Dr. David D. Richardson, Eye Surgeon in California, answers one of the most commonly asked questions about Canaloplasty (an advanced minimally invasive glaucoma treatment), “What Does Minimally Invasive Mean?”

You may learn more about canaloplasty at http://new-glaucoma-treatments.com.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops. Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

Canaloplasty Surgery Patient Testimonial. Nidhi Shetty traveled all the way from Mumbai, India to California, US to undergo canaloplasty procedure under Dr. David D. Richardson. She kindly agreed to share her experience with everyone. You may view other testimonials here.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops. Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

Photo credit: www.sensimed.ch

A new prototype contact lens called SENSIMED Triggerfish^® Sensor is creating a stir among glaucoma specialists as it is set to be marketed in American shores this year. Although it has been successfully used in a number of European countries like Switzerland, Germany, France Italy and Spain for years, its release is still pending approval by the US FDA after clinical trials, one of which is spearheaded by Dr Robert Weibreb at the University of California, San Diego Eye Center.

The SENSIMED Triggerfish^® Sensor is a soft hydrophilic single use contact lens, containing passive and active strain gauges embedded in the silicone to monitor fluctuations in diameter of the corneoscleral junction.²  With its special pressure sensor that detects changes in the corneal shape and an antennae embedded in its clear silicone lens it receives radio signals and transmits it to an external reading device where the glaucoma patient’s intraocular pressure are recorded in real time. Much like having a 24 hour personal eye doctor on call, it provides an accurate and consistent intraocular pressure reading wherever or whatever a patient is doing in a 24 hour period.

Intraocular pressure is one of the best gauges to know a person’s risk for glaucoma. Since higher pressures in glaucoma is believed to cause the destruction of eye’s neural tissues, it is also one of the ways glaucoma specialists determine if a patient will likely become blind or have difficulties in their vision later on.

During a regular eye check-up, an eye doctor utilizes a machine called a tonometer to measure the eye’s pressure. This device however only provides a limited information since the eye’s intraocular pressure fluctuates and normally is lowest during the daytime and highest at night. Therefore a patient suspected of glaucoma may not have a correct pressure reading in a single office day consult and would have to go to their eye doctor on several occasions.

But with the SENSIMED Triggerfish^® Sensor, glaucoma patients are liberated from this cumbersome multiple clinic visits, and instead can have an accurate eye pressure evaluation in the comfort of their own homes. They just come in the next day with the triggerfish contact lens removed and have the data assessed and read in the doctor’s computer. This way, a glaucoma specialist can verify a diagnosis and get a patient’s true intraocular pressure pattern. Moreover, the triggerfish is also a good tool to monitor response in glaucoma therapies like the use of glaucoma eye drops or as a gauge after glaucoma surgery.

Dr Robert Weinreb says: “It’s the difference between seeing a single movie frame and watching a full-length motion picture. With more information, we better understand what is happening to the eye. We can provide earlier and more accurate diagnoses. We can detect changing conditions more quickly. We can adjust or alter treatments more effectively. The benefits are transformative. This is personalized medicine for the eye.”

With this Dr Weireb and his team hope to get favorable outcomes from the glaucoma participants they are studying until the first quarter of 2012 and subsequently get FDA approval by the end of the year. With its cutting-edge technology, Triggerfish^® Sensor will indeed be one of the more sensitive and convenient diagnostic tool for glaucoma in the coming years. For more information on the Triggerfish^® Sensor, you can visit SENSIMED’s website link below.

The triggerfish is just one of the exciting non-invasive technologies for glaucoma including canaloplasty. If you want to know more about canaloplasty as treatment for glaucoma and to see if you are a candidate for this treatment, visit http://new-glaucoma-treatments.com/canaloplasty-online-assessment-parent/canaloplasty/.

