Glaucoma: why family matters

macular degeneration: closeup of woman's hazel eye

Glaucoma stakeholders are urging Australians to have their eyes checked this World Glaucoma Week – and pharmacists can be key in a referral role among others, experts say.

Around 50% of sufferers are undiagnosed, as the disease remains asymptomatic until it has progressed significantly; and it’s little-understood among Australians that 3% of men and women aged over 40 now suffer from the disease.

People with a family history of glaucoma are 10 times more likely to develop the disease, as are diabetics and short sighted people.

“Anyone presenting with symptoms that aren’t normal to them when it comes to their eyes, should be advised to see their GP, optometrist or a specialist,” glaucoma specialist and member of the Association for Research in Vision and Ophthalmology, and board member for Glaucoma Australia, Dr Andrew White of PersonalEYES told the AJP.

“Ask them if they have a family history of glaucoma or diabetes, sleep apnoea or migraines as these conditions could mean they are 10 times more likely to develop glaucoma.”

He says most glaucoma patients prefer to stick with branded medication is indicated by their prescriber, rather than switching to generics.

Ivan Goldberg, Clinical Associate Professor, Discipline of Ophthalmology, University of Sydney, head of the Glaucoma Unit, Sydney Eye Hospital and director of Eye Associates responded to a recent AJP Clinical Tips article by Professor Louis Roller by saying Glaucoma Australia aims to eliminate glaucoma visual disability through raising awareness, supporting patients being treated for the disease and supporting research.

“To achieve this, Glaucoma Australia works closely with pharmacists (as well as ophthalmologists, general practitioners and optometrists) to encourage interaction with patients with adherence-promoting strategies and to inform their first-degree relatives of the need for eye checks,” he wrote.

“Any and all help pharmacists are able to extend in these areas is effective and meaningful.”

Meanwhile, researchers including Dr White have been investigating the use of gene therapy to inform new personalised treatments for the disease.

Researchers from The Westmead Institute for Medical Research are exploring whether genes associated with glaucoma risk can be controlled by repurposing “off the shelf” drugs to create  specifically tailored and inexpensive glaucoma therapies.

“Glaucoma affects 400,000 Australians and costs the Australian economy approximately two billion dollars a year. Treatments continually need improvement and we think we are on the way to finding some of those therapies,” Dr White says.

“Essentially there are a now a number of genes found associated with increased risk of glaucoma. Nobody knows what they do or how they work. We are looking the mechanisms behind these genetic risk factors and how we can tailor specific treatments for those at risk.

“Essentially, we are looking to create cheap, personalised medicine. There are a number of medication options we are exploring and we are still some way from a clinical trial.”

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