with the work at Alpha-C, I will be most
delighted.

At Alpha-C we had never looked at membership as a key requisite for
participation in our programs but on the principle whether glaucoma
sufferers will benefit from the programs. Thus GPAS will extend this
similar arrangement to alphacians in the interim 3 to 6 months.

Details of GPAS future activities will be featured on their website at
http://www.singapore-glaucoma.org

If you need to contact me on GPAS matters my email address is:
glaucoma.patients@gmail.com otherwise the present email will continue
to be appropriate.

This is not "goodbye" for we will certainly meet at other functions.

Many fond memories and warmest regards,
Sam Fong
Group Leader
Alpha-C Support Group

Glaucoma Patients Association (Singapore)

2007-09-02T14:16:00.000+08:00

On August 18,2007 a first General Meeting was held and the following members were elected to hold the respective offices in the GLAUCOMA PATIENTS ASSOCIATION (SINGAPORE)

OFFICE BEARERS: 2007-2009
PRESIDENT SAM FONG
VICE-PRESIDENT TAN LIAN TECK
SECRETARY CHANG BOON SENG
TREASURER RONALD TAN

COMMITTEE MEMBERS
Ms. CHRIS TAN
RICHARD TAN HUAN CHENG
RAYMOND L C TAN
DANNY GOH
Ms. WONG HOW LEEN, ROSALEEN

HEALTH CARE SUPPORT COMMITTEE MEMBERS
Ms. ANNY LEOW
Ms. WENDY KHON

HONORARY ADVISER
PROFESSOR PAUL CHEW

HONORARY GROUP ADVISERS
GLAUCOMA SURGEONS (SINGAPORE)

CORPORATE SUPPORTERS
SINGAPORE WOMEN'S ASSOCIATION
ALCON

REGISTERED OFFICE
BLOCK 409, #01-303
SERANGOON CENTRAL
SINGAPORE 550409

The World Glaucoma Congress in Singapore

2007-08-08T20:51:00.000+08:00

SPEECH BY DR VIVIAN BALAKRISHNAN,MINISTER FOR COMMUNITY DEVELOPMENT, YOUTH AND SPORTS AND SECOND MINISTER FOR INFORMATION, COMMUNICATIONS AND THE ARTS, AT WORLD GLAUCOMA CONGRESS, 18 JULY 2007, 3.00 PM AT SUNTEC CONVENTION CENTRE BALLROOM

Dr. Vivian Balakrishnan said: "I am glad that the Association of International Glaucoma Patient Organisations is also represented here today. It is fitting that the perspective of patients is upheld in the midst of the high science that we are here to share and celebrate. After all, it is the patients’ welfare that is our ultimate index of success."

Alpha-C Support Group welcomes the Minister's speech on the importance of the patient in the search of excellence in glaucoma. We are glad that we have Anny Leow as the sole representative of Singapore in the AIGPO discussions and deliberations.

From AFB Senior Site

2007-07-08T08:42:00.000+08:00

Are you experiencing problems with your peripheral or side vision? Do you have to turn your head to see what's to your immediate right or left?[IMAGE]-->
It might be... Glaucoma
Glaucoma is a serious condition that involves an elevation in pressure inside the eye caused by a build-up of excess fluid. Left untreated, this pressure can impair vision by causing irreversible damage to the optic nerve and, eventually, blindness. Glaucoma results in peripheral vision loss, and is an especially dangerous eye condition because it frequently progresses without obvious symptoms. This is why it is often referred to as "the sneak thief of sight."
There is no cure for glaucoma, although it can be treated. The damage to the optic nerve from glaucoma cannot be reversed. However, lowering the pressure in the eye can prevent further damage to the optic nerve and further peripheral vision loss.
Still, early detection, appropriate and ongoing treatment, and the availability of specialized low vision and vision rehabilitation services can help people with glaucoma live productive and satisfying lives. Starting as early as age 35, a pressure check for glaucoma should be an essential part of your annual routine eye examination. A visual field test will detect peripheral vision loss.
Glaucoma at a Glance:
Affects more than 3 million people living in the United States.
Is the leading cause of blindness in African Americans, who should begin glaucoma tests as early as age 35.
Is caused by increased pressure in the eye due to a buildup of excess fluid.
Results in a loss of peripheral or side vision, which affects your ability to move about safely.
May also affect reading, as loss of visual field may result in being able to read only one word at a time.
Can cause irreversible damage to the optic nerve if left undetected and untreated.
Is particularly dangerous to your vision because there are usually no noticeable symptoms at first.
Possible Signs of Glaucoma:
There are various types of glaucoma that can occur and progress without obvious symptoms or signs. Open-angle glaucoma is the most common, and symptoms are slow to develop. As this types of glaucoma progresses, you may notice that your side, or peripheral, vision is failing, causing you to miss objects out of the side and corner of your eye.
If you are suddenly experiencing the following symptoms, you may have angle-closure glaucoma and should seek immediate treatment:
Blurred vision
Nausea
Headaches
Halos around bright lights
For More Information:
National Eye Institute. Eye Disease Simulations. See what a photo looks like to people with a variety of eye conditions. Includes information in Spanish.
http://www.nei.nih.gov/photo/sims/index.asp
Vision Simulator. An interactive tool that demonstrates progressive vision loss.
http://www.visionsimulator.com/default.asp-->
National Eye Institute. Eye health information.
National Eye Institute. Eye health information in Spanish.
The Glaucoma Foundation
Glaucoma Support Groups.
American Academy of Ophthalmology. Glaucoma information in Spanish.
Association of International Glaucoma Patient Organizations
Prevent Blindness America. The Glaucoma Learning Center.
Glaucoma Research Foundation.
American Glaucoma Society.
MedlinePlus. Glaucoma.

10 Useful Tips for your next visual field test

2007-06-26T17:53:00.000+08:00

Most of us take 2 or 3 visual field tests a year. Each time we need to mentally try to recollect how we did it the previous time.
Here for the first time a properly documented step-by-step procedure is laid out for us.

Thanks to Dr. Leonard Yip who has taken the time and trouble to document the "10 Useful Tips for your next visual field test."
Very few will realize that they need to take proper rest before the test. If our response is not a split second from a cue we would often give the reply a pass (now we know we still have time upon seeing the light - a few seconds to respond). What is little known is that you can stop the VF machine if you feel uncomfortable.

For the 10 TIPS click the title bar of this posting

Neuroprotection and Glaucoma: Questions and Answers from Dr. Moses Chao

2007-06-24T18:50:00.000+08:00

For quite some years we've been hearing about neuroprotection. Some glaucoma eyedrops are even said to have neuroprotective properties - so is the effective protection of the optic nerves anywhere near and available?

What is neuroprotection and how does it apply to glaucoma treatment?

Neuroprotection is a broad term to cover any therapeutic strategy to prevent nerve cells called neurons from dying, and it usually involves an intervention, either a drug or treatment. There is significant amount of scientific work that is currently going on in this area, but much more research is needed to identify the best pathways to target for neuroprotection. - Dr. Moses Chao, Glaucoma Research Foundation

FOR MORE INFORMATION VISIT THE LINK BELOW:

http://www.glaucoma.org/treating/neuroprotection.html

A Guide to Sunglasses from GRF

2007-06-23T05:12:00.000+08:00

A Guide to Sunglasses
Glaucoma can make eyes highly sensitive to light and glare, with some glaucoma medications exacerbating the problem even further. Sunglasses are an easy solution that makes life more comfortable when outdoors, while also providing critical protection from the sun’s damaging ultraviolet (UV) rays.
Long-term exposure to UV rays can damage the eye’s surface as well as its internal structures, sometimes contributing to cataracts (clouding of the lens) and macular degeneration (breakdown of the macula). Ophthalmologists and optometrists now recommend wearing sunglasses and a brimmed hat whenever you’re in the sun long enough to get a suntan or a sunburn, especially if you live at a high elevation or near the equator.
The good news is that sunglasses don’t have to be expensive to protect your eyes and they can often be found at the local drugstore. Unfortunately, a high price is not always a guarantee of high quality and protection. Part of the difficulty is that standards and labeling regarding UV protection are voluntary, not mandatory—and can be confusing.
Here are some things to keep in mind when shopping for sunglasses:http://www.glaucoma.org/living/a_guide_to_sung.html

Alpha-C Support Group cheers the CHIEF for receiving this year's EYE & VISION HEALTH AWARD

2007-06-21T09:41:00.000+08:00

Wherever there are glaucoma support groups in Singapore, Anny Leow is there and actively participating, promoting and encouraging patients to be vigilant in glaucoma care. She personifies the spirit of self-help patient-initiated groups - a growing movement in Singapore.
Alpha-C Support Group is proud that our Chairwoman has received recognition this year as one of the ten recipients of the EYE & VISION HEALTH AWARDS. The awards wil be presented at the 6th National Congress of Optometry and Opticianry.

HAIL TO THE CHIEF! Our thanks & congratulations!

ALPHA-CARE for YOU
Alpha-C Support Group

Alpha-C Support Group congratulates Er. John Tan on his Award at NCOO

2007-06-21T09:30:00.000+08:00

Members of Alpha-C Support Group congratulates the President of Glaucoma Society (Singapore) on his receiving the Eye and Vision Health Award.

inaugural SNEC Glaucoma Patient Support Group Meeting

2007-05-16T05:44:00.000+08:00

GLAUCOMA PATIENT SUPPORT GROUP MEETING

Talk on
Importance of Eye Drop Compliance in Glaucoma Care
(in English)

The Singapore National Eye Centre (SNEC) Glaucoma Patient Support Group is a non-profit, self-help group which aims to help patients and their families cope with glaucoma. Through regular meetings and activities, it will help patients achieve a more holistic approach to the management of glaucoma thereby leading to improvement in their quality of life.

As a start, we have organised a meeting on 26th May 2007 with a theme on “importance of eye drop compliance in glaucoma care”. This theme was chosen because we feel strongly that eye drop compliance is a small but crucial step to achieving better care. Hence, it is important that patient and their families understand what medication compliance is all about.

We sincerely hope that you and / or your family members will join us for this get-together.

Saturday, 26 May 2007

9.30am – 11.00am * Auditorium – Level 4, SNEC

Registration is FREE

For catering purpose, please confirm your attendance with
SNEC Public Relations Department
Tel: 6322 8370 / 74 / 94 or Email: meet@snec.com.sg

Public Forums in May 2007

2007-05-04T07:57:00.000+08:00

Please click on the title above to view public forums organised by the various hospitals in the month of May 2007.