References

1. SENSIMED USA clinical study: http://clinicaltrials.gov/ct2/show/NCT01319604
2. SENSIMED technical whitepaper on Sensimed triggerfish and press release. http://www.sensimed.ch/
3. http://www.news-medical.net/news/20100326/SENSIMED-Triggerfish-developed-to-diagnose-and-treat-patients-with-glaucoma.aspx?page=2

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops. Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

You may view other testimonials here.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops. Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

Optic nerve damage over the years manifests as difficulties in vision which can result in slips, falls, and injuries. It is estimated that a third of persons with glaucoma lose their lower field of vision from glaucoma and subsequently suffer one or more falls in their lifetime.

A recent study conducted in a senior community with glaucoma residing in Queensland Australia confirms that the loss of one’s lower field of vision is significantly correlated with risk of future falls. The study was conducted among seniors who have been diagnosed glaucoma whether or not they were being treated with eye medications.

The participants volunteered to record in a daily diary the number of times they accidentally fell or slipped to the ground in a span of one year. The extent of visual field loss was tested through an eye test wherein each point missed from the goal corresponded to a decrease in the overall score for either superior or inferior visual fields.  The lower the score, the worse the vision

After a year it was shown that a lower visual field score significantly impaired the participants’ mobility, with 44% of them having had at least one or two falls, 22% having had more than two, while a staggering 31% had resulted to more serious injuries like hematomas, fractures or lacerations.  It was estimated that for every five to ten points lost in the two consecutive inferior visual field tests, the participant increased his or her chances of sustaining a fall by 56% to 62%  after a year.

The participants who had the most fall and injuries had also lower inferior visual field scores than superior field scores in their eye assessment tests. Compared to one’s superior and central visual field, researchers explain that a person’s inferior visual field is vital for walking in terms of anticipating foot placement, identifying  and avoiding obstacle in one’s path and navigating one foot after the other while walking downstairs.

These alarming figures clearly indicate that glaucoma specialists and eye doctors must be able to screen for a patient’s loss in the lower visual field. Knowing this early on, the clinician can use it as a reliable and objective means to determine a glaucoma patient’s risk. This is most especially true among the highly vulnerable older age group who maybe suffering from other medical conditions like arthritis and muscle weakness.

Reference:

Black AA, Wood JM and Lovie-Kitchin JE. Inferior Field Loss Increase Rate of Falls in Older Adults with Glaucoma. Optometry and Vision Science. 1040-5488/11/8811-1275/0 VOL. 88, NO. 11:1275–1282

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops (view 3 year results). Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

SUBSCRIBE VIA EMAIL | Keep your self updated. Get notified of new treatments, studies or updates regarding Glaucoma & Canaloplasty. We never share your information.

Unknown to many, the second leading cause of blindness around the world is a condition called glaucoma. People may have it for years without being aware of it. There is really no sufficient explanation as to what causes it. Those who suffer from it have elevated pressures in the eye and show damage in their optic nerve. Although glaucoma is commonly documented in the elderly, genetics is the main culprit behind the early development of glaucoma seen in young African American adults.

It is in fact not unusual to see glaucoma as early in their 20’s to 30’s among African, Hispanic and Asian descent ^{(1, 2)}.  African Americans are twice as likely to develop open angle glaucoma than Caucasian Americans (12%), with Hispanic Americans coming in second (6.5%). These groups also show faster and more progressive damage. Moreover, studies also reveal that among Asian Americans, those of Chinese, Vietnamese and Japanese descent are more likely to have normal intraocular pressures despite obvious damage in their optic nerve. ⁽²⁾

A group of researchers recently discovered that this genetic vulnerability is  due to higher than normal  oxygen levels in African American eyes. Oxygen molecules are believed to produce toxic cellular by-products responsible for the damage occurring in the glaucomatous eye. ⁽¹⁾ Experts say that oxygen in the eye produces free radicals that damage its vital structures- one of which is the canal that normally drains the aqueous fluid and the other is the nerve that transmits the light signals to the brain. This process gradually goes on for years without producing any symptoms.

