I try not to touch the tip of the bottle either, but if I accidentally
touch it to my eyelashes a week after opening it, I'm not going to
throw it away.
I did throw out a bottle that I dropped on the floor, though, but
fortunately I had just picked up my next month's prescription and so
had a new one on hand. If it was a bottle I had just opened, I think
I would have chanced it rather than throw it out.
-Deah
The tech at my glauc doc's office dropped a bottle (not on the floor
though!) and she just wiped the tip off with a bit of alcohol on a cotton
ball. I asked "you can do that???" and she said "sure, not a problem".
Of course, you'd have to be careful not to get so much alcohol on the cotton
ball that some would get in the drops. And they do go through a bottle of
drops quicker than we do!
Sherry
If I don't think all of the drop got in my eye or I blinked, I put in
a second drop. The excess will just run out so it's not as though you
can overdose.
-Deah
Julie,
Thanks for the input!
Glucose meters have a solution used for checking them for accuracy. Typical
of diabetes monitoring supplies, it's way overpriced and I rarely check my
meter. Anyway, the solution is supposed to last for 90 days after opening
and we're supposed to put a date on the bottle so we know when to toss it
(of course, there's no way to *write* on the bottle!). Occasionally I'll
use the outdated solution and it appears to still be effective. How much can
go wrong with a glucose solution?
Of course, I'm more cautious with my meds and eye drops....
Sherry
Since I have pharmaceutical experience, wish to clarify :
* the expiration date is established on the un-opened bottle, stored in ideal ( at stated on the label) conditions.
* After expiration date, the manufacturers can no longer guarantee the potency of the active ingredients.
* Since I am a patient , I feel that the manufacturing companies should include an expiration date after opening as well. We should practice to put the date on the bottles as opened for better control.
* Sherry is correct that the main concern after opening is the contamination which is being introduced by ourself. If we are careful handling the open bottle should not be an issue.
Julie
My understanding is not that medications
become unsafe after the listed expiration date.
As I understand it, the expiration date is merely the
date to which tests have shown the medications
to remain safe.
Normally, it seems, tests are not done to determine
when medications become unsafe.
-- Jim Griffin
I am 37 and have been taking drops for 12 years to control pigmentary gluacoma. I read on here recently that it is difficult to get to the single digits on the pressure reading with drops. I take Cosopt, Alphagan and Lumigan in the left eye and typically have a pressure reading of 11 or 12. The pressure yesterday at the Doc's office was a 9! I had a Trab in the right eye last spring and the pressure there has remained steady at 5/6. I know I will have to get a Trab in the left eye eventually but thought I would pass along that combo of drugs and the pressure reading.
Thankyou for bringing this site to our attention.
I've signed up for their newsletter too, so that I don't miss anything!
Joyce
Thanks Dr. Ritch,
many fascinating topics in this Update.
As I daily eat one or two Brazil nuts to obtain selenium
[which earlier studies indicated may help prevent cancer]
I found Summary #44958
which tells us that selenium could offer
cognitive benefits to be of particular interest.
-- Jim Griffin
Forest Hills, NY
Hi Mee,
If you have already been diagnosed with NTG, that implies that you
have some optic nerve damage already. Did your doctor explain that to
you? You can have nerve damage before you notice significant vision
loss. Once you notice the vision loss, the nerve damage will have
progressed even further. Optic nerve damage is thought to be
irreversible (in the conventional medical view). In addition to that,
there is evidence that the nerve damage of glaucoma is associated
with undesirable changes in the brain (the lateral geniculate nucleus
shrinks).
Don't you think your IOP would go back up to 21 or 22 without the
Xalatan? The effect of Xalatan only lasts about a day, so without the
eye drops what would keep your IOP from returning to where it was a
year ago?
Since you have NTG, that implies to me (a lay person) that your body
may have inadequate defenses against free radicals or other
neurotoxins. (From an Ayurvedic medicine perspective, you could have
an imbalance -- probably Vata -- that affects your whole body.) I
think it is reasonable to assume that the factors underlying NTG may
also affect other systems in your body. I think it might be in your
best interest to do more (antioxidants) rather than less (stop the
drops). I hope my opinion helps. Be careful and listen to a glaucoma
specialist.
David
http://fiteyes.com/blogs/dave/
My step-son's on Lyrica for his seizures (as well as Keppra and Zonegran).
It's helped, but they're still uncontrolled. He's been gaining weight with
the Lyrica but hasn't had any vision problems.
He's one of "those" people who have naturally low IOP - it's only about 10
or 12 when he gets his eyes checked! He sees the same ophth as I do so I
know he's getting a good eye exam. His blood pressure is healthfully low
also - about 110/70.
Other than that, I don't know about Lyrica and the eyes. I think as long as
your ophth watches you closely, it's worth a try, esp if it works. I
certainly would give her a call and ask. The pharmacist is good at helping
you with drug reactions, interactions and side effects, but only your ophth
knows your eyes and whether or not using Lyrica should be a problem.
I hate pain and pills too - you have my deepest empathy.
Sherry
I'm a chronic pain patient too, and see a bunch of nurses instead of a real doctor. He's into money patients and has no time for me. Money ones are the ones who require injections. I'm leery about how these ladies prescribe, considering they're not doctors. I was given a prescription for Lyrica, which is for nerve pain. I tried one pill and my vision was more blurry than usual.
One of the side effects is blurry vision. I asked my pharmacist and he said my eye doctor would be watching me, so it would be ok for me to take Lyrica. That's a really intelligent opinion. I don't see her until April. Should I just call and ask her directly or try a few more pills? Anyone taking Lyrica? Thanks for any information. I'm so tired of drugs as you can tell. Joan
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Hi Mee,
With Normal Tension Glaucoma one can have optic nerve damage at
any number. I have NTG and my IOP usually tests about 12. My optic
nerve has not been showing further damage so 12 can be a good number.
I have been told IOP cannot go below 5 or 6 as you then would not have
enough pressure for the eye to hold its shape.
I take Cosopt 2x a day and Lumigan 1x a day to bring my IOP down from
its normal number of about 20 to about 12.
Every best wish,
Jim Griffin
Mary, I wrote a response just for you: How to Measure Your Intraocular Pressure At Home . Of course, this is intended for anyone and everyone interested in monitoring their IOP.
I would really appreciate it if everyone would read this and then give me some feedback about the idea I propose. To leave comments on my blog you have to register (join). However, joining is quick, simple, free and you will not receive any spam after you join.
If you need more info about tonometers after reading my blog article, please let me know and I'll try to update the article based on your feedback.
David
http://fiteyes.com/blogs/dave/
I have been catching up on all of the posts since my last visit. I
have noticed in the posts a number of medications named including
Travatan but not Travatan Z. Supposedly, it is more gentle on the
cornea than some other drops including Travatan. Since I have a long
history of allergies, he thought this would be better for me.
Has anyone had experience with Travatan Z? The only side effects I am
experiencing is my eye feels dry and sometimes like something is in
it. My eye has not changed color and I do not see any redness. I am
only putting drops in my right eye at this time so I have an easy
comparison looking at the left, untreated eye.
I will be seeing my doctor for the first time since starting treatment
on January 24th. Like Mel, I am hoping for some sign of improvement.