Alpha-C Sharing Session on 14th April 2007

2007-04-29T20:20:00.000+08:00

Forum 29th April 2007 : Blindness from Diabetes can be Prevented

2007-04-25T09:08:00.000+08:00

TTSH Glaucoma Forum - 28th April 2007

2007-04-24T08:57:00.000+08:00

6th National Congress of Optometry & Opticianry... 21-23 June 2007 @ Alexandra Hospital

2007-04-20T15:24:00.000+08:00

Microglia important in glaucoma

2007-04-20T14:20:00.000+08:00

From Glaucoma Research Foundation
Microglia important in glaucoma
The fate of ganglion cells is also controlled by other cells within the retina. The nervous system, including the retina, is thought to be the only place in the body that is not subject to surveillance by the immune system. To search for and deal with signs of trouble, the nervous system uses special cells named microglia. Recent evidence suggests that, while microglia are usually beneficial, in diseases of the nervous system they often end up doing more harm than good. The molecular profile of glaucoma that the CFC published in 2006 had strongly hinted that microglia might be important players in glaucoma. This year the CFC obtained strong evidence that microglia are involved both early in the disease, perhaps contributing to the slow progressive atrophy of retinal ganglion cells, as well as late in the disease, perhaps mediating the spread of the disease from focal to widespread. Needless to say, we viewed microglia as an important therapeutic target.

MACULAR DEGENERATION SOCIETY - SINGAPORE

2007-04-18T08:12:00.000+08:00

OUR MISSION STATEMENT: Building support to maintain independent living for those with central vision impairment.

The former AMD Support Group is now formally registered as the

MACULAR DEGENERATION SOCIETY

SINGAPORE

ROS Registration: 2049/2007

President .... Er Sam Fong, Civil Engineer
Secretary .... Dr Sharon Siddique, Sociologist
Treasurer .... Mr Peh Shing Huei, Correspondent

The Society’s Objectives are:

To help patients diagnosed with Macular Degeneration (MD) and caregivers to form support groups and to discuss effective ways of coping with and managing this disease

The Society will focus on understanding the disease, adjustment needs and stress management issues related to MD

The Society recognises that peer support from people in similar situations is crucial to everyone coping with MD

The Society creates a platform for patients for collective dialogue with Health Care, Low Vision and Government Agencies for effective rehabilitation and independent living.

Website: http://www.amd-singapore.org

emails : admin@amd-singapore.org or amdsg.sg@gmail.com

New Technology at National University Hospital detects glaucoma, 3 to 6 years, ahead of its actual manifestation

2007-04-17T14:45:00.000+08:00

Channel 8 10 O'clock News :Dr Jovina See, Head of Glaucoma Service at NUH, was interviewed in Chinese and discussed the new HRT Equipment and new state-of-the-art technology which are able to detect the initial on-set of glaucoma as early as 3 to 6 years ahead of its manifestation.

Glaucoma Society New Website Location

2007-04-17T09:25:00.000+08:00

Please note that the

Glaucoma Society (Singapore) Website

is now located at :

http://www.ab-glaucoma-sin.org

GLAUCOMA PUBLIC FORUMS - MONTH OF APRIL 2007

2007-04-14T09:19:00.000+08:00

GLAUCOMA FORUM @ ALEXANDRA HOSPITAL
Date: 21 April 2007
Time: 10.00 to 12.00noon
Venue : Alexandra Hospital Auditorium
For registration and enquiries, please contact
Ms Alice How at 63793741 or email : Alice_How@alexhosp.com.sg

Glaucoma Public Forum @ Tan Tock Seng Hospital
Date: 28 April 2007
Time: 1.30 to 3.30pm
Venue: TTSH Theatrette, Level 1
Registration Fee: $5
For registration or enquiries, please contact
Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736
or email: Sing_Yong_Lim@ttsh.com.sg

Alpha-C Sharing Session on 14th April 2007

2007-03-30T13:07:00.000+08:00

Don't Fall Victim to the Silent Sneak Thief of Sight

2007-03-30T06:14:00.000+08:00

GLAUCOMA CARE: LOOKING BACK, LOOKING AHEAD - A PATIENT'S HOPE
DON’T FALL VICTIM TO THE SILENT SNEAK THIEF OF SIGHT
by Sam Fong, Alpha-C Support Group, Glaucoma Society (Singapore)

We cannot ignore this well-known glaucoma statistic. For every one person diagnosed with glaucoma there is another person unsuspectingly suffering silently with the disease. Glaucoma is the silent sneak thief of sight. It is a leading cause of irreversible blindness.

Singapore has about 40,000 glaucoma sufferers, but only half have been detected and are receiving treatment. The burden of seeking a chance, early-stage prognosis of this virtually symptom-less (asymptomatic) disease rests with the sufferer. Glaucoma is defined by the slow progressive loss of visual field together with characteristic signs of damage to the optic nerve. By the time that the sufferer realizes that he has visual-function defects; glaucoma would have reached a fairly advanced stage, with optic nerve damage and extensive visual field loss.

As a patient with this condition, my hope is for our Health Care Authority to help us retain as much of our vision for as long as possible. Early detection and compliance to medication give us the best opportunities to preserve our sight. At present, there is no recommendation that primary health-care clinicians routinely screen for intraocular hypertension or glaucoma. But if we assume that there are an estimated 20,000 undetected glaucoma sufferers in Singapore, not to mention those suffering from other (undetected) degenerative eye conditions, then there may be a case for reconsidering the benefits of recommending routine screening.

For example, the 2002 Swedish study, Early Manifest Glaucoma Trial, concluded that with early detection the progression of the disease may be better managed and vision prolonged when treatment is started early. Educating the public, and specifically the patient, is paramount. Because there are no obvious early symptoms, unless the patient understands that early detection, diagnosis and treatment can make the difference, glaucoma will unfortunately remain “the silent sneak thief of sight.”

The good news is that the future holds great promise for the glaucoma patient. Medical research and technology continue to provide a better understanding of the disease and more precise tools for detection and monitoring. They provide:-

A better understanding of the different types of glaucoma
Improved detection methods
More accurate, computerized visual field testing
New and innovative laser and conventional surgical techniques

Once-a-day eye-drops such as the prostaglandin analogs for glaucoma introduced at the turn of this century and more combination-drops coming on stream will improve the problem of medication compliance through greater convenience to the patient. Improved and refined surgical techniques together with better understanding of pre- and post-operative care greatly reduced the risks of surgical failures.

From the patient’s perspective, we hope the future will bring more effective treatments for glaucoma than merely reducing Intra-ocular Pressure (IOP). We hope that breakthroughs in neuroprotection, which can safeguard the optic nerve, will not be too far away. Beyond that - Stem Cell Therapy for optic nerve regeneration may become a possibility. These will all enhance the prognosis of future patients to preserve their vision, if not “cure” their condition.

Is your IOP "good enough"?

2007-03-29T19:17:00.000+08:00

Ask Dr Jovina See in Ask The Doctor

2007-03-23T10:09:00.000+08:00

Public Forums in March 2007

2007-03-11T18:29:00.000+08:00

12th Mar 2007 : Latest from Tan Tock Seng Hospital - LASIK PUBLIC FORUM ... please call 6357 8266 for Registration and it is FREE!!!

Hi Sam,

Thanks for diseminating the info to your group. We have decided to make out LASIK public forum free. Also, the number to call for registration will be 6357 8266. FYI. Thanks! :)Regards,

Eugene Kwek, Executive, Ophthalmology Department DID: 6357 7736

--ooOOoo--

11th March 2007

Dear Friends,

This month, March 2007, there are 2 Public Forums organized by the Hospitals, each will be held at Tan Tock Seng Hospital and Alexandra Hospital. It looks like it is possible, with some time management, to attend the morning session at AH, take a leisurely lunch and go to TTSH in the afternoon for the next session. Those who are interested to attend may contact the respective organizing personnels:-

TAN TOCK SENG HOSPITAL

LASIK Public Forum

Date: 17 March 2007

Time: 1.30 to 3.30pm

Venue: TTSH Theatrette, Level 1

Registration Fee: $5

For registration or enquiries,

please contact Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736 or email: Sing_Yong_Lim@ttsh.com.sg

ALEXANDRA HOSPITAL

Eye Bags & Sags

Ever wonder what causes eye bags, sagging upper eyelids or sagging eyebrows? Ever dream of removing them to see clearer and look more youthful?

Date: 17 March 2007 Time:

10 am - 11am (English Session)
11 am to 12 noon (Mandarin Session)

Venue: Auditorium For registration or enquiries,

please contact Ms Alice How at 6379 3741 or email: Alice_How@alexhosp.com.sg

Yours truly,

Sam Fong

Pro-Tem Committee

AMD Support Group

http://www.amd-singapore.org

Is glaucoma eye-drops compliance that difficult?

2007-03-09T19:47:00.000+08:00

Is glaucoma eye-drops compliance that difficult?

A patient's perspective

By Sam Fong, Alpha-C Support Group, Glaucoma Society (Singapore)

Far too many glaucoma patients have lost too much of their sight, much too early and unnecessarily, due to non-compliance on the use of their eye-drops. The correct use of eye-drops is surprising low even among the educated population. What are the reasons?

Eye-drops - a symptom reliever
We take our medicine by habit. Traditionally, eye-drops have been primarily seen as lubricants for dry eyes and to be used as and when required. Very few instructions are given to the user other than the drops should get into the eye. Even if it overflows the eye lids, it is acceptable. After the application, the user feels almost immediate relief from the discomfort. So, the feedback is that eye-drops produce good results and when eye is better, the drops are no longer required. It is also the same with pills. A 3-times-a-day medicine does not mean an 8-hourly cycle - you would often take it after breakfast, after lunch and after dinner, or at your leisure. In most common ailments, medication relieves the symptoms of pain or discomfort while the body's immune-system performs its own auto-healing process. Thus, you can get well, with or without medicine, albeit with a little more suffering along the way. Therefore, a patient's views of medicine are gathered through their common experiences. And, however you take your medicine, you usually do get well eventually!

Glaucoma Eye-drops - a pressure regulator
However, with glaucoma, it is not quite the same story. It is not a common experience and the normal technique does not apply. This is because, when you have glaucoma, your eye’s auto-regulation system has failed. Eye-drops are no longer a symptom-reliever but now acts as a regulator of intra-ocular pressures (IOP) in the eye. You can say it is like the pace-maker used to regulate the heart beat and stopping the pace-maker will cause the faulty heart to function erratically. So it is with the eye. When your application of IOP-lowering eye-drops are stopped or not regular, the unregulated glaucomatous eye pressure may fluctuate diurnally by as much as +10 mmHg from its low.