Fortunately, the normal healthy eye is equipped with a built in molecular cleaning system that rids it from these harmful oxygen radicals. The gene called TDRD7 has been shown to code for this vital scavenger protein.⁽³⁾ Those with congenital glaucoma or early onset glaucoma are now believed to have genetic mutations in this gene which cause them to lose this protective mechanism, consequently leading to childhood or early onset glaucoma. ⁽³⁾

In the future, this information may lead to gene therapy for glaucoma. With such therapy, loss of vision need not be the destiny of young African Americans with glaucoma.  Until then, genetically predisposed races, especially African Americans should at least have their eyes checked by an eye doctor or a glaucoma specialist in their 20’s or 30’s and have regular follow-up in the succeeding years.

References:

1.Siegfried CJ et al. Racial Differences in Ocular Oxidative Metabolism Implications for Ocular Disease. Arch Ophthalmol. 2011;129(7):849-854.
2.Stein JD et al. Differences in Rates of Glaucoma among Asian Americans and Other Racial Groups, and among Various Asian Ethnic Groups. Ophthalmology. Volume 118, Issue 6 , Pages 1031-1037, June 2011
3. Lachke SA et al. Mutations in the RNA Granule Component TDRD7 Cause Cataract and Glaucoma. Science 25 March 2011: Vol. 331 no. 6024 pp. 1571-1576

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops (view 3 year results). Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

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More than that Meets the Glaucoma Eye

Sight is one of the basic senses we use in everyday life and often take for granted. Marsha is just one of the many elderly people who are diagnosed with acute open angle glaucoma each day. Glaucoma is a leading cause of blindness all over the world. Failure of the eye’s natural canals to drain raises the pressure inside the eye which ultimately destroys the nerves responsible for vision.

Glaucoma is called the silent sight stealer because it can go on for years without any symptom until the person’s vision is suddenly compromised. Any glaucoma patient will tell you of their terror and anxiety of going blind. If you or loved one experience any glaucoma warning signs like eye pain, blurring of vision and vomiting, it is important to have you or their eyes checked by an eye doctor or glaucoma specialist. Glaucoma is irreversible and progressive once damage to the nerves of the eye has begun, and it is a glaucoma specialists’ job to prevent this from happening.

Wanted: Eye Heroes

A patient diagnosed with glaucoma has one question in mind: Where can I find a glaucoma specialist? There are many avenues by which one can find a glaucoma specialist. One of them is through direct referral from your family doctor or the recommendation of a friend or relative who previously were under their care. In the internet age, it is also easy to find online a glaucoma specialist in your area. However, not all eye doctors are considered as glaucoma specialists. It takes years of study and hands-on training on glaucoma management and surgery to be a good one.

An eye doctor is known as an ophthalmologist. He earns this after four years of medical school and undergoing three to four years of residency training in Ophthalmology. It is during this time that she learns the rudiments of diagnosis and treatment for various eye diseases. A resident has to pass a series of examinations in order to be certified by a country or state professional board where she intends to practice. However, some proceed to another year or two of further training called fellowship, to concentrate on a specific eye disorder one is interested in, like cataract or glaucoma for example. Aside from theoretical study of the principles of glaucoma, a fellow must have hands-on training by seeing glaucoma patients every day, before she can call herself a glaucoma specialist.

How to Save an Eye

In the era of modern medicine, a glaucoma specialist has a huge armament of treatments available which includes medical eye drops, laser, artificial drainage devices, and lastly surgery. A glaucoma specialist will first exhaust medical means through different types of drugs like beta blockers to prostaglandin analogs to lower intraocular pressure before resorting to eye surgery. Although eye medications are very effective, some patients are not suited for them. Some are non- compliant or too sensitive to their side effects, or like in Marsha’s case, require a more rapid way to bring down the pressure by glaucoma surgery.

For the past one hundred years glaucoma surgery was synonymous to trabeculectomy. But with the advent of surgical breakthroughs in microsurgery and state-of the-art catheters and flexible scopes, patients like Marsha have more options like viscocanalostomy and canaloplasty to name a few. Through these modern medical wonders, glaucoma surgeons can operate on delicate and fine structures of the eye safely without endangering them from infection and injury. Due to the technical nature of these novel procedures, only a few glaucoma specialists are qualified enough to do them. Majority are reluctant to learn these new methods due to lack of existing clinical evidence of their safety and efficacy. Moreover some glaucoma surgeons are daunted by the steep learning curve and training it requires. As a patient, you have to be aware of these treatment options and discuss them to your glaucoma specialist.

