ALLERGY, RESPIRATORY
Asthmatics Who Quit Smoking May Reverse Lung Damage
Climate Change Could Sting Allergy, Asthma Sufferers
Air Quality Better in Northeast, Midwest
ALTERNATIVE MEDICINE
The Zen Way to Pain Relief
Quit Smoking the Holistic Way
When Healing Becomes a Commodity
ANIMAL CARE
Beware of Dog Bites
Separation Anxiety, Canine-Style
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Study Examines How Rheumatoid Arthritis Destroys Bone
Human Ancestors Put Best Foot Forward 1.5M Years Ago
New Clues to How Fish Oils Help Arthritis Patients
CANCER
Higher Vitamin D Intake Could Cut Cancer Risk
Sharing Cancer Info May Be Empowering
More Cancer Tests Mean More False-Positive Results
CAREGIVING
High Rate of Rehospitalizations Costing Billions
Bariatric Surgery Centers Don't Deliver Better Outcomes
With Age Comes Greater Risk of Hypothermia
CIRCULATORY SYSTEM
Support Network May Play Role in Benefits of Drinking
Obesity Linked to Heart Failure Risk
Bad Marriages Harder on Women's Health
COSMETIC
New Genetic Links to Baldness Discovered
With Psoriasis, the Internet May Offer Hope
What to Do If You Have Unsightly Veins
DENTAL, ORAL
Health Tip: At Risk for Gingivitis
Biological Product Shows Promise Against Gum Disease
Dental Implants Need More Work Than Root Canals
DIABETES
Chamomile Tea May Ward Off Diabetes Damage
Fish Twice a Week Cuts Diabetics' Kidney Risks
Formula Puts Doctor, Patient Glucose Readings on Same Page
DIET, NUTRITION
More Educated Choose Healthier Foods, But Pay More
Fruit Even Healthier Than Thought: Study Shows
Uncover Why Turmeric Helps You Heal
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Years of Exposure to Traffic Pollution Raises Blood Pressure
Most Mt. Everest Deaths Occur Near Summit During Descent
Flame-Retardant Chemical Linked to Conception Problems
EYE CARE, VISION
Don't Lose Sight of Halloween Safety
Kids Who Spend More Time Outdoors Have Better Vision
High Temps Degrade Contact Lens Solution: Study
FITNESS
Women Who Run May Benefit From Extra Folic Acid
Barefoot Best for Running?
Marathoners Go the Distance on Heart Health
GASTROINTESTINAL PROBLEMS
Peppermint Oil, Fiber Can Fight Irritable Bowel
Intestinal Bacteria Trigger Immune Response
New Guidelines Issued for Management of IBS
GENERAL HEALTH
Deployment Takes Toll on Army Wives
Heal Your Life® Tips for Living Well
Keep Safety in Mind While Your Kids Are Cooling Off in the Water
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
'Comfort Dogs' Come to Emotional Rescue
'Cell Phone Elbow' -- A New Ill for the Wired Age
Magnet Therapy May Ease Hard-to-Treat Depression
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Walk Long, Slow and Often to Help the Heart
Coffee Is Generally Heart-Friendly
How Weight Loss Can Help the Heart
INFECTIOUS DISEASE
Dry Weather Boosts Odds of Flu Outbreaks
Poor Restroom Cleaning Causes Cruise-Ship Sickness
Grapefruit Compound Inhibits Hepatitis C Virus
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Better Sleep, Grades Seem to Go Up
Guard Kids' Eyes Against Long-Term Sun Damage
Gene Variation Found in Boys With Delinquent Peers
MEN'S HEALTH
More Vitamin C May Mean Less Chance of Gout
Soy Linked to Low Sperm Count
Low Iron Levels Cut Cancer Risk in Men With PAD
MENTAL HEALTH
Green Spaces Boost the Body and the Mind
Bullying Seems to Affect Kids Years Later
Brain Scans Show How Humans 'Hear' Emotion
PAIN
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Exercise As Well As Acupuncture, May Ease Polycystic Ovarian Syndrome
Sugary Colas Tied to Gestational Diabetes
Yoga's Benefits Outweigh Risks for Pregnant Women
SENIORS
Want Better Health in the New Year, Add Exercise to Your Day
Community Exercise Programs Boost Seniors' Strength
15-Point Test Gauges Alzheimer's Risk
SEXUAL HEALTH
SLEEP DISORDERS
Moderate Aerobics May Ease Insomnia Symptoms
6 to 8 Hours of Shut-Eye Is Optimal for Health
Pay Attention to Signs That Say You're Too Fatigued to Drive
WOMEN'S HEALTH
Natural Childbirth Moms More Attuned to Babies' Cry
How Much Fish to Eat While Pregnant?
Varicose Veins May Mask Larger Problem
Add your Article

Glaucoma Treatment Can Prevent Blindness

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 2 (HealthDay News) -- Glaucoma doesn't necessarily have to end in blindness, two new studies suggest.