First, we need to try to understand how glaucoma is treated with the use of eye-drops. Currently, the only available treatment for glaucoma is by lowering the IOP. We can do this by taking medicine in the form of tablets, using eye-drops or by surgery where an alternate drainage path is created for AH (aqueous humor) outflow. It is quite obvious that tablet intake is probably the least effective means for lowering IOP in the eye because the medicine is not directly applied to the eye and that surgery is the most effective because it directly and physically creates a vent in the eye for pressure relief.

No feedback indication
What makes it difficult for the patient to understand the usefulness of the eye-drops is that the pressure in the eye is awfully low. Take a drinking straw and fill it with water to 150mm height and hold it against your arm and you will feel nothing; double it to 300mm water height and again you will feel nothing pressure-wise. This represents the limits of the range of pressures between 11 and 22mmHg. The eye-drops in most instances are trying to regulate the IOP in the patient*s eye within this range and to find a "safe" level required by the patient. And because the patient cannot feel the effects physically, the patient cannot appreciate the usefulness of the eye-drops. The process is unable to provide a system of positive feedback that can be measured by the patient. In the case of diabetes, the patient is able to measure daily his blood-sugar level and gauge his compliance but this is not quite the case with glaucoma. With glaucoma, the patient can only get the performance-feedback at his next clinic visit, which may be 5 to 6 months later.

There are various causes of non-compliance in the use of eye-drops. Broadly we may classify them into two groups:-

1) failing to take prescribed doses at recommended intervals
2) failing to dispense the correct dosage due to wrong techniques

Unclear Prescription Convention
It is traditional in medicine prescription to use the day to represent the interval of dosage and then specify the number of times they have to be taken, often before or after food. Thus this practice is also applied to glaucoma eye-drops - do you apply nightly, twice a day, three times a day, or four times a day? The day is taken as the yardstick. What then about the night? Does one sleep through it without medication? If the patient sleeps 10 hours a day, what happens to the 3 or 4 times a day dosage interval? It is possible in such instances that the eye-drops would have over-regulated the IOP during the wake-hours and under regulated the IOP during the sleep-hours. This can only lead to undesirable results for patients with "spiked-up" IOPs during the night.

If the traditional prescription methods are confusing, then change them. Perhaps it may be better to base the application times on a 24-hour day (inclusive of the night) - applying eye-drops 12 hourly, 8 hourly, or 6 hourly - instead of the 2x, 3x or 4x per day convention. In this way, the time of dosage each day will be the same and much easier to remember. This makes the exact dosage times clearer and helps the patient to be more disciplined. The patient will also have a better idea of the dosage interval and plan ahead. Thus, if adherence to a 6-hourly dosage schedule is not possible for the patient because his work, age, health etc, it would be better that the ophthalmologist prescribe eye-drops which have longer effectiveness. Studies show that greater compliance is seen with lower-dose frequency and falls sharply as the frequency is increased. With once-a-day dosage, 75% of patients use their drops regularly. But, the patients' compliance falls to 40% when the dosage ís increased to a 6-hourly schedule.
Consumption rates of common dosing schedules are around 80% when the drops are taken by patients who are on a once-a-day dose; and falls to 50% when patients are placed on 6-hourly dosages.
Though the consumption rate looks better, the time interval of application has often been compromised. Often non-compliance may be due to:-

1) Lack of planning
2) Forgetfulness
3) Change of daily schedule
4) Confusion about instructions
5) Cost of the medicine

Proper Instilment
However, getting the correct timing for dosing is only one aspect of compliance. The other, which is more difficult to manage, is getting the necessary dosage into the eye where it is required. Here, tablets have the advantage over eye-drops for compliance because the former can be counted but the latter is difficult to measure. An eye-drops dispensing bottle is designed to release one drop-size at a time into the eye. Most eyes are capable of receiving at least 0.8 of a drop-size. Three things can happen to a drop when instilled:-

1) some over-flow the rim of the eye
2) some gets drain out through the tear duct
3) some gets absorbed by the eye - the only useful portion

Depends on Patient, his Patience and Persistence
The objective is to allow as little of (1) and (2) to happen and as much of (3), which is the only useful portion of the eye-drop, to take place. The eye-drop must get to the eye to do its job. How much of the drop is going to be effective depends on the patient, his patience and his persistence. Too little of (3) would result in partial compliance or lack of efficacy. How much of the drop should do useful work i.e. (3) is a chicken-and-egg issue. The test is, if by maximizing the usefulness of the drop will maximize the IOP lowering, the maximum usefulness should logically be targeted. It saves money, it gives less side effects.

Consider a Case Study. Let us say that a control patient needs a 35% IOP reduction to reach the target pressure. Assuming that, with this patient, the prescribed eye-drop is capable of lowering the IOP by 40% if optimal efficacy is practiced but only 20% was obtained due to poor but consistent application. As a result, on examination of the optic nerves and visual field results, the ophthalmologist prescribes to add on another eye-drop so as to lower the IOP further by another 20% and the target IOP was met. Note that this could actually be achieved with the first drop if there was good compliance. Thus, with good compliance, it is possible to reach the target pressure with less cost, a less frequent dosing regime and less side effects. Trying to get everyone to achieve the maximum benefit from the drop may not be practical but some good practices may yield better results than haphazard applications.

Some Good Techniques for Good Compliance
Let us consider some of the better techniques adopted for good compliance. In a workshop study of 20 patients some good practices were introduced and the performance gauged after the next visit. The results of the initial visit and subsequent visit are tabled: The results showed that with proper instructions and practice, the procedures could be taught and learnt by patients.
Let us try to understand how each of these steps helps to improve the procedure of application. Getting the eye-drops properly absorbed by the eye requires time and it varies with different eye-drops and from person to person. Generally, 5 minutes would be sufficient but with the carbonic anhydrase inhibitors (CAI) they might take as much as 10 minutes because of their more waxy and viscous nature. Keeping still for 5 minutes in the tilted head back and the eye gently closed position will keep the drop at optimum instilment mode. Closing the eye gently without blinking and squeezing will improve the dosage. The action of blinking will cause fluid to drain down the tear ducts and together with some of the medicine. Applied pressure-lacrimal puntae, a procedure of applying slight pressure to the inner corner of the eye with the finger, will physically close the tear duct blocking drainage through this channel temporarily. The patient should try to apply drops to one eye at a time instead of both eyes simultaneously if difficulties are experienced in preventing over-flowing. A delay of 1 or 2 minutes between instilment of drops to each eye often helps. Similarly, if more than 1 drop is instilled to the same eye at close interval, a minimum of 5 to 10 minutes between applications will ensure that the second drop does not wash out the first drop.

Even the most conscientious patient forgets or misses the time to take a medication occasionally. But, immediately upon realizing it, he should take the medicine as soon as possible unless the time is so close to the next scheduled medication, that he should skip the dose and carry on according to his normal schedule.

One must safeguard against the folly of being fully compliant just before the next clinic review with the objective of obtaining good IOP readings, with the hope that the ophthalmologist would not increase the dosage of eye-drops and thus save cost. This will not work, as the optic nerves and visual field results will reveal the long-term consistency or inconsistency of eye-drops compliance. But it is only when the patient understands the importance of being consistent, that the patient would want to be compliant.

Conclusion
Finally, the patient should remember that the IOP-lowering eye-drop acts as an IOP regulator. In order that it can function in this role, the interval of application should be regular, as prescribed, and consistently maintained over long periods of time. The ability to apply each dose with maximum effectiveness to the eye will enable maximum benefit to be obtained from each drop and avoid additional medicine. By being compliant the benefits to the patient are:-

It will require less eye-drop dosage
It will have fewer side-effects
It will save you money
Most importantly, it will save your SIGHT!

TIPS - Searching the Alpha-C Blog

2007-02-21T05:35:00.000+08:00

Help for Members who are unfamiliar with blogs.

If you like to look for information on past postings, you can shorten your search by using the key word search labelled "SEARCH BLOG" located at the top left-hand corner of the page.
Let's say you want to re-read the sharing session where "Kua Cheng Hock" was the speaker, you may key in either his full name or part of his name or any other key words you think are related to the subject.

Am I at risk for glaucoma?

2007-02-20T05:27:00.000+08:00

Am I at RISK for GLAUCOMA?

If you are 55 or older, you should get an eye exam at least once every two years.
If you have diabetes or other health problems, you may need to see an eye doctor more often.
A dilated eye exam will allow your doctor to check for glaucoma.

ASK YOURSELF THESE QUESTIONS :

Have I had an eye injury or eye surgery, even as a child?
Am I very near-sighted?
Have I taken steriods on a long-term basis?
Most importantly: have I had an eye exam recently?
Am I 40 years of age or older?
Did my parents, grandparents or great-grandparents lose their sight? What was the cause of their vision loss?
Do I have diabetes?

SEE: Wills Glaucoma Service : Chat Highlights: Glaucoma Risk Factors and Their Significance

http://www.wills-glaucoma.org/supportgroup/20030625.php

Risk Factors for Glaucoma:

http://www.wills-glaucoma.org/risks.htm

Secondhand smoke raises heart disease risk: study

2007-02-13T07:59:00.000+08:00

Secondhand smoke raises heart disease risk: study

http://news.yahoo.com/s/nm/20070212/hl_nm/smoking_secondhand_heart_dc_2

Keeping Doctor Appointments

2007-02-12T10:33:00.000+08:00

Keeping Doctor Appointments
Interview Questions

We are looking into why a lot of people make doctor appointments but do not show up or are too early/late for the appointed time. With your comments we hope to get an understanding of the many problems relating to no-show.

Why do you think people do this?
Tell me about a time you or someone you know had an appointmentbut didn’t or couldn’t come.
What made it hard to keep the appointment with the doctor?
[Or] Is there anything that makes it hard for you to keep an appointment?
Do you have difficulties keeping the appointment time?
Do you have to make any special arrangements to get here?
(Transportation, child care, insurance company referrals, work, other)
How difficult is it for you to be on time for your appointment?
How do you know when you or someone in your family needs to seethe doctor?
How did you decide to choose a clinic?
What do you come here (the clinic) for?
How do you feel about having to see the doctor (eg, worried, anxious,hopeful, etc)? Why?

You need not answer all the questions. Just state the Question No. in your comments with your Answers.

How to use your eye drops

2007-02-11T09:53:00.000+08:00

Alpha-CARE for U

Speed up the treatment, spread the word - compliance, compliance, compliance ......