Kathy
I don't suppose you can elaborate on that? What sort of problems do
you have with it?
David
Yesterday I had an interesting personal experience related to this discussion. I had a stomach virus and I spent several hours lying in bed. This had a dramatic effect on my IOP . It seems that lying down during the day might increase my IOP more than sleeping at night. If you are interested in more details, I posted a lot of info on my blog (click the link above).
Since I don't have NTG, my experience raises the question of whether postural changes might be important in other forms of glaucoma as well.
David
http://fiteyes.com/blogs/dave/
Dora,
Thank you. This is a beautiful message. Can I post it on my blog for
others to read? (I would also be happy to set up a blog for you so you
have your own personal place to publish your glaucoma story, if you wish.)
One experience I have been having lately is a feeling of appreciation
for my glaucoma. I emailed Joyce a while back and told her that, "I
feel like the glaucoma has been a blessing for me. It is teaching me
some wonderful things, and I'm becoming a better person because of it.
I'm happy to have it actually because glaucoma is helping me find a
greater sense of inner peace" and it is helping me grow as a person.
I almost feel guilty for being so happy when so many others with
glaucoma are suffering so much anguish. Therefore, I often hesitate to
share my positive feelings. However, Rosalie and Joyce have helped me
appreciate the value of sharing positive feelings like this.
Therefore, I'll try to do more of that in the future.
Not only do I feel glaucoma has been a blessing for me, I am also
having a lot of fun with the IOP research project (case history) I'm
doing on my blog. I don't know anyone else having so much fun with
their glaucoma. (My next challenge is to stop feeling guilty when I
mention in public forums all the good things I'm getting out of my
glaucoma experience.)
"It's all good," as World Champion motorcycle racer Nicky Hayden often
says in the face of obstacles.
Regards,
David
http://fiteyes.com/blogs/dave/
I had a huge iridectomy when I was 9 years old - Not sure if I have ever
become used to it! Carol
Is it available on tape or CD?
Thank you for this most beautiful email that serves to remind me of all that I have to be grateful for and to let go of fear and any anger that might be there. You have done me a great service!
How right you are Mel!
I find my IOP's are down when I cultivate a don't care attitude or
when I am depressed, also I'm pleased to say when I have been at the
computer for a while, in bright light.
What time of day did you get measured?
My IOP's are highest when I first get up and lowest at night.
Joyce
I'm wondering if anyone on the board has had an iridectomy. For some reason my
doctor did an iridectomy when he did the trab. Now my eye is extremely
sensitive to light, so much so that I can't bear being outside even with two
pairs of sunglasses. It's been three weeks since the operation so the doc
doesn't think the eye will do much more dilating, and says he's hoping I'll get
used to it. Does anyone else have experience with thsi kind of thing?
David
Cockeyed, by Ryan Knighton, Public Affairs, NY, 2006. Autobiography of a
young guy going blind from retinitis pigmentosa. Really well written. Funny.
Reminds me of P.J. O'Rourke. I highly recommend.
R
Robert Ritch, MD
Professor of Clinical Ophthalmology
Chief, Glaucoma Service
Surgeon Director
The New York Eye and Ear Infirmary
310 East 14th Street
New York, NY 10003
Medical Director and
Chairman, Scientific Advisory Board
The Glaucoma Foundation
Private - Tel: 212-673-5140
Director of Intelligence: Karen Cheifetz
kcheifetz@...
Patient Appointments - Tel: 212-477-7540
Fax: 212-420-8743
e-mail: ritchmd@...
http://www.glaucoma.net
http://www.nyee.edu
Whenever I'm having a bad day and the fear of living in darkness the
rest of my life overcomes me, I think of all the children born blind.
All those who never saw a human face, who never saw a sunrise, who
never saw a sunset. Who never saw what beauty the world has to offer,
yet somehow they overcome their disability and most lead wonderful
lives. Like Ray Charles who was blind by the age of seven, and Stevie
Wonder who was always blind. I'm 42 now but there is a possibilty that
I could be blind by 50, nobody really knows. What I do know however is
that glaucoma gave me a gift of not taking things for granted for not
only looking at things but really seeing them. I notice detail that I
would never have noticed before. Colours seem brighter, people seem
more beautiful,animals are more fascinating and the world seems more
amazing.
I have been fortunate enough to have learnt so much through my sight,
to have fallen in love, to marry and to produce two beautiful children.
Maybe glaucoma can erase the possiblity of seeing again in the future
but it cannot erase my memory, those images are with me
forever...............
Dora
Hi Roger,
Sorry you are having redness too. I guess with Alphagan P, at least I
have white eyes for a while--trying to look on the bright side =)
Mel
Hi everyone,
Thanks to all of you who took the time to answer my question about
redness and eye drops. I saw my doc today, and he believes the
redness is no more than is typical with Alphagan P, and is not
indicative of an allergic response.
The somewhat disappointing news is my pressures did not come down
much. They were 22/23 and are now 19/21. He is taking the next
reading in one month at a different time of day, and if they are not
down, (or go up), I will be switched to something else.
My doc is very patient--I went in armed with a very long list of
questions, and he answered them all. He also told me I could stop
Alphagan P immediately, but he would like to give it another month
before deciding it wouldn't work--but left the choice to me. I
decided to stick with Alphagan P to see if another month (and the
time of day the pressures are taken) makes a difference. At least I
will have given it a fair trial before giving up on it.
I purchased an exercise bike, and when the weather is warmer I will
add walking to see if exercise will help lower my IOP. I am making
modifications to my diet. Ginkgo biloba made me nauseous, so that is
out. I know some believe caffeine causes fluctuations in IOP, but I
seldom drink it. I sleep with my head elevated, and don't drink too
much fluid in one sitting. I do punctal occlusion with my drops. This
is a rather long way of saying I am doing everything I can do. I only
need to nix the worrying.
Have a great weekend everyone--your support means a lot! And I will
gladly provide the same in whatever way I can =)
Mel
Dear Mel.
It can be intimidating for me to decide whether my questions are worth asking the doctor.
I have learned to err on the side of asking too much.
I would rather be told that my reactions are okay than guessing whether the weirdness is okay or not.
It isn't always easy to know what is critical and what is not.
Prior to having a trabeculectomy, I was on lumigan for a long time and my eye got VERY red and the doctor actually took photos for her collection. I eventually developed a serious allergic reaction and was switched to xalatan which was milder and kinder. Neither actually lowered the pressure so it was all a waste but most people do eventually find drops or a combination that works for them.
It isn't babyish to ask questions.
Sari
Sari,
Thanks for your very informative email. It is reassuring. I have not heard yet
when they are going to schedule the procedure.
Grace
Been there. Had that. I was upset at first but calmed down and had the laser iridotomy (I think that's what it's called).
I was surprised also that you can have both. I also learned that it is a subjective diagnostic call. A judgement call. I saw at least 4 doctors who didn't get worked up about the narrowness of my angle.
The doctor that diagnosed it explained it to me. Seems the shape of your eye is not a static thing. The iris can flatten- iris plateau (?) and then they do this procedure. She explained that the procedure doesn't have any side effects except for what it is intended to do- prevent me from have an attack of narrow angle glaucoma. The hole they make in the iris doesn't always stay open and then they do it again.
