UN officials screened for glaucoma in observance of WGD

New York-In observance of the second annual World Glaucoma Day, ambassadors, deputy ambassadors, and the secretary general and his staff at the United Nations headquarters here were invited to a free glaucoma screening Wednesday, which was hosted by the New York Eye and Ear Infirmary (NYEEI) and The Glaucoma Foundation.

Glaucoma is the second leading cause of blindness in the United States; in African-Americans it is the leading cause. Early detection of glaucoma is paramount to halting the deleterious effects of glaucoma and to implementing effective treatment.

"Glaucoma is a slowly progressive degeneration of the optic nerves. It is often (but not always) associated with elevated IOP. The vision loss in glaucoma occurs first in the periphery before involving the central vision. Patients are, therefore, unaware of the progressive loss of peripheral vision until the very advanced stages of the disease," said Robert Ritch, MD, professor and chief of glaucoma services at NYEEI, and Allison Angelilli, MD, clinical glaucoma fellow, Glaucoma Associates of New York, NYEEI. "Like many other degenerative diseases of the central nervous system, damage to the optic nerves in glaucoma is permanent. Prevention and early detection are, therefore, the cornerstones of successful glaucoma management."

The role of the clinician in the early detection of glaucoma cannot be overemphasized, according to Drs. Ritch and Angelilli.

"Glaucoma is an extremely common disease, and most ophthalmologists are quite skilled at identifying patients with or at risk for glaucoma," they said. "To detect the subtle cases, clinicians must maintain a high index of suspicion for glaucoma. A thorough evaluation will include a discussion of family history, ocular history, past or present exposure to corticosteroids, a history of trauma, and an assessment of medical conditions that predispose to glaucoma including sleep apnea, thyroid disease, migraines, hypotension, and Raynaud’s syndrome."

Further, Drs. Ritch and Angelilli continued, effective screening for glaucoma includes some additional tests.

"Of course, no examination is complete without darkroom gonioscopy to identify angle closure, IOP measurement, and examination of the optic nerves for disc hemorrhage, parapapillary atrophy, nerve fiber layer defects, and the appearance of the neuroretinal rim. Patients with risk factors for glaucoma or a suggestive clinical examination may then undergo the appropriate perimetric testing and imaging of the optic nerve head to assess the extent of disease. Stereoscopic disc photography in patients with glaucoma risk factors is a powerful tool to establish a baseline and detect future pre-perimetric glaucomatous change," noted Dr. Angelilli, who also is a clinical instructor at the New York University Medical Center.

Screenings were held in the North Secretariat Lounge of the UN, between 8 a.m. and 4 p.m., under the direction of Dr. Ritch, co-chairman of the World Glaucoma Day Committee of the World Glaucoma Association. This event was held in hopes that the high profile of this venue will raise international awareness of glaucoma.

The screenings included visual acuity assessment, measurement of IOP, optic disc evaluation, and slit-lamp examination. Participating UN officials were registered and asked to complete an intake questionnaire and exam about their knowledge of glaucoma. They were escorted to the various stations, where different phases of the screening were performed by an ophthalmologist. Technicians also were present to assist the ophthalmologists where needed. Dr. Ritch performed the slit-lamp examinations.

Participants were given their results, which specified whether they had glaucoma, had suspected glaucoma, or had normal eyes.

"World Glaucoma Day is an opportunity to bring attention at an international level to the importance of early glaucoma detection and treatment. Glaucoma is a leading cause of blindness worldwide, and it is largely preventable with proper care. Resources and clinician training are desperately needed in most countries," Drs. Ritch and Angelilli said. "We chose to hold a glaucoma screening at the UN this year in the hopes that it will increase awareness of glaucoma and create a discourse among political leaders who have the power to implement change on an international scale."

For more information on World Glaucoma Day or for information about becoming a part of this annual event, visit www.wgday.net.

Taking a quiet moment before screening more than 400 staff of the United Nations, are (left to right): Nathan Radcliffe, MD, Murray Fingeret, OD, Frank Ashburn, MD, and Robert Ritch, MD. In addition to New York Eye and Ear Infirmary, ophthalmologists volunteered through the Congressional Glaucoma Congress.

Robert Ritch, MD, of New York Eye and Ear Infirmary, screens one of the 400 United Nations staff for World Glaucoma Day. Assisting in the project were Scott Christensen of the Glaucoma Foundation, ophthalmologist Gustavo deMoraes, MD, and more than 30 doctors, technicians and other volunteers.

At the World Glaucoma Day screening at the United Nations, individuals being screened moved from station to station, where they received numerous exams from visual acuity, tonometry, visual field and optic disc evaluation. More than 30 medical professionals, technicians and volunteers from health-related organizations participated. (Photos courtesy of Photo Bureau: New York Eye and Ear Infirmary and Glaucoma Foundation)