In one report, researchers say they found traditional surgery for glaucoma has better outcomes than using glaucoma drainage devices. The second report found that even patients with end-stage glaucoma can be successfully treated. Both studies were published in the July issue of Ophthalmology.

In the first report, researchers looked at the number of complications from traditional glaucoma surgery versus complications from inserting a device that drains fluid from the eye.

"We found a higher complication rate for glaucoma drainage devices than for traditional surgery," said lead researcher Frank Sloan, the Alexander McMahon Professor of Health Policy and Management at Duke University. "Of course, adverse outcomes for either procedure are rare."

In deciding between the two procedures, physicians will have to balance the risks versus the benefits, Sloan said. "It's good for ophthalmologists to have these outcome rates in mind when they counsel patients," he said.

In the study, Sloan and his colleagues collected data on 14,491 Medicare patients with glaucoma. These patients all underwent one of three surgeries. These included primary trabeculectomy (PT), trabeculectomy after scarring from previous surgery or trauma (TS), or the implanting of a glaucoma drainage device (GDD).

All these surgeries are designed to improve the drainage of fluid from the eye and reduce intraocular pressure. In trabeculectomy, a small portion of the tissue at the base of the cornea is removed to increase fluid flow, and in GDD a tiny shunt is implanted, which redirects fluid flow.

Sloan's group found that all of procedures had few adverse outcomes. However, GDD resulted in more patients progressing to low vision or blindness (2.6 percent), compared with patients who underwent PT (1 percent) or TS (1.3 percent).

Dr. Robert Cykiert, an ophthalmologist at New York University Medical Center and a clinical associate professor of ophthalmology at New York University School of Medicine in New York City, said that this study "says that one should try trabeculectomy procedure first, if you can."

In these patients, "experience and intuition says that additional trabeculectomy surgery usually won't work. That's why we go to a glaucoma drainage device," Cykiert said. "This study indicates that if there's any belief you can get away with doing a trabeculectomy procedure, you are better off doing that then putting in the drainage device."

These results will make people a little more conservative, Cykiert said. "Some glaucoma specialists jump ahead to the glaucoma drainage device sooner than they might or should," he noted.

In the second study, Dr. Jason W. Much, from the Department of Ophthalmology at the University of Virginia in Charlottesville, and his colleagues looked at the charts of 64 patients with end-stage glaucoma. All these patients were considered legally blind at the start of the study.

All patients underwent trabeculectomy or laser trabeculoplasty, where tissue is removed by laser. The researchers found that, despite impaired vision, these patients did not become blind.

"Relentless progression to [complete] blindness is not the norm in treated patients," Much said in a statement. "Patients should be encouraged that treatment is not futile. They may retain their visual acuity for many years and be able to perform simple tasks of daily living and enjoy reading and hobbies."

Cykiert said this study contradicts what has been thought for a long time. "The thinking has been that treating patients with end-stage glaucoma is often unsuccessful, because they wind up losing their vision," he explained.

The conventional wisdom has been that once optic nerve was damaged beyond a certain point, no matter what one did, the nerve would eventually die, Cykiert said.

"This study shows that's not the case, even people with end-stage glaucoma, if you treat them aggressively and follow them carefully, you can preserve that little amount of vision that's left," Cykiert said.

Glaucoma is a disease that damages the optic nerve, which if untreated will eventually lead to blindness. Glaucoma is detected by an intraocular pressure test. When the pressure climbs above 21 millimeters of mercury, glaucoma is present.

There are several types of glaucoma. The most common in the United States is called primary open-angle glaucoma. In the United States, many people have ocular hypertension, which is a precursor to glaucoma. Ocular hypertension results in elevated fluid pressure in the eye, but no damage to the optic nerve or vision loss.

Blacks and Hispanics are at higher risk for glaucoma, and progression to end-stage glaucoma is very common among blacks.

More information

For more on glaucoma, visit the U.S. National Library of Medicine.



SOURCES: Frank Sloan, Ph.D., Alexander McMahon Professor of Health Policy and Management, Duke University, Durham, N.C.; Robert Cykiert, M.D., ophthalmologist, New York University Medical Center, clinical associate professor, ophthalmology, New York University School of Medicine, New York City; July 2008, Ophthalmology

Last Updated: July 02, 2008

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