I'd forgotten about all this and your letter reminded me. Funny how things that once seemed major get shrunk by the next procedure they do.
She was also surprised that none of the other experts I had seen diagnosed it but after watching it for awhile and doing the gonioscopy over and over, she decided to go for it.
The procedure itself is relatively easy. It is uncomfortable to have the lens (or some part of the equipment) pushing on your eye but it is over really quickly and I felt pretty much fine afterwards.
I asked a few times afterwards if the hole was still open but she hasn't followed up on it much. I stopped asking.
She called it an "innocent" procedure which is her way of saying that I shouldn't get worked up about because there is very little risk involved.
Good luck with it.
Sari
Hello Mel,
I use cosopt and travatin and my eye (I only have
glaucoma in my left eye) always gets red.
Roger
Hi everyone,
I am going to see my eye doc for a pressure check on Friday. I was
diagnosed last month so this is my first check since the diagnosis. I
am on Alphagan P.
When I first use the drops, my eyes get white. I understand this is
because of "conjunctival blanching", a side effect of Alphagan P. But
by the time the next dose comes up, my tear ducts and the rims of my
eyes are very bright red. It frightened me when I saw how red they
were tonight. Put the drops in, away goes the red. For a while...I
also have white streaks down my cheeks from where the drops hit my
skin a few times. I found an article that talks about this:
http://bjo.bmj.com/cgi/content/full/84/6/667e
Since I have never used other drops, I wonder...is this type of thing
common to all drops and something I will have to put up with, or
should my doc be told? I don't want to be a baby about it; I know the
drops beat the alternative. I also know all drops have potential side
effects.
The problem is I take an oral beta blocker, and am allergic to sulfa--
so there aren't many options I guess. What should I do and should I
be scared that my options are so limited?
Mel
My primary care physician wants me to start using:
a. a statin such as Lipitor (the specific drug depends on what my medical insurance will cover)
and
b. Boniva or Fosamax for osteoporosis.
I have an appointment with my opthalmologist next week for my regular pressure check,
and I am going to ask her if there is any reason I should not take these.
I'll let you know what she says.
I guess what makes me nervous is that things have been so stable up to now, and I don't
want to do anything to upset things: but sometimes it can be necessary.
Laurie
Hi Grace,
I have advanced narrow angle glaucoma. It's worse in my right eye then my left and I've lost a lot of my vision in my right eye already and depend mostly on my left eye. I had the laser done on both eyes a couple of months ago. It's not as bad as I thought it was going to be... I was extremely nervous. The worse part of it for me was that I reacted to the drops they put in my eyes... they caused a bad and vomiting. Other than that the surgery was not painful at all and you do not bruise. In fact, after I got over the headache and vomiting a few hours later my eye felt a little scratchy. By the next day I was fine as if nothing ever happened. My pressure was at 31 and 28 after the surgery it's gone down to 21 and 19, which have been the lowest so far. Unfortunately I've had a lot of damage to my optic nerve from the pressure being so high for so long. If I had not had it checked out when I did, the doctor said I would have gone blind within the next 3 to six month of
my examination. Don't worry it should work. It worked good for me. Good luck, please keep me posted as to what happens with you.
Liz
I have been treated for glaucoma now for a few years - have tried all kinds of
drops, but none seem to work. Yesterday, my pressures were up to 30 and 28. My
optic nerve over the years has shown very litle change, but with new photos, the
doctor said there was a slight change now. My doctor said the angle in my eye
was getting narrower -- I have always had open angle glaucoma, but now it seems
I have narrow angle. Didn't know you could have both???? So I am scheduled to
have a laser done whereby a hole is made in the iris to help the flow. He said
the flow isn't good, and he is hoping that is why my pressures are so high. I
sure do hope this works. QUESTION: Has anyone in the group had a similar
problem???????
Thanks Grace
This Board's past threads can readily be searched.
On the site's main page simply enter a word such as
'cataracts' in the search box.
Over several weeks last year I read all of this Board's
past messages starting from Message No. 1. These
messages are both a great medical resource and a
great source of human interest stories posted
by our fellow Board members.
--- Jim Griffin
Forest Hills, NY
Good question I missed the conersation too if it has been discussed because I
have Open Angle Glaucoma and cataracts in both eyes I had surgery on the right
eye first but my eye never did heal
opurplelady <opurplelady@...
before but if so I missed it. During
my last visit to have a pressure check , the doctor said I will soon
need to have the cataract removed on my left eye. Does cataract
surgery have any effect on the Glaucoma? Just one of the questions I
failed to ask.
Thanks.
Billie
This has probably been discussed before but if so I missed it. During
my last visit to have a pressure check , the doctor said I will soon
need to have the cataract removed on my left eye. Does cataract
surgery have any effect on the Glaucoma? Just one of the questions I
failed to ask.
Thanks.
Billie
According to the news report this is very early in the process.
Cheryl
Stem-Winding Study
By TIM ANNETT
Science and politics never make for comfortable bedfellows, and while a new breakthrough in stem-cell research could help lessen the political drama surrounding the issue, it appears to be far from a cure-all.
Over the weekend, researchers from Harvard University and Wake Forest said that they had found stem cells in amniotic fluid, in a development that may let scientists duck the controversial use of embryonic stem cells. The stem-cell issue, with its resonances in the abortion debate, has proven highly divisive in Washington and around the country. Many voters support the use of stem-cell research to find new therapies for ailments ranging from Parkinson's disease to lymphoma to spinal-cord injuries. But opponents say the use of embryonic stem cells for such research should be forbidden, arguing that the use of the cells is tantamount to the destruction of a potential human life. The scientists said they were able to extract stem cells from amniotic fluid (which provides a cradle for babies in the womb) without doing harm to either the mother or the fetus. The extracted tissue was then grown into several different kinds of cells, including brain, liver and bone tissue.
Scientists cautioned that the research was still in very early stages. Dr. Anthony Atala, the senior researcher on the project, said his team doesn't know exactly how many different cell types can be fashioned from the stem cells discovered in amniotic fluid and even preliminary tests in human subjects are years away. And other scientists said that embryonic cells are still the most promising venue for research. Dr. George Daley of Harvard said the discovery shouldn't forestall embryonic studies. He said the amniotic cells "are not a substitute for human embryonic stem cells, which allow scientists to address a host of other interesting questions in early human development.'' Dr. Robert Lanza, chief scientist at Advanced Cell Technology, said the amniotic cells may not be able to perform as many "tricks" as embryonic cells but added that he thinks "this work represents a giant step forward for stem cell research."
Researchers and patients would like to surmount the political obstacles standing in the way of stem-cell research, but even with Democrats now in control of the Congress, stem-cell advocates may face a tough ride. Last year, President Bush took up the veto pen for the first time in his presidency to quash a bill that would have expanded federal spending on research derived from embryos that were slated for destruction after being created for fertility treatments. (Current federal rules prohibit funding for research from all but a small number of stem-cell lines that existed in 2001.) That bill enjoyed broad bipartisan backing. With Democrats commanding only a slim majority in the Senate and the House, it's uncertain whether they would have the muscle to overturn a veto, even with the help of moderate Republicans. And with a fierce battle over troop levels in Iraq looming, Democrats may be looking to keep their powder dry for other fights.