Glaucoma Specialists versus Glaucoma Surgeons

A glaucoma specialist’s knowledge depends on the experience she has acquired through years of private practice. Due to personal inclinations or preference, some choose not to train in novel surgical techniques. Therefore, in certain respects, not all glaucoma specialists are trained to do certain glaucoma operations. Unlike a glaucoma specialist who has earned her knowledge in formal fellowship training, a glaucoma surgeon has to earn her reputation by doing countless surgeries to master her craft. A glaucoma surgeon’s edge therefore lies on a specific surgical technique he does best. A good example for this would a surgeon trained to do a non-invasive procedure like canaloplasty. To accomplish this, she has to apprentice under a more experienced surgeon who has done a number of canaloplasty cases himself.

What You See is What You Get

Now that you glaucoma specialist has decided for glaucoma surgery, the next question would be: “how do I assess the skills of a glaucoma surgeon?” To do this you must check his professional track record; not just in the number of patients he has operated on but by what they actually say about him or her after their surgery. Like any craft, quality is always evident on the service rendered. In the case of a glaucoma surgeon, how early and effectively he or she can arrest the onslaught of blindness is your hero or heroine. But whatever the surgical technique she uses to restore intraocular pressures to normal or near normal levels, a good glaucoma surgeon does it without undue harm to the patient during and after surgery.

Finally, in choosing the right glaucoma specialist for you, you must not only consider her technical expertise but also her bedside manners. Often forgotten in the world of ultra modern and highly specialized medicine is good patient care, it is the personal touch a doctor to her patient. It shows in the way she listens and touches her patient. Or it could be as simple as explaining your glaucoma in a level that you can understand, including your treatment options and the risks it entails. Doctors who possess this quality have high patient referrals and positive testimonials from former patients. They win you over by seeing you as a whole person and not just another piece of eye to apply his magic hands and try out his wonder gadgets on.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops (view 3 year results). Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

SUBSCRIBE VIA EMAIL | Keep your self updated. Get notified of new treatments, studies or updates regarding Glaucoma & Canaloplasty. We never share your information.

If you have been diagnosed with glaucoma and contemplating surgery, it is but normal to be racked with questions and fear in your mind. Glaucoma is the second leading cause of blindness in the US and majority of the cases seen by eye doctors are on the early stages of glaucoma, which is medically known as primary open angle glaucoma (POAG). Because of its benign nature, POAG is often treated by glaucoma specialist initially with eye drops. Surgery is considered only after medical therapy fails.

But with the advent of modern medical machines and technologies, glaucoma treatment surgery is now a routine and part of early intervention for all types of glaucoma, especially for POAG. Unlike the previous decades wherein persons with uncomplicated and early glaucomas had to go through a daily regimen of eye medications and hope for years that their eye pressures normalize or return to healthier levels, patients can now find immediate relief and be spared from blindness with non surgical procedures like canaloplasty, laser trabeculoplasty and sclerotomy.

How Can I Assess the Skills of a Glaucoma Surgeon?

If you decide to have glaucoma surgery, you do not want just any doctor poking your eye of course. So, how do you assess the skills of a glaucoma surgeon? Just like any great painter or master craftsman, an excellent glaucoma surgeon becomes one by years of doing a number of glaucoma surgeries.

The same principle also is true for surgeons. A glaucoma surgeon is said to have had at least 2,000 glaucoma eye surgeries tucked in his belt before he can say he has “enough experience”. An eye doctor becomes a glaucoma surgeon by apprenticing for years under a more senior or renowned glaucoma surgeon specializing in a specific kind of surgery, like say canaloplasty. Called a wet lab, the eye doctor observes several eye surgeries and operates on a number of cadaver eyes before being allowed to do supervised operations in human patients.

Hence not all glaucoma specialists can call themselves a glaucoma surgeon. Just like a golf enthusiasts who calls himself a golfer does not necessarily have the same handicap and hole-in-one, as say Tiger Woods. A sportsman earns his right to be called a master in the sport by years of experience, training and number of wins. Likewise, a glaucoma surgeon must not only have a certificate of training framed in his wall but have many successful operations over the years.

