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HomemifeatureGlaucoma: Beyond the White Noise

Glaucoma: Beyond the White Noise

There is a lot of white noise around the topic of glaucoma. It is regularly discussed but rarely understood by the average person untouched by the disease, and is usually referred to as an old person’s disease – but that’s not necessarily the case. It’s often believed to be entirely manageable – but that’s only when this insidious sneak thief of sight is caught early. We spoke to Channel Nine football commentator Andrew Voss, and Labour Senator John Faulkner, about their personal experiences with the disease.

Andrew Voss was eight when his father died. His mother – Lola – learnt to drive and returned to work so she could pay the mortgage and raise her family of three sons. At 75, Lola retired from her part-time role with a real estate agency. Then at 79 she was diagnosed with glaucoma. Two years later Lola’s twin sister, Enid, was diagnosed with the same disease. Today, just two years down the track, Lola has completely lost her sight in her left eye and has partial sight remaining in her right. Enid’s vision has almost completely gone. Andrew was not aware of any prior family history of the disease.

“I don’t remember the day Mum told me she had glaucoma,” said Mr. Voss. “It wasn’t the sort of thing she wanted to talk about – she was fiercely independent and didn’t want to become a burden. But already she’d lost significant sight.

“When she gave up driving, Enid would accompany Mum into the city to visit her ophthalmologist. Now I take both of them in each month,” he said.

I was hit on the head by bouncing balls several times, because I’d lost perspective and so my judgement went awry. I had my eyes tested, and I am very lucky I did – the eye specialist found that my IOP pressure was sky high…

Fear of the Future

While Enid lives independently in a retirement village, Lola continues to live on her own in the family home. Andrew says she is extremely proud of the house in which she reared her three sons, and passionate about her garden.

“Mum’s house is her pride and joy and although we know one day she won’t be able to live their on her own, right now it’s the best place for her – she is so familiar with her surrounds.

“Unlike Enid, she still has some vision remaining in her left eye, which means she can watch the television and enjoy getting out in the garden. But pleasures like reading are a thing of the past. I’ve tried to teach her to use a Kindle and simplified the process as much as possible but it is very difficult to teach an 83 year old to use new technology.

“My wife and I talk about Mum’s options as her range of vision narrows, but Mum doesn’t like to address the issue directly. She has admitted she is very scared about what lies ahead – she fears totally losing her independence,” he said.

Missing Out

With three sons of his own, Andrew says it is heartbreaking to realise his mother can’t fully enjoy her role as a grandmother. “My sons play football and my eldest plays night hockey as well. They would love their grandmother to come along and watch a game, but there’s no point. Particularly with night hockey – all she would see is shadows running around.”

Similarly, when she looks across the road from her house, Lola sees nothing.

Andrew’s experience with his mother and aunt has taken him in unanticipated directions. He is an Ambassador for Glaucoma Australia and is about to begin working with Guide Dogs NSW and ACT. Additionally, he said, his boys are beginning to develop an awareness of the importance of sight.

“My son was hit in the eye with a stick just before Christmas and had to wear a patch. He decided to explore the concept of being blind and one day when I got home I found him crawling around the floor with both eyes covered – experiencing what it’s like to be blind.

“Although they don’t really understand the extent of their grandmother’s vision loss yet, the boys are very forgiving of the fact that she can’t get out to support them. And they’re wonderful at helping their grandmother and great aunt up the stairs or across the road.”

Senator John Faulkner

Senator John Faulkner was just 25 when he was diagnosed with Glaucoma. It was fortunate timing – left untreated, he’s been told, he would have been completely blind by the age of 35. Instead he has led a fulfilling, sighted life in politics as a member of the Labour Party and, since 1989, a member of the Senate. Additionally, he continues to play competitive cricket.

Although Senator Faulkner says his glaucoma today is “magnificently managed”, the journey has not been without its challenges.

“I am one in 200 people to have been diagnosed with glaucoma before 50 years of age,” said Senator Faulkner who is soon to turn 60.