* * *
Hi Chris,
I can understand how scared you are. I was diagnosed with glaucoma
about a month ago--I am 45.
First, they need to determine that you have it, and the type of
glaucoma you have. If you do, it is likely they will put you on eye
drops to help lower the pressure in your eyes.
Future vision loss is often preventable, and the prognosis for many
types of glaucoma is quite good. There are people who have been here
much longer than I have, and Sherry (the board's moderator) will be
able to give you better info than I can. I just wanted you to know
someone else is almost exactly where you are, and that if you are
found to have glaucoma, there is treatment!
There is also support--the members of this group have been wonderful
to me. Hang in there =)
Mel
dont be scared, there are lots of really good people on this site who will help you and give you all the
support you need. Ask lots of questions... the wills website is really good with lots of info. I was only 38
when i was diagnosed, i am 41 now and i have no damage, mine was caught early and i have a really
good specailist who keeps a close eye on me, i would like to think that because of this i have avoided
alot of damage. You need to stick to any eye drop regiemes that they give you as this keeps pressures
down and so helps to prevent damage. Any worries at all , no matter how daft it may seem to you, ask
these guys here they are great and extremely helpful, and there is usually someone who has been through
whatever you may be going through. Good luck and keep your chin up.
sandra
I have never been more scared in my life! I am 49 went to get some new
computer glasses just a "routine" exam and then the doc comes in and
says my iop is high and does this other test and numbs my eyes and
sticks this pen like thing in my eye and says my numbers are high 29
and 31. Says he is concerned I could have glaucoma and needs me to go
to a specialist. I am at this point freaking out. I thought I was to
young for such a thing. So here I am and awaiting my appointment and
looking for some encouragement. If this has been caught soon enough an
with treatment can vision loss be avoided? How long before this happens
if it does? I am so scared...
Thanks again to Dr. Ritch:
Highlights of Recent Progress
[http://www.nei.nih.gov/strategicplanning/]
Over the past 5 years, results from three major clinical trials confirmed the value of reducing IOP in patients with ocular hypertension or glaucoma to prevent the onset of glaucoma in the former case and the progression of disease in the latter. The Ocular Hypertension Treatment Study (OHTS) noted that lowering IOP at least 20 percent produced a 50 percent protective benefit over baseline among those individuals who had elevated IOP without optic disc or visual field deterioration. The Early Manifest Glaucoma Trial determined that patients with newly diagnosed glaucoma progressed less often than untreated patients when IOP was reduced at least 20 percent compared with baseline. The Collaborative Initial Glaucoma Treatment Study demonstrated that patients with glaucoma who undergo either medical or surgical therapy were equally likely to avoid progression of disease after 5 years of followup.
Analyses of key baseline, clinically important factors among ocular hypertensive patients enrolled in the OHTS uncovered or affirmed a number of risk factors for the development of glaucomatous damage, including IOP, large cup-to-disc ratio, age, and central corneal thickness.
Significant advances in identifying glaucoma-causing or associated genes have been made with the mapping of more than a dozen glaucoma loci and the cloning of more than a half dozen glaucoma genes. New studies involving genome-wide screening are beginning to identify alleles that may play a combinatorial role in complex POAG. Identification of trabecular meshwork glucocorticoid response/myocilin, optineurin, cytochrome P450 1B1 (CYP1B1), and other genes that play a less prominent role in disease causation promises a better understanding of normal eye development and of the molecular pathophysiology of glaucoma in general. The application of genomic technologies has provided an ever-enlarging database of genes/proteins expressed in various anterior segment tissues. Having a rich supply of candidate genes will speed the search for new genes involved in glaucoma pathogenesis.
The introduction of a number of rodent models, both genetic mouse and induced ocular hypertension rat models, has expanded the ability to investigate mechanisms at the molecular and systems levels. One exciting new development in the field of congenital glaucoma is the recent report that tyrosinase modifies the glaucoma phenotype in the CYP1B1 knockout mouse. Significantly, this work supports findings that modifier genes play a role in the etiology of congenital glaucoma in children. Other models have allowed the evaluation of pharmacological approaches that target neurodegenerative processes.
Over the past 5 years, candidates for molecular mediators of the pathophysiology of glaucoma have been identified. This list includes a number of second messengers, stress response proteins, immunologic proteins, and transcription factors. Myocilin was one of the first proteins to be associated with glaucoma. Much progress has been made on the characterization of myocilin, including an improved understanding of the differences in biochemical and cell biological characteristics between disease-causing and benign forms of the protein.
New applications of technologies, such as the flash and multifocal electroretinogram and multifocal visual evoked potential, allow objective assessment of inner retina functioning in nonhuman animal models as well as in humans. Outcomes of both functional and histologic studies point to a pathological process that does not discriminate between subsets of ganglion cells and involves changes in the glial cells and retinal ganglion cell axons within the optic nerve head, as well as in the dendrites and somas of the retinal ganglion cells in the retina.
Development of new and existing instrumentation for quantification of the retina, retinal nerve fiber layer, and optic nerve head surface has allowed substantial improvement in the clinical detection of structural damage. Algorithms for sensitive and specific screening (detecting glaucomatous damage) and change detection (monitoring glaucomatous progression) are approaching clinical usefulness for several of these instruments.
Program Objectives
* Elucidate the prevalence, pathophysiology, natural history, and history of intervention results of optic neuropathies such as glaucoma and optic neuritis over the full time course of these diseases and within ethnic subgroups.
* Develop improved diagnostic measures to detect optic nerve disease onset, progression, and treatment effectiveness, including development and validation of predictive genetic testing.
* Develop novel therapeutic approaches to optic neuropathies, including stem cell therapy, gene therapy, vaccination, and other neuroprotective strategies, and develop safe and effective surgical procedures, pharmaceuticals, and delivery systems for treatment.
* Continue mapping genetic loci contributing to diseases of the optic nerve, with expanded efforts to enlarge the base of well-characterized patient collections. Exploit new paradigms to explore gene-environment interactions.
* Identify and characterize the genes, gene products, developmental regulatory signals, and pathways responsible for disease of the optic nerve; modulation of their phenotypes; and variable treatment responses using gene mapping, genotype/phenotype studies, animal models, gene expression profiling, and proteomics.
* Determine the mechanisms of optic nerve damage and retinal ganglion cell loss and survival in optic nerve diseases such as glaucoma, as well as their functional correlates. Characterize glaucomatous neurodegeneration and other optic neuropathies within the entire visual pathway at the cellular, structural, and functional levels.
* Develop transgenic and other genetic animal models of optic nerve disease, with emphasis on the principal clinical subtypes of glaucoma (especially open-angle glaucoma), that display key disease features such as optic nerve head cupping and ischemia, retinal ganglion cell loss, and increased IOP.
* Enhance understanding of the structure and function of the aqueous humor outflow pathways at the cellular and molecular levels.
* Exploit genomics and proteomics, as well as cellular and molecular methodologies, to further characterize the response of the optic nerve and optic nerve head to a variety of physiologic and pathophysiologic perturbations.