How to use your eye drops

Some General Information

Use your drops as instructed by the doctor.

Read the label carefully and put the drops in at the times stated by the doctor/nurse. It is important to put your drops in at the same time each day.

Keep your drops in a cool, clean place (some drops may need to be kept in the fridge)

Remember to take your drops with you if you go out and, in particular, when you go on holiday.

Do not let your drops run out. Get a new bottle from your doctor in good time.

Always get a new bottle after 28 days even if you have some left

Do not stop using the drops unless your ophthalmologist tells you to do so

Some eye drops can affect your heart rate and/or breathing. Inform your doctor if you are using eye drops

If you experience any discomfort when using the eye drops please contact your eye doctor

--ooOOoo--

How to put your eye drops in

Wash your hands

Position yourself comfortably (stand, sit or lie)

Tilt your head back so you are looking up at the ceiling
Gently pull down the lower eyelid

Hold the bottle directly over the eye – you may find it helpful to use the bridge of your nose to rest the bottle on

Do not allow the dropper tip to touch the eye

Squeeze a drop into the pocket inside the lower lid – do not worry if more than one drop goes into your eye or it runs down your cheek

Close the eye and apply slight pressure to the inner corner of the eye for 2 to 3 minutes. This will prevent the drops from running down the tear duct into the back of the throat and will increase the benefit of the medication

If you use more than one drop in the same eye, allow about 5 minutes between each medication

Please speak to your doctor or clinic nurses if you are having problems putting your drops in as they may be able to help.

--ooOOoo--

Also see : Is eye-drops compliance that difficult? http://alphacian.blogspot.com/2007/02/is-eye-drops-compliance-that-difficult.html

Glaucoma - Ask the Expert

2007-02-11T05:43:00.000+08:00

In conjunction with Glaucoma Awareness Month - January 2007

Ask the Expert

January 18, 2007: Thursday, FOX Morning Show with Dr. George L. Spaeth, a Wills Glaucoma Service physician. (Video - 262 Kbps 02:19 mintues)

Into counselling

2007-02-10T15:05:00.000+08:00

© Australian Institute of Professional Counsellors

Into counselling

Most therapists possess an innate desire to help others, and because of this emotional involvement, sometimes it can be challenging to convert the potential into practical results.

Whilst we’ve tackled the basic premises which can help counsellors enter the market and attract clients, there is still one aspect of the counselling relationship which is indispensable for a counsellor’s success: client satisfaction. But isn’t that a matter of competence and an intrinsic part of being a counsellor?

Yes, it is. Being able to progress clients through to the achievement of their counselling goals has plenty to do with the counsellor’s ability to perform his/her services at the most basic level. However, it is exactly that logical assumption that induces many counsellors to oversee basic communication needs and counselling skills which will be the key for their success as a professional counsellor.

The Counselling Setting

Prior to engaging in the interpersonal communication process, there are basic requirements which will influence the client’s ability to express him/herself, and to make decisions regarding the relationship. These aspects refer to the counselling setting, which in the initial meetings can cause a significant impact in the client’s perception towards the counsellor. In a nutshell, the counsellor should observe the following:
Comfort: a comfortable setting improves client expression of feelings.
Security/Privacy: providing the client with security during a session.
Noise control: ensuring that noise does not affect communication.
Stimuli control: a neutral environment (light colours and decoration).
Supportive environment: a space in which the client can share in their own pace.
Facilities: Amenities, décor and other office facilities are relevant aspects to be observed.

Rules of Engagement

There are certain ‘rules of engagement’ which dictate the likelihood of a counselling relationship being constructive, and these rules apply to any context. For example, if you have just been introduced to someone at a social event, you should initially avoid asking personal questions as that is perceived to be intrusive. These rules are inherited by particular social groups, and following them is the basis for creating a positive profile and developing a receptive attitude from other group members.

In the counselling setting, there is much more necessity in applying such rules. The client is there for a specific purpose, which requires a particular approach to the situation. The client is also likely to be “uneasy” or unsure about what to expect, which increases the ‘risk’ of making a bad impression or not developing good rapport. Finally, there are more urgent ethical guidelines which must be complied within the counselling room, but would be of little relevance in a social setting.

In order to encourage the client to engage in a formal relationship, the counsellor must first avoid the common pitfalls which can make communication difficult. The first and foremost issue to consider in this scenario is the elusive impact of ‘first impressions’ in the eyes of a client. Trust and rapport are emotional keywords in a client’s subconscious, and once they have been negatively ‘red-flagged’ for any reason; it is very unlikely that relationship will move forward. So what can make this occur?

Dodging the Pitfalls

The standard communication pitfalls found in any relationship cover most potential problems of the first couple of meetings. They relate to a range of conscious and subconscious thinking patterns which could create communication gaps between the client and counsellor.

These patterns are based on the each individual’s education, relationships, attitudes, motivational targets, self-confidence levels and a range of other factors. Because the initial stages of a counselling relationship tend to be open and unpredictable, a good strategy to move forward is engaging in prevention: aiming to reduce the probability of communication pitfalls. To prevent this, counsellors must be aware of the common mistakes, or negative patterns, of good communication:

Judging: Criticising, name-calling, diagnosing and praising evaluatively
Sending Solutions: Ordering, threatening, moralising, and advising
Avoiding the Other's Concerns: Diverting, logically arguing, reassuring

The probable outcome of avoiding such pitfalls is establishing grounds for a productive relationship through good rapport and developing a certain level of trust and openness.

The Mindset of the Client

When it comes to interpersonal communication in therapy, being flexible and responsive is one of the most beneficial skills a counsellor can have. Different mindsets and emotional states require a particular approach; and the counsellor’s ability to adjust to a client’s needs is likely to dictate the success of that relationship.

In order to better exemplify the diversity of mindsets which clients may approach counseling with, there are five generic profiles of clients – and respective strategies -to help improve the relationship and enhance client-counsellor rapport.

Profile 1: an emotionally unstable client

The client is emotionally unstable and finding difficulty in expressing him/herself.

Emotionally unstable clients normally require a client-centred approach which enforces the need to establish rapport and trust, and to ensure the client is aware that he or she is in a safe and friendly environment. The client will normally have difficulty in expressing him/herself because he/she is unable or not ready to deal with emotions.

Counselling strategies to establish rapport would include: using self-disclosure to relate to the client’s situation and create an emotional link; creating goals and accountability in order to encourage action from the client; providing transparency and positivity through communication.

Profile 2: an involuntary or skeptical client

The client has been forced to attend to counselling (e.g. legally mandated).

This type of client may be difficult to deal with in the early stages of the relationship. Normally, he or she will be skeptical about the process, and may not acknowledge any need to change. It is important for the therapist to gain respect from the client, and use that respect to establish trust.

One of the most common strategies to gain respect and create responsiveness from the client is to outline the process of counselling: what he or she is there for; what is the structure of the relationship; what are the rights and duties of the client; what might be the expected positive outcomes. Solution-focused strategies are a good way to create a sense of accountability and need for change.

Profile 3: the child

The client is a young child or adolescent.

Dealing with children is always challenging as there is a perceived ‘bigger’ communication gap. The goal for the counsellor is to establish trust using humour; engaging in activities such as games; encouraging a collaborative approach; using self-disclosure and role-playing. These are all common strategies to help improve communication with young clients.

Profile 4: the uncommitted client

Lack of commitment can be a challenging problem in the counselling setting. Normally, a client with little or no commitment has a specific agenda which justifies their attendance at a counselling session (an example would be a husband who was asked by his wife to attend counselling in order to preserve their marriage). Framing and re-framing are good tactics to re-model the way the client perceives the counselling relationship: shifting from the ‘helping’ mode to the collaborative approach. Creating goals and structuring will also motivate the client to go through the necessary stages for change, collect the rewards, and move on with his/her own life.

Profile 5: the demanding client

A demanding client will normally believe that the counsellor will provide answers to his/her problems. They will come to counselling without much resolve to act upon their current situation, and will normally create very unrealistic expectations regarding the counselling relationship and the counsellor.

Again, encouraging accountability, managing expectations and establishing well-planned goals is a good approach. The client should be encouraged to realise that change can only occur from within. Using role-playing, narrative therapy skills, and/or a solution-focused approach to empower and encourage the client may be the key for deriving motivation.

Hopefully, the above strategies assist with providing a firm foundation to establish the client-counsellor relationship.

--ooOOoo--

© Australian Institute of Professional Counsellors. To republish or reproduce this article, please include this information at the end of the article. For more information about the Institute – please visit www.aipc.net.au/lz. To access our Article Library, visit www.aipc.net.au/articles.

Now that I've been told I have glaucoma, what can I expect?

2007-02-10T07:48:00.000+08:00

Now that I've been told I have glaucoma, what can I expect?

By George L. Spaeth

"Now that I've been told I have glaucoma, what can I expect? " This question has to enter the mind of every person who has just learned that he or she has glaucoma. It may be a sufficiently frightening question that the person never speaks it aloud. But it's the sort of question that most physicians dread, because it asks for projections that are extremely difficult to make. It asks the ophthalmologist to "play God," and, while physicians may be respected for their knowledge, they are usually aware that they have no unique ability to see into the future. Nevertheless the question is the right one for patients to ask, and it is an essential one for the ophthalmologist to address with a patient.

The first thing that a person who has been told that he or she has glaucoma ought to do is to ask the doctor what he or she means by the word "glaucoma." The word "glaucoma" is still used in so many different ways, and it means so many different things to different people, that the question about what it means for the person to have glaucoma can't really be addressed at all until there's some agreement on what the word "glaucoma" means.

Expect the Unexpected
The first thing that the patient with glaucoma should expect is the unexpected. Some types of glaucoma seem so serious that the physician worries that the affected person is likely to go blind. Other glaucomas seem quite mild, and the doctor may wonder if any treatment is necessary at all. But the patient with what appears to be a serious glaucoma may respond wonderfully to treatment and not have any further significant visual loss, while the one with the seemingly mild glaucoma may end up visually incapacitated because glaucoma in this case proves very resistant to all sorts of treatments.

Does this mean that the individual affected with glaucoma can't make any plans? No. While unexpected things are routine, the changes that occur in most people with glaucoma, once the initial diagnosis has been made and the initial treatment started, usually occur slowly over a period of many years. If the patient is alert and the physician is alert, the different directions in which the glaucoma is going can be spotted, and new and more appropriate projections made.