“I really found out about it because of an inexplicable level of difficulty – relative to my usual level of confidence – in judging anything moving or not moving at eye level or above. This was usually most apparent at sport… which is not one of my strengths anyway… I was hit on the head several times by bouncing balls, all because of glaucoma – I’d lost my sense of visual perspective and so my judgement went awry. I had my eyes tested, and I am very lucky I did – the eye specialist found my IOP pressure was sky high.”

The diagnosis was primary open angle glaucoma and, Senator Faulkner said, the symptoms he was experiencing turned out to be a classic case of significant and irreparable vision loss in the upper half
of his vision.

“I’ve been told by the best ophthalmologist in the country that the condition was so aggressive that left untreated I probably would have been blind by age 35. Having been treated for a third of century, by now I would have been blind three or four times over.”

“Instead I drive, I play cricket, I do everything,” he said.

Glaucoma ‘The World is a Wonder’ Photo Competition

Glaucoma Australia has announced a national photo competition for the public entitled ‘The World is a Wonder’.

Geoff Pollard, National Executive Officer at Glaucoma Australia said the competition marks the beginning of a new future for the charitable group, which was established in response to community feedback following an interview on glaucoma on Channel Nine in 1988.

“For the past 25 years, we have run as a small, lower profile organisation, largely surviving on small contributions from individuals with glaucoma themselves. Now it’s time to raise our presence and seek more sustainable contributions to support our work.”

The competition runs from Monday 4 March to Friday 10 May 2013 and entries will be judged on their merits by Geoff Lawson OAM (optometrist and cricket player, coach, commentator, writer and Glaucoma Australia Ambassador); Mark Cushway (mivision Editor); and Assoc. Prof. Ivan Goldberg AM (ophthalmologist and Glaucoma Australia President).

To enter go to: www.glaucoma.org.au/wonderphoto.htm

There are four categories and prizes include Canon digital cameras donated by Optimed.

World of Glaucoma Week March 10-16

Glaucoma is a major cause of vision loss in Australia and it is becoming more prevalent as our population ages. Yet awareness remains low – studies show that half of the 300,000 Australians
who have glaucoma are not aware they have the disease.1

The 2008 “Economic Impact of Primary Open Angle Glaucoma” released jointly by the Centre for Eye Research Australia and Access Economics, predicts that by 2025 primary open-angle glaucoma will affect almost 400,000 Australians.

Age is one of the most important risk factors for the disease, with at least five times as many people affected with glaucoma by the age of 65 years when compared with the number at 40 years of age.2

While anyone can get glaucoma, people at higher risk include those with a high eye pressure, those with a family history of the disease, those of African or Asian descent, those aged 40 and over, and any adult over the age of 50.

Early Warning Signs

Although glaucoma has few symptoms in its early stages, research using data from the Blue Mountains Eye Study, has found that certain changes in blood vessels in the eye’s retina can be an early warning that a person is at increased risk of the disease.

The study, led by Professor Paul Mitchell from Sydney University’s Centre for Vision Research, found that patients who had abnormally narrow retinal arteries when the study began were also those who were most likely to have glaucoma at its 10-year end point.

“Our results suggest that a computer-based imaging tool designed to detect narrowing of the retinal artery calibre, or diameter, could effectively identify those who are most at risk of open-angle glaucoma,” said Professor Mitchell.

Comprehensive Examinations Essential

In the meantime, Geoff Pollard, National Executive Officer of Glaucoma Australia, says optometrists should not rely on a mere IOP test to detect patients with glaucoma. “Optometrists need to discuss glaucoma with their patients and provide a comprehensive examination – a thorough patient history, followed by a comprehensive examination is critical; tests and investigations confirm and document the diagnosis,” he told mivision.

Optometrists and ophthalmologists have traditionally shared the management of patients with chronic glaucoma. Now the Optometry Board of Australia (OBA) is currently considering permitting “endorsed optometrists to initiate treatment and manage patients diagnosed with chronic glaucoma, or who are
at high risk of developing the disease.”

According to a submission from the OBA, should permission be granted, “optometrists can still choose to enter into a collaborative or shared-care arrangement with an ophthalmologist – and it is expected that many optometrists, where access to specialist care is not an issue, are likely to continue to do so.” See our lead news story for industry response to the submission.

World Glaucoma Week runs from 10-16 March.

Wensor et al, 1998 Le et al, 2003