* Develop a comprehensive bioinformatics infrastructure that will integrate and coordinate all genetic, genomic, and proteomic databases, as well as data on animal models that are important for the development of the eye and visual functions. A website with these databases will be the primary vehicle for rapidly disseminating information and making these tools and reagents available to the research community.
I think that's a common reaction. I usually get a headache later in
the day after dilation. I don't know whether it's from the drops
themselves or the increase in light; I've always assumed it was from
the light and also straining to see, since while my eyes are dilated
everything is a bit blurry.
-Deah
Yes - I get headaches and feel a bit shaky after my eyes have been dilated - Carol
Add me to your address book...
Want a signature like this?
International Council of Ophthalmology
ICO Leader Letter:
Curricula for Ophthalmic Education Published
January 2007, Volume 4, Number 1 In This Issue: 1. Thanks and Happy New Year <#a1
Bruce
Spivey, MD
International Council of Ophthalmology (ICO) Director for Education Mark Tso, MD, reports below on publication of the four ICO curricula for ophthalmic education, which is the culmination of a huge amount of work by many individuals, dating back to 2001.
On behalf of the Council, I would particularly like to thank Mark and the lead authors and editors for each curriculum:
* Mort Goldberg, MD, and Andrew Lee, MD (residency education)
* Richard Parrish, MD (medical student education)
* Sivaguru Selvarajah, FRCS, FRCOphth, FACS (education of para-professionals)
* Zbigniew Zagorski, MD (continuing medical education).
As we begin the new year, I also want to recognize the members of the Council and its Advisory Committee and all of the others who contribute to international ophthalmology and the ICO in so many ways.
With your participation and help, we achieved a remarkable amount in 2006. I look forward to working with you in 2007 to do even more to enhance ophthalmic education, improve access to eye care and preserve and restore vision for the people of the world.
A happy, healthy and productive New Year to all!
- Bruce Spivey, MD, ICO President
2. Publication of ICO Curricula For Ophthalmic Education
<http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846450&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurricres%2epdf&g=0&f=-1
The German journal Klinischen Monatsblätter für Augenheilkunde has published the ICO's four international curricula for ophthalmic education as supplements to its November issue.
ICO Secretary General Jean-Jacques De Laey, MD, has mailed copies of the supplements to each member of the International Federation of Ophthalmological Societies (IFOS), and they can also be downloaded from the ICO Web site:
* Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist (www.icoph.org/pdf/icocurricres.pdf <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846450&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurricres%2epdf&g=0&f=-1
*
*
* Principles and Guidelines of a Curriculum for Ophthalmic Education of Medical Students (www.icoph.org/pdf/icocurricmed.pdf <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846448&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurricmed%2epdf&g=0&f=-1
*
*
* Principles and Guidelines of Curriculum for Para-ophthalmic Vision Specialist Education (www.icoph.org/pdf/icocurricpara.pdf <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846449&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurricpara%2epdf&g=0&f=-1
*
*
* Principles and Guidelines of a Curriculum for Continuing Medical Education in Ophthalmology (www.icoph.org/pdf/icocurriccme.pdf <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846447&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurriccme%2epdf&g=0&f=-1
- Mark Tso, MD, ICO Director for Education
3. Focus on Adaptation and Use of Curricula
Mark Tso,
MD
With publication of the four curricula, the focus of our international education task forces now turns to promoting and facilitating adaptation of the curricula by ophthalmologic societies and training programs and their use around the world to enhance ophthalmic education.
Earlier this month, the Executive Committee of the Turkish Board of Ophthalmology decided to translate the ICO curriculum for residency education and adopt it with changes to reflect local considerations.
The Mexican Board of Ophthalmology has used the ICO curriculum for residency training to develop consensus on the competencies that the graduates of training programs in Mexico should have.
Council Member Enrique Graue, MD, who is President of the Pan-American Association of Ophthalmology, translated an earlier version of residency curriculum into Spanish, and that's available from www.icoph.org/pdf/icocurricressp.pdf <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846451&u=http%3a%2f%2fwww%2eicoph%2eorg%2fpdf%2ficocurricressp%2epdf&g=0&f=-1
It would be very helpful for our task forces to learn:
* How the curricula are being adapted in other countries
* What we could do to help you use them to enhance ophthalmic education.
You can contact me at education@... <mailto:education@...
- Mark Tso, MD, ICO Director for Education
4. Five Supranational Society Congresses in 2007
2007 is the year for supranational ophthalmologic society congresses. Here's the schedule:
* February 24 - 28: Asia Pacific Academy of Ophthalmology, Lahore, Pakistan (www.apao2007.com <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846431&u=http%3a%2f%2fwww%2eapao2007%2ecom&g=0&f=-1
* March 29 - April 1: Middle-East African Council of Ophthalmology (MEACO, formerly the Pan-Arab African Council of Ophthalmology), Dubai, United Arab Emirates (www.meaco.org <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846453&u=http%3a%2f%2fwww%2emeaco%2eorg&g=0&f=-1
* May 31 - June 3: Pan-American Association of Ophthalmology, Cancun, Mexico (www.apaocancun.org.mx <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846432&u=http%3a%2f%2fwww%2eapaocancun%2eorg%2emx&g=0&f=-1
* June 9 - 12: European Society of Ophthalmology (SOE), Vienna, Austria (www.soe2007.org <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846454&u=http%3a%2f%2fwww%2esoe2007%2eorg&g=0&f=-1
* June 20 - 25: Afro-Asian Council of Ophthalmology, Marrakech, Morocco: (www.aaco2007.org <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846430&u=http%3a%2f%2fwww%2eaaco2007%2eorg&g=0&f=-1
- Jean-Jacques De Laey, MD, ICO Secretary General
5. January 31 Deadline To Apply for the Assessments
Peter
Watson,
FRCS,
FRCOphth
A reminder that January 31 is the deadline for candidates to apply to take the ICO International Basic Science Assessment in Ophthalmology and the Clinical Sciences Assessment in 2007. The Assessments will be offered on April 12 at centers around the world.
The ICO organizes these examinations to help ophthalmologists and ophthalmologists-in-training evaluate and demonstrate their knowledge in the basic and clinical sciences related to ophthalmology.
Since 1995, more than 12,000 candidates have taken the Assessments, including more than 1530 who enrolled for the exams in 2006 at 92 test centers in 61 countries.
Those interested in applying should contact the Assessments Office at assess@... <mailto:assess@...
- Peter Watson, FRCS, FRCOphth, ICO Director for Assessments
6. IFOS Application Deadline Is January 31
Jean-Jacques De Laey, MD
Two subspecialty societies have applied for membership in the International Federation of Ophthalmological Societies (IFOS), and several others have let us know they intend to apply.
The American Association for Pediatric Ophthalmology and Strabismus and Club Jules Gonin have applied for IFOS membership. We appreciate their desire to participate and look forward to welcoming them officially as IFOS Members after the ICO votes when it meets in March in Cape Town.
IFOS membership applications must be submitted by January 31 for consideration by the Council this year.
