EyeWorld Asia-Pacific June 2011 Issue

33 June 2011 EW GLAUCOMA ground during its first meeting, and the action plans will take time to implement. Change will not happen overnight, but Drs. Shaarawy and Melamed are optimistic about the future. “We have a plan. We have committees and these committees are working on their issues,” Dr. Shaarawy said. “We hope that in a couple of years we can put into motion a target for 2012 to start having byproducts of the action plans. “One thing that has already started that I can report very optimistically is that for the first time we have a network of people who are concerned with glaucoma from within Africa,” Dr. Shaarawy continued. “We have identified new leaders of glaucoma from within Africa and those people are very clever, very enthusiastic. We created a network of people that will work together to provide change. This is something that did not exist prior to this meeting.” “How to implement all these recommendations is a big challenge,” Dr. Melamed said. “If only 10% of all we want to do is implemented, then this would be a big success. I think, step-by-step, some kind of improvement will be made.” Glaucoma challenges in the developed world Glaucoma is a problematic disease worldwide, just in different ways. The US doesn’t have the human resource issues of Africa, but it does have screening, diagnosis, and adherence difficulties. Adherence to therapy is one aspect of glaucoma that Dr. Quigley and his team at Johns Hopkins have examined thoroughly through studies such as the “Glaucoma Adherence and Persistence Study” published in 2007, discovering that on average, glaucoma patients using eye drop therapy only take about 70% of the medicine. “This is not an issue of the patients not understanding what they are supposed to do. If you ask these patients, ‘Are you taking your drops?’ 95% of them will say, ‘Yes, I’m taking them all,’ ” Dr. Quigley said. “The problem is one of forgetting. These patients actually think they are taking them.” The fall-off rate of people renewing prescriptions and continuing the medications over time is alarming. Various studies have shown that 25% of Medicare glaucoma patients filled one prescription and never filled a second one. “They didn’t get to the end of the year and they didn’t get to the second prescription,” Dr. Quigley said. “In that study, we don’t know how many patients were handed a prescription and never filled the first one.” Because glaucoma is asymptomatic, patients have no physical symptoms reminding them to take their medicine, which is one of the biggest problems. “People don’t see the benefits,” Dr. Goldberg said. “They don’t see the drops making them better. They don’t see an improvement in their sight because the drops don’t do that. They can’t feel that their Now available EyeWorld.org/ascrsalconlivesurgery2011 Live Surgery in High Definition from the 2011 ASCRS•ASOA Symposium and Congress Host Surgeon: Robert J. Cionni, MD Faculty: Ike K. Ahmed, MD Rosa M. Braga-Mele, MD Richard J. Mackool, MD Stephen G. Slade, MD Sponsored by © 2011 Novartis AG MCA11585JAD 5/11 continued on page 45