For example, the first patient mentioned above needs to be counseled at the start that there's a reasonable chance that he will lose his vision due to glaucoma. But as soon as it becomes apparent that the response to treatment is better than expected, a new counseling session is necessary in which the patient comes to understand that he's doing very well and the outlook for the future is far more favorable than had initially been considered. In a similar vein, when it becomes apparent to the physician that the second patient is not responding well to therapy, it's essential to share that information with the patient so the patient have a more accurate idea of where he or she can expect to be 20 years later.

Remain Vigilant
Except for a few types of glaucoma, the tendency for glaucoma to cause continuing damage remains with the person for the rest of the person's life. Thus, the person must not think that he or she is "cured" and stop being vigilant. There's a great difference between being vigilant and being a hypochondriac. To be vigilant means to be alert to warning signs and to exercise appropriate "preventive maintenance." To take care of a car properly does not require that the owner spend an hour a day inspecting the car. It does mean that periodically the car needs to be checked to make sure that the operating systems are working appropriately and that, if they don't seem to be working properly, that they are checked out promptly.

Warning signs that should alert the patient to call the doctor are symptoms of any kind that make the patient wonder if everything is OK. Of course, the most worrisome symptom is any sense that visual function is worse in any way. These symptoms would include:

a sense that it's harder to get around, an increasing sense of clumsiness

loss of depth perception

more difficulty seeing at night

less ability to distinguish between colors

haziness of vision that is not corrected by glasses

a perception that there are certain areas in the person's visual field that are getting worse

pain in the eyes, especially when it's associated with smoky or misty vision or with rings around lights

pain or fatigue after close work or when going into dark places such as restaurants or movie theaters

achy eyes, that feel as though they have some pressure in them, especially when such aches occur repeatedly

colored haloes around single lights such as street lamps

a fluctuating sharpness of vision.

It's appropriate for the person to test each eye individually periodically. This need not be time-consuming or threatening. One way, for example, is on the first of each month for the person to check each eye individually to see if there's been a change in the smallest print that the person can read, and to check each eye to see if there's a change in the sense of the visual field, i.e., the awareness of all the things that surround a person. If one uses the same printed material each time to check vision, it becomes immediately apparent if the vision is becoming worse. If one looks at the same general scene, such as at a specific picture on the far side of the wall, then major changes in the visual field are easy to appreciate on repeated testing.

There are, of course, a wide variety of other visual symptoms that indicate that something might be wrong, such as "seeing double" or marked problems with glare. These symptoms, however, usually point to concerns other than glaucoma.

It's also important for the person to be vigilant regarding his or her general health. A person's general health has a profound effect on his or her glaucoma, and the glaucoma can have a profound effect on general health. Changes in the person's sense of well-being, the person's sense of energy, level of general fatigue, stress, and important events in the individual's life should be noted and relayed to the physician.

Prepare for Battle or Be Wary of Treatment?
Eyes that have far-advanced damage have demonstrated that the person's glaucomatous disease is the type that causes damage. Eyes that don't have much damage have demonstrated that they have the type of condition in which damage is much less likely to occur. The person, then, who at a relatively young age is found to have far-advanced glaucoma damage has to be prepared for a real battle. On the other hand, the person who's really doing quite well and isn't showing signs of progressive deterioration is more likely to be damaged by methods used to prevent further damage than he or she is likely to be damaged by the glaucomatous process itself.

Value Your Own Assessment of What You're Feeling
The person with glaucoma has to realize that the system of medical care which has come to be considered to be the best medical care is based on science, and science is based on unbiased, objective measurements which are analyzed in an unbiased, objective way. This means that the concerns of patients, which are never objective, and are always biased, are always considered with skepticism by the scientist. But in fact every individual person is unique and different from every other person. The patient wants a physician to be scientific, objective, and knowledgeable, but the patient must be prepared to do battle with physicians who don't appear to value what the patient feels about himself or herself. For example, when a patient says to the doctor that he's getting worse, by definition the patient is getting worse. The doctor may not be able to find manifestations of that deterioration but that doesn't mean the deterioration isn't occurring. The glaucoma patient, then, must pay a great deal of attention to his own sense of well-being and must be prepared to communicate that convincingly to his or her physician.

Be Ready for Repeated Optic Disc and Visual Field Assessments
The two most important tests done on the glaucoma patient are evaluation of the optic disc and visual field. Patients need to be prepared to have serial, repeated tests of these two functions. The patient also must be prepared for the huge amount of variability that exists between testing sessions and must not conclude that he or she is either getting worse or stable just on the basis of an apparent change in a photograph or on a visual field. The determination of whether a test really does represent a deterioration or an improvement is frequently an extraordinarily difficult determination and should not be made lightly by either the physician or the patient.

Be Prepared to Make Trade-Offs
The person who has a serious glaucoma, in which the optic nerve already has become damaged must realize that he or she is going to have to make trade-offs. Using drops is a nuisance; the vision is temporarily blurred, it's not comfortable to have to leave a meeting to go into the bathroom to use one's drops, it's a nuisance to make sure that one always has one's drop with one, etc. But if one has the type of glaucoma that is going to get worse, and the glaucoma is being controlled with medications, either one uses the drops or the glaucoma gets worse.

The two most important tests done on the glaucoma patient are evaluation of the optic disc and visual field. Patients need to be prepared to have serial, repeated tests of these two functions. The patient also must be prepared for the huge amount of variability that exists between testing sessions and must not conclude that he or she is either getting worse or stable just on the basis of an apparent change in a photograph or on a visual field. The determination of whether a test really does represent a deterioration or an improvement is frequently an extraordinarily difficult determination and should not be made lightly by either the physician or the patient.

Similarly, when glaucoma surgery is done, the eye is not returned to normal. The pressure may be controlled by the surgery, but the surgery usually substitutes one problem of less magnitude for the greater problem of losing vision. It is essential that the patient understand that there will be such trade-offs and it is the job of the patient and physician together to decide how to prioritize the problems so that the patient is most likely to accomplish those things which are of most importance to the patient.

Source: Wills Glaucoma Service

Year of the Boar

2007-02-08T14:02:00.000+08:00

Alpha-C Support Group

wishes all our Chinese friends a

Happy Lunar New Year

Glaucoma - Interview in Malay

2007-02-07T09:36:00.000+08:00

It is worth repeating the Radio Interview conducted in July 2006 with SNEC Ophthalmologist, Dr Hoh Sek Tien, on Glaucoma in Malay

http://www.ab-glaucoma-sin.org/media/RSI/11jul2006.html

Kata orang ya, mata adalah jendela kita untuk melihat dunia. Dengan matalah, kita lihat keindahan alam sekitar dan telatah manusia ya? Setuju, saudara?

2007-02-07T05:36:00.000+08:00

Opportunity is limitness.

Where there is an open

mind, there will always

be a frontier.

- Charles F. Kettering

Visit to SAVH : Low Vision Clinic on 13th Feb 2007

2007-02-07T04:55:00.000+08:00

Dear Members and Friends,

The visit to the Low Vision Clinic at SAVH is confirmed for 13th Feb 2007 at 2:30pm.

There are a few more slots available for members interested to attend and they may contact me at samfong@glaucoma-singapore.org

Yours truly,
Samfong

Those who like more details please visit SAVH website listed below:
Singapore Association of the Visually Handicapped (SAVH)47 Toa Payoh Rise Singapore 298104Tel: (65) 6251 4331 (ext 142)Fax: (65) 6253 7191

URL: http://www.savh.org.sg/

Lifestyle & Glaucoma - Wills Glaucoma

2007-02-06T09:06:00.000+08:00

P: Nine months ago I started a walking routine, usually 45 to 50 minutes a day. After five months of that exercise, my blood pressure had dropped low enough that I no longer needed medicine to control it. My cholesterol also dropped. Further, I lost 17 pounds. The best news, however, is that at my last checkup my IOPs were10 mm Hg. My glaucoma specialist said that my visual field is stable. Since I have not changed glaucoma medication, I attribute the decrease in IOPs to walking. My IOPs have never been that low.
Dr. Rick Wilson: You are a good example: I see that all the time. In fact, when my son was born 21 years ago, I was found to have seriously high blood pressure. I started swimming four times a week and lost 15 pounds. I have never had to take medicine for high blood pressure as it dropped significantly.

You don't use it, you lose it!

To access Chat Highlights : http://www.willsglaucoma.org/supportgroup/20070103.htm

Glaucoma - Is there a cure?

2007-02-06T08:48:00.000+08:00

Public Forums at Tan Tock Seng Hospital relating to the Eye

2007-02-05T15:28:00.000+08:00

1. LASIK Public Forum
Date: 17 March 2007
Time: 1.30 to 3.30pm
Venue: TTSH Theatrette, Level 1
Registration Fee: $5
For registration or enquiries, please contact Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736 or email: Sing_Yong_Lim@ttsh.com.sg

2. Glaucoma Public Forum
Date: 28 April 2007
Time: 1.30 to 3.30pm
Venue: TTSH Theatrette, Level 1
Registration Fee: $5
For registration or enquiries, please contact Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736 or email: Sing_Yong_Lim@ttsh.com.sg

3. Public Forum: Warning signs for diabetes complications in eye and foot problems
Date: 12 May 2007
Time: 2.00 to 4.00pm
Venue: TTSH Theatrette, Level 1
Registration Fee: $5
For registration or enquiries, please contact Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736 or email: Sing_Yong_Lim@ttsh.com.sg

4. Cataract Public Forum in Mandarin
Date: 19 May 2007
Time: 1.30 to 3.30pm
Venue: TTSH Theatrette, Level 1
Registration Fee: $5
For registration or enquiries, please contact Ms Lim Sing Yong / Mr Eugene Kwek at 6357-2678 / 7736 or email: Sing_Yong_Lim@ttsh.com.sg

Events at Alexandra Hospital relating to the Eye

2007-02-05T09:32:00.000+08:00

Myopia : genetic, risk factors, emerging treatment

2007-02-04T09:33:00.000+08:00

Alpha-C Support Group role in this posting is to lead members to a progamme hosted in the Health Promotion Board Website

To access radio interview : http://www.hpb.gov.sg/web/nmpp/myopia_interview.html

Alpha-C Sharing Session - 3 Feb 2007 - Discussion on Glaucoma

2007-02-04T07:18:00.000+08:00

Here are some photos of the 11 participants at this discussion session . A Summary of the discussion will be appended to this posting soon. We specially welcome Peggy, Dr Sharon Siddique's mother, who came from Vail, Boulder, USA and she is in Singapore for a one-month family visit.

Alpha-C Sharing Session - 3 February 2007
.
For this Sharing Session a 15min video was screened from the internet a talk on “Discussion on Glaucoma” by Leila Rafla-Demetrious, MD, Assistant Professor of Ophthalmology at Cornell University, NY
.