Last February, the Council approved 17 international subspecialty societies and related groups and five national societies for membership (see www.icoph.org/soc/index.html#subspec <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846452&u=http%3a%2f%2fwww%2eicoph%2eorg%2fsoc%2findex%2ehtml%23subspec&g=0&f=-1
For more on the benefits of membership in IFOS and applications forms, see www.icoph.org/apply <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846435&u=http%3a%2f%2fwww%2eicoph%2eorg%2fapply&g=0&f=-1
- Jean-Jacques De Laey, MD, ICO Secretary General
7. Next ICO and IFOS Meetings and World Ophthalmology Congress (WOC)
* International Council of Ophthalmology: March 23, 2007, Cape Town, South Africa
* WOC: June 28 - July 2, 2008 in Hong Kong (www.woc2008hongkong.org <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846455&u=http%3a%2f%2fwww%2ewoc2008hongkong%2eorg&g=0&f=-1
* IFOS General Assembly: June 28 or 29, 2008, during during the World Ophthalmology Congress in Hong Kong
Other future ICO/IFOS Meetings: www.icoph.org/lead/icomeet.html <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846442&u=http%3a%2f%2fwww%2eicoph%2eorg%2flead%2ficomeet%2ehtml&g=0&f=-1
8. Coming in the February ICO Leader Letter:
Ophthalmologic Society Web Sites
9. More News
For more news of the ICO and international ophthalmology and resources for ophthalmologic leaders, see the ICO's Eye Site at www.icoph.org <http://cmpgnr.com/r.html?c=862712&r=861969&t=526365899&l=1&d=87846434&u=http%3a%2f%2fwww%2eicoph%2eorg%2f&g=0&f=-1
10. Request for Other News and Resources
Do you have other news of international ophthalmology or know resources (particularly on the Web) that would be valuable to society leaders? Please let us know at leader@... <mailto:leader@...
11. Comments, Change of Address, Privacy Policy, Subscribe and Unsubscribe
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Does anyone else experience headache when giving dilating drops at the eye doctor office?
I don't experience this all the time, but when I do, what I feel is a dull aching headache,
as well as mild nausea: I also am subject to headaches (unrelated to dilating drops) that have not officially
been diagnosed as migraines, but seem similar, and the headache from the drops feels like a milder version of this.
This makes me dislike being dilated.
I am wondering if it isn't the drops per se, but perhaps that the drops initiate a headache trigger?
Maybe the sudden increase in light into my eyes under dilation?
Sometimes I take a painkiller before going to the doctor and it seems to work.
Laurie
You might be interested in reading some of the posts on my blog about
tonometers and IOP here: http://fiteyes.com/blogs/dave/
It has been very worthwhile for me to have my intraocular pressure
checked very frequently during everyday life situations.
I have found that stress increases my IOP and that there are simple
things I can do to lower my IOP. Maybe you'll find similar things work
for you too.
David
http://fiteyes.com/blogs/dave/
Just wonder whether those who have dry eyes no longer have any tears.
So do old people all have dry eyes because they rarely have tears when they weep.
Schepens Eye Research Institute has a good article on dry eye at
http://www.schepens.harvard.edu/dry_eye_fact_sheet.htm
Yes, the problem does increase with age. My Dad's been afflicted with the
problem for years and the lubricant drops aren't always effective.
Sherry
Hi Linda,
That depends on what your pressures have been running all along and
whether it is winter where you live.
During the winter, more hours of darkness, your IOP will be slightly
higher.
Mine were running 10 to 12 and now they are 16. It is winter here
with about 9 hours of light per day.
RK
Lumigan gave me VERY dark circles around my eyes but when I switched to Xalatan, I believe things lightened up.
One of the positive side effects of the deterioration in my right eye is that I don't notice these things as much. ;-)
I don't remember if I ever sent in an update on my dry eye problem. It is worth repeating if I did.
I patched my eye on the 12 hour flight and had no problem with dry eye when I landed. Big relief since it took me a week to get rid of it after the first flight.
I now have a solution. I use the new refresh night gel ointment with a patch when the dry eye problem strikes. The drops alone didn't help at all and the ointment without the patch ditto.
I got the doctor's permission to use the occluding patch even though he was convinced that I wouldn't need it.
So I recommend these solution to anyone who is battling dry eye post trab. It seems to be helping lessen the frequency of the dry eye too and I haven't needed to use anything for the past two weeks. Hurrah.
Happy 2007
Sari
Hi, I just joined this group, and I have a question. I am 42 years
old, and my father was diagnosed with glaucoma when he was in his late
30's. When I was 18 my opthomoligist noticed I had enlarged cups at my
optic nerves in both eyes, and I have been closely monitored eversince,
and never had any changes in them.
Last week, my normal doctor (a glaucoma specialist) was on vacation, so
I saw the another opthomoligist in his office. I had an OCD, and a
small change was noted in my left eye. My pressure was 17 in each eye,
and my visual field test was normal and no other changes. The other
opthomoligist (who is not a glaucoma specialist) said don't worry, we
will just see you in another year.
So, my question is, should I insist that my normal opthomoligist take a
look and determine if any sort of treatment should be started or not,
or should I not worry since my visual field test was normal and my
pressure is within the normal range?
Thanks,
Linda
You might find my own experiences with postural changes and IOP
interesting.
I posted my story on my blog here:
http://fiteyes.com/blogs/dave/2006/12/16/Postural-Changes-and-IOP
I am also posting my visual field tests, GDx tests, Heidelberg tests,
fundus photos, IOP data and my other glaucoma-related information on
my blog.
Regards,
David
http://fiteyes.com/blogs/dave/
Hypotension is certainly a risk factor for NTG.
There's a really interesting chat on NTG at the Wills site:
"P: Are there any known causes for NTG?
Dr. Rick Wilson: NTG may well be a wastebasket term for different optic
nerve diseases that cause the typical kind of glaucoma damage. Decreased
circulation to the eye, usually systemically, often has been linked to NTG.
Low blood pressure throughout the body makes it harder for the heart to pump
blood into the eye against the IOP and can cause NTG. Low blood pressure
during the sleeping hours (nocturnal hypotension) has also been linked to
NTG.
"P: When is blood pressure the lowest, and does that affect IOP?
Dr. Rick Wilson: There is a diurnal curve of blood pressure similar to the
diurnal curve of IOP. As with eye pressure, the blood pressure is at its
lowest during the early morning hours. In patients with hypertension (high
blood pressure), the lowest pressures are between 2:00 and 4:00 a.m.
Two-thirds of the normal population will have a blood pressure drop of
greater than 10% during that period. These people are termed "dippers."
"Patients with systemic hypertension usually show evidence of a much greater
swing in systolic and diastolic blood pressure, with an average drop in
pressure of 26% from day to night. Hypertensives treated with beta blockers
can have diastolic blood pressures during sleep of 50 mmHg or less and
rarely down to 30 mmHg or less. An abnormally deep dip in pressure may
compromise local vascular supply. Dr. Stephen Drance found a much higher
incidence of POAG (primary open-angle glaucoma) progression among dippers
than among non-dippers."
http://www.willsglaucoma.org/supportgroup/20060621.htm
(hmm.... wonder if I'm a dipper? - my blood pressure is usually higher
during the day than my doc would like it to be in spite of being on three
meds for it!)
Sherry
Thanks so much for posting this RK. I just bought two bottles last
night, and haven't used them yet. Mine are the ones affected by the
recall, Systane Free Liquid Gel. I don't like the others with the
preservatives, so I might take these to the store for a refund
instead of a replacement. I guess I'll try another brand.
