March 2019 E-Newsletter

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Advancing the Understanding of Exfoliation Syndrome

In recent issues, we’ve talked about several secondary glaucomas in connection with our “Living with Glaucoma” series. Exfoliation syndrome (XFS), the major cause of secondary glaucoma, has been the focus of all of The Glaucoma Foundation’s research initiatives since 2012.

We would very much like to profile a reader or another individual with exfoliation glaucoma for our next issue. If you have this disease or know of someone else who might share their story, we’d love to hear from you. Please contact The Glaucoma Foundation at asteele@glaucomafoundation.org]

XFS, a systemic disease characterized by deposits of a flaky, dandruff-like material in many ocular tissues, is the most common recognizable cause of open-angle glaucoma worldwide, comprising the majority of cases in some countries. In 2007 scientists identified genetic variants in the lysyl oxidase-like 1 (LOXL1) gene that have been strongly associated with XFS, but do not alone cause the condition. Environmental effects, such as lifetime ocular UV exposure, and other factors appear to play a role in whether or not someone predisposed to the disease will develop it.

Since XFS and its associated exfoliation glaucoma have been The Glaucoma Foundation’s research focus, TGF has sponsored six annual International Think Tanks and funded 27 grants for research projects that have already advanced the understanding of exfoliation and provided new insights into the genetics, pathology and biology of XFS.

Two new grants have recently been funded.

One project is studying the effect of both genetic and non-genetic factors in XFS disease pathology. A second is testing the idea that certain specific molecular changes induce the formation of exfoliation material.

One of the goals of The Glaucoma Foundation’s Annual International Exfoliation Think Tank has been to identify areas for future research and funding. The TGF Think Tank has stimulated research at a geometric level and the number of researchers working on XFS has markedly increased.

The 2019 Think Tank, the seventh dealing with exfoliation, will convene in New York City in June, once again providing a unique opportunity for scientists and clinicians from a variety of disciplines and numerous countries to apply their research and expertise to the challenge of glaucoma.

The Think Tank aims at fostering new relationships among the attendees that will lead to continued communications across disciplines and between laboratories – long after the meeting has ended.

Sleep and Glaucoma

Did you know that people who suffer from sleep apnea are more likely to develop glaucoma than those who do not have this sleep problem according to studies? And that IOP varies with body position? There are other correlations between sleep and glaucoma which are being studied. We will tell you them in the next issue of the newsletter.

Light Sensitivity and Glare

Light sensitivity and glare are common problems for people with glaucoma. Patients who experience light sensitivity typically feel discomfort from sunlight, incandescent light and/or fluorescent lights. Halogen lights, like those used in car headlights and fluourescent lighting or fixtures can cause an uncomfortable glare for those with glaucoma. Here are some tips for driving and working at your computer – two scenarios impacted by glare and light sensitivity.

DRIVING WITH GLAUCOMA
Many glaucoma patients choose to avoid night driving due to the headlight glare that makes is difficult to see well. Warning signs that driving may be dangerous include: loss of peripheral vision (making it difficult to see and react in time to avoid obstacles like other cars and pedestrians coming from the side); blurred vision (making it harder to distinguish clear images and see movement such as passing cars or someone crossing the street); increased light sensitivity, (making it more difficult for your eyes to adjust from headlight glare at night); and close calls (because of a failure to notice obstacles in the road).

Here are two resources that can help you evaluate your driving skills:

American Association of Retired Persons
Driver Safety Program
http://www.aarp.org/families/driver_safety/
800-424-3410

AAA Foundation for Traffic Safety
Drivers 65 Plus: Test Your Own Performance.
Available as a brochure and other information is available at
https://seniordriving.aaa.com/

If you choose to continue to drive be sure to:

--Select proper glasses for both day and night driving. Darkened or polarized lenses can be helpful in blocking glare in daytime driving or during outdoor activities like fishing, skiing or riding a bike. But when driving at night, the eyes need to adapt to darker natural conditions. If you wear glasses, keep them clean.

-- Avoid wide-temple frames, which can interfere with side vision.

-- When you buy a car, choose a clear windshield and keep your windshield clean, inside and out. People often forget the importance of wiping off the inside of the windshield, which is easily smudged.

-- Maintain and clean off your headlights, which can get coated with road grime.

-- Make sure your windshield wipers are in good condition and change them as needed.

-- Keep pace with the flow of traffic.

-- Be alert. Keep eyes on the road ahead but check each side of the car for vehicles, children, animals or other hazards. Move your head and eyes frequently from side to side and glance often at the rear view, side mirror and instrument panel.

WORKING AT YOUR COMPUTER
Extended time on the computer jeopardizes even the healthiest of eyes. This is magnified for people with glaucoma. A few tips might help.

-- Glare problems can be reduced with a good filter that fits over your screen.

-- Before selecting a permanent position for your computer, check out the effect of light on the screen. Avoid facing the window. Light streaming from outside creates glare and interferes with your view of the screen. Light from a window behind you may also worsen glare.

-- Overhead lighting my also produce glare. Try illuminating your screen with desktop lighting, focused directly on your work.

-- Arrange your monitor in such a way that you gaze down at a 15-angle, which is easier on your eyes.

-- Avoid staring at your screen – Look around, e.g. out of a window or at a far wall. And remember to blink. Not blinking can promote dry eyes.

Get Involved with TGF

Support TGF's research and education programs and donate today.

Join a TGF glaucoma support group online to learn how other patients manage their disease.

Connect with other glaucoma patients on TGF's Facebook page.

Follow TGF on Twitter and start the #glaucoma discussion.

Share your personal glaucoma story with us.