The video summarizes the results of Ocular Hypertension Treatment Study (OHTS) and the Early Manifest Glaucoma Trial (EMGT) and explains how these studies impact the management of glaucoma..

-
--ooOOoo--
.

As a follow up from the video we discussed and shared how these studies and practices relate to our own personal experiences

The two studies address 2 seperate concerns. Both studies focus on lowering IOP as the vehicle for slowing down the disease progression.

1. OHTS - people with ocular hypertension: what are the chances that they develop POAG and will medication slow-down or prevent the disease.

2. EMGT - people with early manifest glaucoma: will medication prevent or slow-down the progression of the disease.

The Ocular Hypertension Treatment Study (OHTS)

Two Groups were studied for period of 5 years: one without medication(Observation Group) and a medication group. Note that the sample population selected had not developed POAG but exhibited high IOP. This is a very large study carried at multi-centers throughout America.

Selection of population study on basis of ages between 40 and 80 with IOP greater than or equal to 24 mm Hg but less than or equal to 32 mm Hg in at least one eye and IOP greater than or equal to 21 but less than or equal to 32 mm Hg in the fellow eye,

Study closed in June 1996.

Result of Study:
At end of 5 years, the study concluded the cumulative probability of developing POAG was 4.4 percent in the medication group and 9.5 percent in the observation group. There was little evidence of increased systemic or ocular risk associated with ocular hypotensive medication.

The study was able to highlight to doctors reasonable estimates of risk for individual ocular hypertensive patients and to determine which ocular hypertensive individuals are most likely to benefit from early prophylactic (preventive) medical treatment.

Baseline factors that predicted POAG included older age, larger vertical or hotrizontal cup-disc ratio, higher intraocular pressure, greater pattern standard deviation, and thinner central corneal measurement.

Early Manifest Glaucoma Trial (EMGT)
The study concluded in 2002 -- called the Early Manifest Glaucoma Trial conducted in Sweden-- followed 255 patients, aged 50-80 years, with early stage glaucoma in at least one eye. Most patients were identified in a population screening. The average age of the patients at the beginning of the study was 68 years. One group was treated immediately with medicines and laser to lower eye pressure, and the other group -- the control group -- was left untreated. Both groups were followed carefully and monitored every three months for early signs of advancing disease, using indicators that are extremely sensitive for detecting glaucoma progression. Any patient in the control group whose glaucoma progressed was immediately offered treatment.

After six years of follow-up, scientists found that progression was less frequent in the treated group (45 percent) than in the control group (62 percent), and occurred significantly later in treated patients. Treatment effects were also evident in patients with different characteristics, such as age, initial eye pressure levels, and degree of glaucoma damage. In the treated group, eye pressure was lowered by an average of 25 percent.

The findings from this study reinforce the known evidence that lowering eye pressure in glaucoma's early stages slows progression of the disease. It suggests that early detection and treatment will slow the disease progression.

.
--ooOOoo--
.

Read also the Chat Highlights on OHTS from Wills Glaucoma Service at

http://www.wills-glaucoma.org/supportgroup/20021030.php

http://www.wills-glaucoma.org/supportgroup/20020828.php

References:
Ocular Hypertension Treatment Study (OHTS)
http://www.nei.nih.gov/neitrials/viewStudyWeb.aspx?id=24
Early Manifest Glaucoma Trial (EMGT)
http://www.agingeye.net/glaucoma/emgt.pdf

--ooOOoo--

What has our Health Ministry got to say about the 2 clinical trials:
IOP goals in specific groups of glaucoma patients
Recent large prospective randomised clinical trials conducted in the
US have provided some benchmarks that should guide the clinician
when managing specific categories of glaucoma patients.
It is recommended that glaucoma therapy in the local context should
be informed by, but not unduly constrained by, or indiscriminately
adherent to, the following trials:

1. The Collaborative Normal Tension Glaucoma Study (CNTGS)
2. The Advanced Glaucoma Intervention Study (AGIS)
3. The Collaborative Initial Glaucoma Treatment Study (CIGTS)
4. The Early Manifest Glaucoma Trial (EMGT)
5. The Ocular Hypertension Treatment Study (OHTS)

Source: MOH Clinical Practice Guidelines on Glaucoma - Ministry of Health : Singapore

Definition of Glaucoma : Diagnosis & Screening

2007-02-03T11:26:00.000+08:00

Source: Ministry of Health- Singapore

2nd Glaucoma Day Forum

2007-02-02T11:32:00.000+08:00

Last year the Glaucoma Society Singapore held its Glaucoma Day Forum on 3 June 2006 and it was an overwhelming success...

This year the 2nd Glaucoma Day Forum will be held on 22 July 2007 .. Look out on these pages for further announcements. The President,GSS revealed that: "The forum will feature a panel of world renowed specialists in Glaucoma."

Support the AMD Support Group

2007-02-02T08:38:00.000+08:00

Visit : AMD Support Group Website : http://www.amd-singapore.org/

Plan now to meet it head on ... OLD AGE

2007-02-01T17:00:00.000+08:00

In order to achieve anything one needs to plan

and that includes planning for old age

--ooOOoo--

In seed time learn, in harvest teach,

in winter enjoy

- William Blake

--ooOOoo--

Source: THE STRAITS TIMES - HOME - THURSDAY - FEBRUARY 1, 2007

Glaucoma - the second leading cause of blindness

2007-02-01T16:10:00.000+08:00

Why join Support Groups?

2007-02-01T15:30:00.000+08:00

Alpha-C Support Group February Sharing Session

2007-02-01T05:25:00.000+08:00

Alpha-C Sharing Session - 3 February 2007

For this Sharing Session we will run from the Internet a 15min video on “Discussion on Glaucoma” by Leila Rafla-Demetrious, MD, Assistant Professor of Ophthalmology at Cornell University, NY

The video summarizes the results of Ocular Hypertension Treatment Study (OHTS) and the Early Manifest Glaucoma Trial (EMGT) and explains how these studies impact the management of glaucoma..

--ooOOoo--

As a follow up from the video we will discuss and share how these studies and practices relate to our own personal experiences

--ooOOoo--

References:

Ocular Hypertension Treatment Study (OHTS)

http://www.nei.nih.gov/neitrials/viewStudyWeb.aspx?id=24

Early Manifest Glaucoma Trial (EMGT)

http://www.agingeye.net/glaucoma/emgt.pdf

Alpha-C Support Group - Our Objectives

2007-02-01T05:15:00.000+08:00

Alpha-C Support Group

A sub-group of GSS GLAUCOMA Patient Support Group

The ALPHA Cell Group (Alpha-C for short) is the first of a series of "cell" groups that may be formed out of the main Glaucoma Support Group chaired by Anny Leow.

Our Objectives

We aim to discuss and formulate effective ways of coping with and managing this disease.

The group will focus on understanding the disease, adjustment needs and stress management issues.

We belief that a sound knowledge of glaucoma and its treatment is important to our personal well being.

We recognise that peer support from people in similar situations is crucial to everyone coping with GLAUCOMA.

2007-01-31T16:25:00.000+08:00

"Although the world is very full of
suffering, it is also full of the overcoming of it."
- Hellen Kellier

Searchlight on Glaucoma

2007-01-31T16:08:00.001+08:00

Searchlight on Glaucoma from Wills Glaucoma

Read the December 2006 issue of this informative newsletter that provides helpful articles about glaucoma written especially for patients and their families.

Link:

http://www.willsglaucoma.org/searchlight/vol15no3.htm

Eye Supplements, Yes or No?

2007-01-31T15:44:00.000+08:00

EYE SUPPLEMENTS, YES OR NO?
A PATIENT’S PERSPECTIVE

Sharon Siddique, PhD
All For Eyes Pte Ltd
Singapore

Whether or not to take vitamin and herbal supplements for eye health confronts everyone with low vision. We need to take this issue seriously because there is evidence that certain vitamin and herbal supplements appear to slow down (but not reverse) eye deterioration caused by eye conditions, such as AMD (age-related macular deterioration), glaucoma, and cataracts. It is up to the individual, in consultation with his/her eye doctor, to decide what is appropriate.

Information (as always) is the key. There are basically three approaches. Some believe that it is sufficient to eat a healthy diet, full of the types of foods that provide nutrients for eyes. Others feel that it is sometimes beneficial to supplement (or “top up”) this healthy diet with a selection of vitamins, minerals, and herbs. In Singapore we can also consider various types of TMs (traditional medicines), which include TCM (traditional Chinese medicine) and Ayurveda (traditional Indian medicine).

HEALTHY DIET

A healthy diet for eyes will include several portions of green, yellow, orange and red fruits and vegetables every day. Fortunately for us, Singapore markets have an abundance of greens (kai lan, yu choy, bak choy, Chinese cabbage, bitter gourd. etc), and yellow vegetables - carrots, peppers, squash, pumpkin, tomatoes and yams. Fruits such as papaya, kiwi, various melons, mango, oranges, pomelo, clementines, starfruit, grapes, persimmons, plums, etc. are plentiful. In Singapore, they are not only easily available, they are also relatively cheap.

So if we eat a healthy diet, is there a reason to take supplements? Some say no. But how many of us actually follow the “healthy diet” described above, on a daily basis? If we have to admit that we fall short of this ideal, it may make sense to consider adding certain supplements to our daily health regime. There is a bewildering number of vitamins, and it is easy to get lost in the terminology. Navigating through the information is challenging. Basically, there are Vitamins, Herbs, and Traditional Medicines (TM) to discuss.

VITAMINS

Antioxidants can help our eyesight because they prevent the damaging effects of oxidation, particularly in the retina. Vitamins A, C, and E are the most effective antioxidants. In addition to the vitamins themselves, there are a number of associated natural extracts (called carotenoids and flavonoids) that are found to be rich in these vitamins, and which may be easier for the body to absorb. Finally, Vitamins A, C, and E are more effective when taken together with certain minerals (zinc and, selenium) and other vitamins (particularly the B complex of vitamins).

Vitamin A and Carotenoids

Carotenoids are a class of highly unsaturated yellow to red pigments occurring in plants and animals. They are the natural extracts from which Vitamin A is derived. Three carotonoids most often mentioned in the context of eyes are beta carotene, lutein, and zeaxanthin. Lutein and zeaxanthin appear to be particularly important to eye health. They have been found to be highly concentrated in the macula of healthy retinas and appear to neutralize free radicals generated when ultraviolet and blue light strikes the retina.