Mel
Shirley,
What kind of surgery are you going to have? There are a lot of different
types of glaucoma surgery.
Thanks for using Legacy.
Sherry
Customer Support
Millennia Corporation
Support@...
http://www.LegacyFamilyTree.com
We are changing the world of genealogy!
When replying to this message, please include all previous correspondence.
Thanks.
After rereading this I wonder if this has to do with postural hypotension??? I have that. When I switch from a lying to a sitting position in bed I get dizzy if I move too fast because of postural hypotension. Since sleeping with my head elevated I haven't had those symptoms as much.
RK
Thanks Dr. Ritch for the
December 20, 2006 issue of NEW JOURNAL STUDIES
You continue to provide us with fascinating and useful information.
"The progression of visual field damage in NTG is associated with IOP in the supine position
and the magnitude of IOP elevation accompanying postural changes. These results suggest that
deterioration in NTG may occur when patients are lying flat during sleep.
I am going to have to have surgery and I wan wondering if someone could
tell me about their experience that they have gone through. Or does
anyone know anything about Glaucoma surgery.
Thanks Shirley
Diane,
All the messages ever posted to the group are in the group archives at
Hi, I submitted some topics and have not heard anything plus I do not
know if they are saved some place or whether I should just post to
message board. Would you share some guidance with me?
Diane
Maybe I should be writing messages as opposed to starting
topics...where do I go to see communication on topics that I listed?
Diane
Mary Kay - sounds awful - but it sounds like you are now on the right track. Glad to hear that things have improved. Look after yourself - Carol
I heard there was a recall on Systane Liquid Gel Eye Drops.
RK
Hi all,
Haven't written much lately as I've really been going through a lot lately.
On Devc 19 I had a trab on my left eye. Had the other one done last March.
The right one was holding up until a few months ago when my eye dr. here
noticed the pressure was rising and there was scarring, and the left eye was
out of control with pressures in the 40's. So, I made the trip to the
specialist and he did the left first.
At my follow up appt. the next day he took the bandages off the left eye and
the pressure was still high so he released a stitch. The he talked about
the right eye and we decided to go ahead and get rid of the scar tissue. He
did this right in the office and when I saw him come in the room with a
shot, something told me that wasn't going anywhere except for in my eye. I
was right. He proceeded to work on the scarring, Don't know if this is what
was called needling or not, but, it was....well.....uncomfortable. Had to
go back the next day for another followup appt. I've now got to see all
three of his offices and the closest one to me is still an hour and a half
away. Thank goodness my nephew is so good to me and works for himself.
Felt good to finally sleep in on the Friday after surgery, but when I woke
up, right eye was red. Called Chicago and they called my dr. here and I
ended up going in. I was lucky that my dr. here called the specialist and
they were able to work it out over the phone. Sent me home with some
ointment and I was glad there was no infection. Saturday I woke up with my
right eye completely swollen shut! Called Chicago again and they said use
warm compresses and a different perscription. Christmas Eve morning not
only was my eye swollen, but the swelling had gone into my cheek and
forehead. Yup, you guessed it...called specialist and he wanted to meet me
in the office. So, over the river and through the Dan Ryan we went. Ended
up being a severe reaction to the ointments. He said if had been an
infection I would be spending Christmas in the hospital. He also lasered a
stitch out as the pressure in my left eye was still really high. After that
the pressure in both eyes went down to a level he was happy with. I was
doctor free on Christmas but at my appt. yesterday, he said I've begun to
turn the corner as the pressure in both eyes was great!!!
I'm keeping my fingers crossed that in the new year I'll be able to 'see'
things in a new light. I've got to find a place to live as I've lived with
my mother and since her death a few weeks ago I'll no longer be able to
afford or keep up as big a place as this is.
Thanks for listening.
Marykay/Illinois
Allergan Norden AB
Allergan Announces FDA Issues Approvable Letter for COMBIGAN(TM) (brimonidine tartrate/timolol maleate ophthalmic solution) 0.2%/0.5%
2006-12-22 08:50
IRVINE, Calif., Dec 21, 2006 (BUSINESS WIRE) -- Allergan Inc. (NYSE:AGN) today announced that the U.S. Food and Drug Administration (FDA) issued an approvable letter for COMBIGAN(TM) (brimonidine tartrate/timolol maleate ophthalmic solution) 0.2%/0.5% for the reduction of elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy due to inadequately controlled IOP. An approvable letter outlines the remaining conditions that a company must meet in order to obtain FDA final marketing approval.
"We remain committed to the program and to working diligently with the FDA on any remaining issues," said Scott M. Whitcup, M.D., Allergan's Executive Vice President, Research and Development. "In its approvable letter, the FDA suggested an additional confirmatory study to address certain questions posed by the Agency. Allergan already commenced a clinical study at the end of 2005 that addresses the remaining FDA questions."
COMBIGAN(TM) includes two agents known to reduce IOP - ALPHAGAN(R) (brimonidine tartrate ophthalmic solution 0.2%) and timolol ophthalmic solution 0.5%, a beta-blocker - in one drop. COMBIGAN(TM) is approved and marketed in Europe, Canada, Brazil and Australia. Glaucoma currently affects approximately three million people in the United States and 65 million people worldwide(1) and is the leading cause of preventable blindness in the United States.(2) Elevated IOP, or pressure inside the eye, represents a major risk factor for vision loss associated with glaucoma; the higher the IOP, the greater the likelihood of optic nerve damage, which can lead to vision loss and potential blindness. Reducing elevated IOP is the only treatable glaucoma risk factor.
About Allergan, Inc.
With more than 55 years of experience providing high-quality, science-based products, Allergan, Inc., with headquarters in Irvine, California, discovers, develops and commercializes products in the ophthalmology, neurosciences, medical dermatology, medical aesthetics, obesity intervention and other specialty markets that deliver value to its customers, satisfy unmet medical needs, and improve patients' lives.
Forward-Looking Statements
This press release contains "forward-looking statements", including the statements by Dr. Scott Whitcup and other statements regarding the potential FDA approval of COMBIGAN(TM) and the potential outcome of ongoing studies of COMBIGAN(TM). These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or unknown risks or uncertainties materialize, actual results could vary materially from Allergan's expectations and projections. Risks and uncertainties include, among other things, general industry conditions; challenges inherent in the research and development and regulatory processes; and governmental laws and regulations affecting domestic and foreign operations. Accordingly, Allergan can give no assurance that COMBIGAN(TM) will be approved by the FDA. Additional information concerning these and other risk factors can be found in press releases issued by Allergan, as well as Allergan's public periodic filings with the
Securit ies and Exchange
Commission, including the discussion under the heading "Risk Factors" in Allergan's 2005 Form 10-K for fiscal year 2005 and Allergan's Form 10-Q for the quarter ended September 29, 2006. Copies of Allergan's press releases and additional information about Allergan are available on the World Wide Web at www.allergan.com or you can contact the Allergan Investor Relations Department by calling 1-714-246-4636.
(1) Glaucoma Research Foundation Web Site. "Glaucoma Facts and Stats" http://www.glaucoma.org/learn/glaucoma_facts.html.