To determine the appropriate glaucoma surgery for you, it is important to know the different surgical options available. There are two schools of thought in glaucoma surgery. One is the traditional filtering surgery called trabeculectomy and more recently, the minimally invasive ones like canaloplasty and sclerotomy. Because it is a relatively novel procedure, only a few glaucoma specialists are trained enough to do them. You have to look for a qualified glaucoma surgeon who does them well, and you do not have to necessarily pick the first eye doctor your health insurance provider suggests. Moreover not all glaucoma specialists are good surgeons. Some choose to concentrate in traditional surgery or medical therapy and are uncomfortable doing non-invasive surgeries sclerotomy and canaloplasty.

However, at the end of the day, what determine the skill of a glaucoma surgeon are the countless patients who have regained their sight and have been saved from what could have been a lifetime of blindness. Through a procedure like canaloplasty, you now have the option to be medically eye-drop free for the rest of your life. You may also ask your primary physician to refer you to a good glaucoma surgeon who is trained to do non-invasive glaucoma surgeries like these.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops (view 3 year results). Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

SUBSCRIBE VIA EMAIL | Keep your self updated. Get notified of new treatments, studies or updates regarding Glaucoma & Canaloplasty. We never share your information.

Starting middle age, the incidence of glaucoma proportionally increases after40 years old and advancing age. It is also highly prevalent among African-American, African-Caribbean and Hispanic races, who are genetically predisposed to develop glaucoma even at an earlier age, typically as young as those in their 20s to 30’s. Persons who suffer from diabetes and hypertension are also the most vulnerable. Any relative or family member who had glaucoma also poses a high probability of other blood kin of having it.

If you or someone you know have one or any of the said risk factors, it is absolutely necessary to have a thorough eye examination by a glaucoma specialist who can help look for any physical evidences of glaucoma in your eye.  In most cases, glaucoma is diagnosed either by a family physician or an optometrist. These two health professionals will then refer the patient to a glaucoma specialist. A single consult alone will spell the difference of saving or losing your sight. The expertise of a glaucoma specialist cannot be underestimated. A glaucoma specialist for one can determine the specific glaucoma stage you are in, estimate your risk for blindness and decide whether to initiate treatment.

Although a general eye doctor called an ophthalmologist would know how to manage glaucoma, it is still best to have your eyes taken care of by a glaucoma specialist. It is like having an automotive mechanic repair your car instead of a jack of all trades mechanic. Although glaucoma specialists are also ophthalmologists, their fellowship training for another two to three years in the field of glaucoma, adds an extra feather to their cap and puts them in a better position to effectively treat all cases of glaucoma, from the simple to the most complicated.

It is most crucial to see a glaucoma specialist especially in the earliest stages of the disease, wherein there has yet been no extensive damage to the nerves of the eye. Recent studies show that patients who had early medical or surgical intervention by a glaucoma specialist were least likely to progress to blindness and disability as a result of lowered pressures in the eye.

There are a myriad of new glaucoma treatment available for all types of glaucoma- from drugs, laser, and artificial drainage devices to the minimally invasive glaucoma treatment, Canaloplasty, which you can intelligently discuss the pros and cons of each with your glaucoma specialist.   You may also download our free ebook, “10 THINGS YOU MUST KNOW BEFORE CHOOSING YOUR GLAUCOMA SURGEON” here.

Dr. David Richardson is among a select group of ophthalmologists in California offering Canaloplasty as a treatment option for his glaucoma patients. Canaloplasty is a newer, safer surgical glaucoma treatment which has been successfully helping many glaucoma patients worldwide control their eye pressure (IOP) – many who after surgery no longer need their eye drops (view 3 year results). Find out if you qualify for Canaloplasty. Learn More About Canaloplasty

SUBSCRIBE VIA EMAIL | Keep your self updated. Get notified of new treatments, studies or updates regarding Glaucoma & Canaloplasty. We never share your information.