Vitamin C and Flavonoids

Vitamin C is a major antioxidant in the lens of the eye. Flavonoids help the body to absorb Vitamin C, and assist in maintaining the intercellular glue (collagen) that strengthens connective tissue throughout the body. They have antioxidant powers and are essential for strong blood vessels, including the sensitive blood vessels of the retina. The most common flavonoid associated with eyes is rutin. Rutin has also been associated with maintaining healthy pressure levels within the eye. Other flavonoids, such as quercetin and the anthocyanidins, may help protect the lens of the eye from cataracts.

VITAMIN E AND MINERALS

Vitamin E functions mainly as an antioxidant. Vitamin E, also known as tocopherol, is a fat-soluble vitamin, so Vitamin E is carried through the body attached to fat. The body stores vitamin E in fat deposits and in the liver. The minerals zinc and selenium help the body absorb Vitamin E. Zinc is required for the function of certain enzymes in the retina that are critical for vision.

The B-Compound vitamins are needed for maintenance of the nervous system, and proper functioning of the cell and its energy metabolism. It is generally recommended that the B vitamins be taken in tandem, as their specific functions are interrelated. Riboflavin (vitamin B2) is manufactured in the body, and is needed to activate vitamin B6 (pyridoxine), which may ease watery eye fatigue and may be helpful in the prevention and treatment of cataracts. The B vitamins include thiamine (B1), Riboflavin (B2), Niacin (B3), Pantothenic acid (B5), Pyridoxine (B6), Biotin (B7), Folic acid (B9), and Cyanocobalamin (B12).

HERBS

Bilberry, a close cousin to the blueberry, has long been widely used in Europe for eye health. Bilberry is rich in fatty acids, flavonoids, iron, zinc, and selenium. During World War II British Royal Air Force pilots reported improved night visual acuity on bombing raids after consuming bilberry jam. Subsequent claims have been made that bilberry extracts result in improved night visual acuity, quicker adjustment to darkness and faster restoration of visual acuity after exposure to glare. Bilberry has been used in the treatment of glaucoma as well.

The herb Eyebright is great for the eyes. Since the Middle Ages, Eyebright has been a popular herbal eyewash. Eyebright's antibiotic and astringent properties tighten membranes and mucus surrounding the eyes, effectively strengthening and improving circulation. Eyebright contains bitters, essential oils, flavonoids, several B vitamins, and Vitamins A, C, D, and E. Today Eyebright is used for relieving eye problems such as eye strain, pink eye and inflamed, irritated and sore eyes Eyebright is also used for cleansing and purifying the blood, therefore stimulating healthy liver functions.

TRADITIONAL MEDICINE (TM)

We are familiar with Bilberry and Eyebright because they are European, and they are therefore much better marketed. With regard to Asian traditional medications, we are barely scratching the surface of fascinating connections and similarities between European, Chinese and Indian TM in general, and, in our case, as applied to eye health. Here are two examples.

In both Chinese and Indian TM, there is a direct relationship between herbs used for the treatment of liver function, and the eyes. Wolfberries, for example, are the Asian cousin of the European bilberry, and are cheap and plentiful in dried form, found in any Chinese medical hall in Singapore. Called "goji" in Chinese, ancient Chinese medical texts extolled wolfberries for strengthening the eyes, liver, and kidneys as well as fortifying the "qi" (chi) or life force. There are also interesting parallels in Indian traditional medicine. Triphala is a composite herbal preparation containing equal proportions of three native Indian fruits, and it is taken for various eye disorders, as well as cleansing the liver.

The turmeric root is also used to support liver function, as well as eye health, in both Ayurvedic (Haridra) and Chinese (jiang huang) herbal medicine. Turmeric protects against the damaging effects of toxins and free radicals. Turmeric, which is a member of the ginger root family, is a deep yellow colour, and is commonly used in Indian cooking. And hence we return to the diet, which, according to Western health directives, should contain plentiful supplies of eye friendly green and yellow vegetables. It is difficult to find anything more intensely yellow than turmeric!

SUMMING UP

We are fortunate to be in Singapore, where off-the-shelf vitamins and supplements have been tested and approved by the Ministry of Health. There are many Western multi-vitamin supplements which are specially formulated for eyes, as well as herbal preparations and traditional medicines. They are available throughout Singapore, and generally contain various combinations of the vitamins and herbs mentioned above. So investigate this interesting subject, and discuss it with your GP and ophthalmologist. It is up to each of us to take responsibility for doing everything possible to preserve our precious gift of sight.

Read about Dr Sharon Siddique : A Clear Visionary at http://www.glaucoma-singapore.org/LowVision/All4Eyes/ClearVisionary.html

Singapore Eye Hospitals explain Glaucoma

2007-01-31T11:45:00.000+08:00

Alexandra Hospital
http://www.alexhosp.com.sg/disease_info_details.asp?id=44

The Eye Institute
http://www.tei.nhg.com.sg/eyecare/TEI%20GLAUCOMA%20final.pdf

Tan Tock Seng Hospital
http://ttsh.com/new/clinicalspecial/02_glaucoma.pdf

Singapore National Eye Centre
http://www.snec.com.sg/eye/glaucoma.asp

National University Hospital - Eye Clinic
http://www.nuh.com.sg/eye.html

Singapore Changi Hospital
http://www.cgh.com.sg/ipg/en/main.asp (there is a very good interactive video on glaucoma among others)

How about Medisave Chronic Disease Management Programme for GLAUCOMA?

2007-01-31T09:16:00.000+08:00

Source: Today - Wednesday - January 31,2007

Should Glaucoma qualify for the Medisave Chronic Disease Management Programme?

Should we qualify? : YES

Are we presently in the Scheme? : NO

Here are my reasons why Glaucoma should be included:-

Glaucoma is a chronic disease and has to be managed for life

It is a progressive disease and thus cost of management increases with time
Medication is expensive and cost of early-stage glaucoma management exceeds $500 per year and may increase to over $1000 with some cases in a couple of years. This is apart from consultation charges, vison testings, etc
Cost of surgery for advanced-stage glaucoma management is prohibitive and may need to be repeated with time to prevent blindness
The disease affects more the aged-population; the elderly who are without a source of income
Glaucoma carries a stigma on employability; other chronic diseases such as diabetes do not!
There are presently no subsidy for LOW VISION AIDS

I like to have readers opinion too.

Yours in Alpha-CARE,

Sam Fong

Support Groups at the Various Hospitals

2007-01-31T07:39:00.001+08:00

At Changi General Hospital :
http://www.cgh.com.sg/medical/support_index.asp

At Singapore National Eye Centre :
http://www.snec.com.sg/patient/support.asp

Glaucoma Management & Care

2007-01-30T22:11:00.000+08:00

Glaucoma Management and Care - A discussion with Dr Jovina See, Head of Glaucoma Services-National University Hospital

Do you know where to get your eyes screened?

2007-01-30T18:05:00.000+08:00

If you wish to go for an eye screening and don't know where to go then ...

Click below to find out where you can go :
http://www.alexhosp.com.sg/for_download/Poster_SEE.pdf

Talk - MIGRAINE - Could your eyes be the cause?

2007-01-30T09:06:00.000+08:00

Source: TODAY - TUESDAY - JANUARY 30,2007 - HEALTH PROMOTION BOARD HEALTHLINE

If you missed the show, maybe these links will help :

(1) http://www.wstm.com/global/story.asp?s=1230101

(2) http://www.eyeguys.net/ocularmigraine.html

Myopia genetics study tops biomed fund awards

2007-01-30T08:44:00.000+08:00

Source: THE STRAITS TIMES - TUESDAY - JANUARY 30, 2007

The following link may throw some light on Myopia and Myopia Genetics : http://webess16.micromedex.com/content/DiseaseDex/000926.htm

How to be a proactive patient

2007-01-30T06:04:00.000+08:00

How to be a Proactive Patient - A Discussion with Dr Sharon Siddique,PhD

Visit Dr Sharon Sidduque's All for Eyes Website at : http://www.allforeyes-singapore.com

Xalatan - eyedrops from Pfizer

2007-01-29T16:00:00.000+08:00

Pfizer on Xalatan

Look what I found, but ask your doctor first, and secondly our room temperatures are much higher ...

How should I store XALATAN?

•Are you wondering why you have to refrigerate your prescription XALATAN before opening but not the free sample from your eye doctor? There’s a good reason! The expiration date (shelf life before opening) determines whether refrigeration is required. And the expiration for prescription XALATAN from the pharmacy and sample XALATAN from your doctor are different.

•Prescription XALATAN has an 18-month expiration date until you open it. This longer shelf life makes refrigeration necessary until you open it

•Samples of XALATAN have a 12-month expiration date. This shorter shelf life allows doctors to easily store samples at room temperature in their offices

•Once opened, your sample or prescription XALATAN may be stored at room temperature (up to 77°F) for 6 weeks

Source:
http://www.xalatan.com/consumer/questions.asp

Useful Glaucoma Monitoring Booklet from Allergan

2007-01-29T15:46:00.000+08:00

This is quite a good record book to keep on your glaucoma progress.

Is there quality life at the end of tunnel vision?

2007-01-29T14:14:00.000+08:00

Is there quality life at the end of tunnel vision" - A discussion with Mr Kua Cheng Hock, President of the Guide Dogs Foundation for the Blind

Learn more about how Cheng Hock goes about his daily life with Kendra ... visit : http://www.ab-glaucoma-sin.org/Alpha_Cell/Oct7/LoveMe_LoveMyDog.html

POAG puts pressure on the heart

2007-01-29T10:40:00.000+08:00

We search the World for articles that could benefit the patient.

POAG puts pressure on the heart

Click below for access:

http://www.oteurope.com/ophthalmologytimeseurope/article/articleDetail.jsp?id=397605

Glaucoma explained in Chinese by Allergan

2007-01-28T12:22:00.000+08:00

The Importance of Sunglasses: A Patient's Perspective

2007-01-28T10:30:00.000+08:00

THE IMPORTANCE OF SUNGLASSES:
A PATIENT’S PERSPECTIVE

Sharon Siddique, PhD
All For Eyes Pte Ltd
Singapore
October 2006

THE SUN’S HARMFUL RAYS

In tropical Singapore we are all aware of the damage that the sun can do to our skin. Protective clothing and sun creams are commonly used to try to prevent sunburn, wrinkles, and skin cancer. Unfortunately, we are much less aware of the damage that strong sunlight can do to our eyes. Too much exposure to ultraviolet (UV) radiation can leave the eyes red, teary, strained, and light sensitive. Just as with the skin, damage is cumulative, and can lead to an increased risk of cataracts and retinal damage, including AMD (age-related macular degeneration).