(2) The Glaucoma Foundation. "TGF Urges Eye Exams to Detect the Disease Early" January 8, 2006. http://www.glaucomafoundation.org/news_story.php?i=38.
SOURCE: Allergan Inc.
Allergan Contacts
Caroline Van Hove, 714-246-5134 (media)
Heather Katt, 714-246-6224 (media)
Jim Hindman, 714-246-4636 (investors)
Joann Bradley, 714-246-4766 (investors)
Emil Schultz, 714-246-4474 (investors)
Copyright Business Wire 2006
http://www.fda.gov/oc/po/firmrecalls/alcon12_06.html
Alcon announces voluntary recall of Systane free LIQUID GEL Lubricant
Eye Drops in the US and Puerto Rico.
(No other Systane formaulations affected by recall)
Mold was found in the partially used bottles.
Read more about this news release on the above web site.
RK
Thanks Dr. Ritch,
Hope our guests today like
almonds, green tea and red wine and
the other foods these articles suggest
might be beneficial. (I do.)
Every best wish,
we are grateful for all you have shared in 2006,
Jim Griffin
Forest Hills, NY
Re:
Clinical Pearls Nutrition Research Updates for the Week of December 25, 2006
Brought To You By Tishcon Corp., The Makers of Q-Gel®
]=
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From: Vitasearch <vitagram@...
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To: <ritchmd@...
Subject: Weekly Update - December 25, 2006
(Mailing list information, including unsubscription instructions, is located at the end of this message.)
<http://www.vitasearch.com
Clinical Pearls Nutrition Research Updates for the Week of December 25, 2006
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Again, thanks Dr. Ritch for sharing infomation with us.
High dietary intake of vitamins C and E, iron, and zinc is associated with a lower risk for incident AMD,
with a risk reduction of 35%.
There is a dose-response relationship between dietary zinc and vitamin E intake and incident AMD.
--- from Medscape's Top Ophthalmology News of 2006
Hi Sherry,
Thanks so much for all the information. I really needed the eye drop
video, because though I have been getting them in, I have swallowed
small amounts a couple of times. I was pinching on the ducts, and I
now see that is a no-no. I have also spaced drops more than 12 hours
apart (I take Alphagan-P twice a day). I have been putting them in
the fridge, and though it is a jolt at first, it helps me know they
are in my eyes.
I have been concerned by the fact that beta blockers and sulfa drugs
won't work for me, (limiting my options), and I need to ask my doc
about sleeping with my head elevated. I also saw that we are not
supposed to lift heavy things and not drink too much water at once--I
didn't know any of this, so searching this site has been helpful.
It has only been 10 days since the diagnosis, so I am still trying to
stay calm--I imagine that is tough for everyone, even after time
passes.
I checked out the site for web designers, and will make adjustments
if needed with Windows accessibility tools (on my pc). Thanks so much
for the help, and Happy Holidays!
Mel
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From: Medscape's Top News <TopTen@...
Date: Fri, 22 Dec 2006 16:46:33 -0500 (EST)
To: <ritchmd@...
Subject: Top 10 Ophthalmology News Stories of 2006
Medscape's Top Ophthalmology News of 2006 <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HvYM0GA
News <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HvYM0GA
<http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBjN0Gb
Medscape has gathered the most popular news stories of 2006 for your convenience, many with CME credits available. Revisit the most interesting topics of the year in Ophthalmology <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HvYM0GA
Top Ophthalmology News of 2006:
1. High Dietary Antioxidant Intake May Reduce Risk for Age-Related Macular Degeneration CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HGdV0Gh
2. High Glycemic Index Diet May Increase Risk of Developing AMD CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HaTZ0Gv
3. Dietary Lutein Protects Against Age-Related Macular Degeneration in Younger Women CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBnX0Gp
4. Exercise May Help Protect Against Age-Related Macular Degeneration CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0H64l0Gy
5. Fish Consumption May Reduce Risk for Age-Related Maculopathy CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0HlIR0Gn
6. Ranibizumab May Safely Improve Vision in Patients With Age-Related Macular Degeneration CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0H1y40G7
7. Physician Reimbursement Methods May Affect Rate, Cost of Cataract Surgery CME <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBnY0Gq
8. LASIK and LASEK Have Similar Outcomes <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBnZ0Gr
9. Pilot Study Suggests Acupuncture May Help Dry Eye <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBna0Gy
10. Possible Increase in Nonbacterial Infections in Corneal Ulcers Among Contact Lens Users <http://mp.medscape.com/cgi-bin1/DM/y/hBFHp0KIcFg0Q6B0IBnb0Gz
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Ever since reading that lying flat elevates IOP I have slept with my head elevated.
My husband commented on this saying that in some countries people never sleep with their heads on the ground or flat. They are always elevated.
BTW I read about this way before seeing this issue of NEW JOURNAL STUDIES.
RK
Thanks Dr. Ritch for the
December 20, 2006 issue of NEW JOURNAL STUDIES
You continue to provide us with fascinating and useful information.
"The progression of visual field damage in NTG is associated with IOP in the supine position
and the magnitude of IOP elevation accompanying postural changes. These results suggest that
deterioration in NTG may occur when patients are lying flat during sleep."
Thanks Dr. Ritch for the
December 20, 2006 issue of NEW JOURNAL STUDIES
You continue to provide us with fascinating and useful information.
"The progression of visual field damage in NTG is associated with IOP in the supine position
and the magnitude of IOP elevation accompanying postural changes. These results suggest that
deterioration in NTG may occur when patients are lying flat during sleep."
I don't think it's inevitable for everyone that changes will occur,
but it takes a while for a doctor to figure out how your glaucoma
behaves. My doctor said the same thing, that he would be able to tell
if there were any changes before I lost any more vision, but that
isn't what happened. After a while I quit complaining that I thought
my pressures should be lower and that I could see more damage because
I realized that until his tests verified what I was saying, he wasn't
going to change anything. I suppose it stands to reason that doctors
are hesitant to prescribe more medication if they aren't certain your
glaucoma is progressing, and it takes time for them to be able to
track that.
Eventually the tests proved what I was saying, and my doctor added
another medication. We'll see if that makes any difference. He still
says that he will be able to detect any changes in my normal eye and
treat it before I lose vision, but I no longer believe that.
Most glaucoma doctors do seem to take the same tactic--they want to
be sure there is really a change before they will use more aggressive
treatment. I guess that is reasonable but it is little solace to
those of us who lose vision while the doctor is waiting to be sure.
From what I've read, a lot of patients can be managed on glaucoma
eyedrops alone but certainly many will eventually need more
treatment. You don't have any way of knowing ahead of time which
category you will be.
However, you should also keep in mind that visual fields can
fluctuate and you shouldn't put too much credit into a single field
test. Your next one might be better.
-Deah
Just a quick note to let everyone know we finally have power! It
came back on about 10 am this morning. YAY! A week without power
is way too long! I understand there are still some areas that
might not get their power back before Christmas.
Dave will continue to moderate a couple more days while we head
out on a much needed mini-vacation. Thanks to Dave for helping
out this week!
I plan on being back full-bore with the group sometime Sunday.
Sherry (Pioneer no more <g