UV radiation is so potentially dangerous because we literally can’t “see” it. It is composed of invisible, high-energy, light rays from the sun that are found beyond the violet/blue end of the visible spectrum. Our eyes are particularly sensitive to damage from ultraviolet A (AV-A) and ultraviolet B (UV-B) light. Children, the elderly, and those of us with eye problems are particularly at risk.

Children’s eyes are more vulnerable because their pupils are larger, meaning more light enters the eye, and reaches the retina. By the age of 18, studies show that more UV light will have been absorbed by a child's eyes than over the rest of his life. And yet we seldom see Singaporean children using sunglasses. As Singapore’s population ages, we are already seeing the effects of long-term exposure to the sun’s harmful rays as the rates of cataract and AMD increase.

Ultraviolet protection is especially important for people after cataract surgery. Since the lens absorbs UV radiation, individuals who have had cataract surgery are at increased risk of retinal injury from sunlight. This is because although the lens implant contains some UV blocking agents, it does not provide the same degree of protection to the macula as the natural lens. Taking certain medications - such as tetracycline, sulfa drugs, birth control pills, diuretics and tranquilizers – also increases the eye's sensitivity to light, and potential damage.

A good pair of sunglasses should protect against harmful UV light entering the eye. Ask before you purchase. Do the lenses provide both UV-A an UV-B protection? Are the lenses polarized, which ensures that they will reduce reflected glare? Do the frames fit snugly to provide the eyes with maximum protection, particularly over and around the rims of the frames? Sunglasses which are specifically designed to fit-over a normal pair of spectacles may be particularly suitable for many spectacle-dependent Singaporeans.

THE CONFUSING WORLD OF COLOURS

There is a big misconception that the darker the lens, the better the protection. In fact, UV coating is colourless. Clear lenses, with no colour-tint, can still be UV-light blockers, and they are very useful in protecting the eyes from impact, debris, dust, chemicals, or after eye surgery. Clear lenses can be used during low light or nighttime activities, and are particularly effective to reduce glare under fluorescent light.

Most sunglasses come in a bewildering range of colours, from common amber and grey, to yellow, red, green, and even orange and plum. Does this mean, then, that the choice of colour is merely cosmetic? Absolutely not. Different colours absorb or transmit specific wavelengths of light. That is why, for example, when we look through red-coloured lenses, the world looks, well, rosy.

So when and why is the choice of colour important? Those of us with eye problems need to pay particular attention to these “colour codes” because by absorbing and transmitting certain specific wavelengths of light, tinted lenses – also called absorptive lenses - can improve our ability to see. For example, glaucoma-sufferers typically perceive the world as being "too dark." As a result, they may show a preference for yellow lenses, which increase the apparent brightness of objects or surroundings. People with macular degeneration may favour an orange, yellow-orange or plum tint. And people with retinitis pigmentosa may prefer an orange or red tint to reduce glare.

The two most commonly available colours for sunglasses are grey and amber. Grey lenses are described as neutral because they do not enhance contrast or distort colors. Choosing lighter shades of grey can help relieve indoor glare, especially under fluorescent light. In general, grey is soothing, sharpens focus, and provides good glare protection. Grey is often the colour of choice for post-op cataract surgery, glaucoma sufferers, diabetics or people who have had corneal transplants.

Amber tints are known for their “blue blocking", protective effect. There is some evidence that the retina may be more sensitive to blue visible light. Blocking the visible blues eliminates much of the scatter created by the shorter wavelengths of light. The result is an apparent increase in contrast and depth perception. Objects appear more clearly defined, and thus amber tints are popular with skiers, boaters, and pilots. They also provide good contrast enhancement, useful for those with macular degeneration, and retinitis pigmentosa.
Yellow is a powerful a "blue-blocker" because the color keeps blue light from entering the lens. Yellow and orange sunglasses make objects appear sharper, with more contrast, but there is some colour distortion. Both yellow and orange are helpful for reading. Yellow is often the choice of those suffering from retinitis pigmentosa and macular degeneration because it provides maximum brightness and good visual acuity. Yellow glasses are great for relieving eye fatigue from prolonged exposure to computer screens. Orange is even more effective than yellow for intensifying backgrounds, allowing the wearer to see objects more clearly.

For normally sighted people, red is a rather uncomfortable color to look through, but it is recommended for certain eye conditions. Red does cut down on blurred vision caused by blues, greens and yellows. Red lenses are good for medium and lower light conditions because they enahnce contrast. Reds and pinks are great in alleviating computer eyestrain, but there is also a certain amount of color distortion. A light or medium tinted lens is good for day-to-day wear. Dark plum is an excellent dark lens, and provides a high amount of glare relief.

Green is a less commonly found colour, but it offers some color contrast with little or no color distortion. Green is also great for glare protection. Because green allows only low levels of visible light to enter the eye, it is a good colour choice for post-op cataract surgery and glaucoma.

SUMMING UP

A final thing to pay attention to in the confusing world of colours is what is called the VLT (visible light transmission). Some types of sunshades come with a colour and a VLT, expressed in percentage terms. Thus, “40% Amber” means that the tint is amber, and that 40% of the visible light is transmitted through the lens. Sometimes the terms “light” (generally over 70% VLT), “medium” (10% to 69% VLT) and “dark” (below 10% VLT) are indicated.

To maximize visual acuity, select the highest visible light transmission (VLT) which is comfortable, and a colour that “feels” good. There is no one correct fit. It depends very much on the conditions under which the sunglasses are going to be used, and the condition of the eyes. Many people require different filter transmissions for cloudy and bright conditions or for inside versus outside applications. In general, the goal is to achieve the maximum visual acuity, while minimizing eye discomfort and strain.

In sum, sunglasses are an ESSENTIAL part of the proactive patient’s vision tool kit. Choose a pair of sunglasses carefully. Decide under what conditions you are going to be wearing them (inside/outside; bright sunny/hazy conditions). Make sure they fit around your eyes to block out glare, that you have maximized your visual acuity with the tint and VLT, and that they are polarized, scratch-proof, and provide 100% UV-A and UV-B protection. Above all, they should fit comfortably – otherwise you won’t wear them. And remember, often our eyes do warn us that they are under stress by tearing, blurring, redness, dryness, and pain. Learn to listen to them.

Maintaining quality of life at a sustainable cost ...

2007-01-28T08:11:00.000+08:00

Management of glaucoma

The goal of treatment in glaucoma is to maintain useful visual function and the patient’s quality of life at a sustainable cost.

IOP lowering is the only clinically effective approach in the management of glaucoma.

The target IOP is an estimate of the mean IOP achieved with treatment that is expected to prevent further optic nerve damage. An individualised target IOP range should be set for every glaucoma patient.

The first line of treatment in Primary Open Angle Glaucoma is medical therapy and the choice of the drug depends on the target IOP, the safety profile of the drug, patient acceptance and cost.

The first line of treatment in Primary Angle Closure Glaucoma is a laser iridotomy. A laser iridotomy is also required for the fellow eye. Supplemental medical therapy may also be required.

In the emergency setting of acute angle closure glaucoma, additional systemic drugs like osmotic diuretics and oral/parenteral carbonic anhydrase inhibitors may be employed to rapidly reduce the IOP to avoid permanent, devastating nerve damage.

In Open Angle Glaucoma, laser trabeculoplasty may be used as an adjunct to medical therapy.

Surgery is indicated in patients who fail or are unable to comply with medical therapy and may be combined with cataract removal for enhanced visual rehabilitation.

Trabeculectomy is the primary surgery of choice in medically uncontrolled glaucoma.

Patients who have undergone glaucoma surgery should be advised that there is a lifelong need to be aware of symptoms of infection, which include blurring of vision, pain, redness, discharge and swelling.

Steroid eye drops are a frequently unrecognised cause of glaucoma. They should only be used as short-term therapy and IOP monitoring is vital in such patients.

Source: Ministry of Health (Singapore) : MOH Clinical Practice Guidelines 3/2005

Exercise can help lower IOP?

2007-01-28T07:38:00.000+08:00

P: Are there any foods, herbs, vitamins, or exercise that can help lower IOP?

Dr. Rick Wilson: Exercising 20 minutes, four times a week, is said to be equal to one eye drop in its pressure-lowering effect. No vitamins, and so on, lower IOP. Theoretically, vitamin E should help reduce the harmful effects of elevated IOP.

Source: Wills Glaucoma :Target Pressure Chat Highlights August 8, 2004

World's highest incidence of acute angle closure glaucoma

2007-01-28T07:03:00.000+08:00

Source: Ministry of Health (Singapore) : MOH Clinical Practice Guidelines 3/2005

The "Dry Eye" Syndrome

2007-01-27T15:20:00.000+08:00

WET EYES = DRY EYES?
I went to see my eye doctor at Changi General yesterday, a Monday afternoon of 18th December after I had lunch with my friend Shan Chi. She is a lady and has been my assigned glaucoma doctor since July 2005 -- an adorable ophthalmologist, worth her weight in gold.
Our first discussion was that my eyes tend to tear and sometime the tears would well over the eye lids and run down my cheeks. Looking at my eyes at a distance, she told me that my eyes look dry and that was why I tear. *Are you crazy, doc?*, I thought to myself. No, the doctor is always right and I must check this out.
With this paradox in my hand "crying" out for an explanation, I searched the internet for an answer to satisfy my curiosity. I did a global search on "all symptoms on dry eyes" Here is the explanation:-
Tearing in dry eyes may see m to be perplexing. My eyes are apparently wet yet I have dry eyes. This happens because the eye is not getting sufficient lubrication. The autoimmune system sends a distress signal through our nervous system for more lubrication. This emergency call causes the eye to flood with tears to overcome the dryness. But the generated tears are mainly water with little lubricating properties compared to our normal tears. They are capable of washing out debris but have poor adhesion-lubricating properties. Further, these emergency tears often arrive late, and the eyes need to regenerate more. So even if I *cry me a river*, they are of no help.
Treatment is needed and instilment of formulated artificial tears will help. "Thanks, Doc! And a happy New Year to you" I said. "You take care!" she replied. The door clicked to close.
"So I see: teary eye is the effect; dry eye is the cause."

My friend, Sharon Siddique added:
"I think that the "dry eye" syndrome can also be helped by vitamin/herbal preparations that are ingested. There is a formula called "Bio-Tears" that my ophthalmologist recommends at his clinic. Several patients have had good results, and have been continuing to use it."

Cheers,
Samfong