EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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July 2012 Pseudoexfoliation February 2011 EW FEATURE 39 the local temperature so it is closer to 98.6 degrees. Those are the strategies I would hope down the road would be useful in reducing blindness from this condition." He's also looking into coffee consumption. It turns out Scandina- vians are the highest consumers of coffee in the world, drinking around 10 cups a day on average. The U.S., in contrast, only consumes about 3 cups a day. "So the question is since exfolia- tion is hyperendemic in Scandina- vian countries—1 in 5 people over the age of 60 have the condition in Norway, Sweden, and Demark— could it be driven by coffee con- sumption? There is some evidence to say the answer is yes," he said. Additional research needs to be done, but this type of approach could be the future of glaucoma treatment. "Whether it's pseudoexfoliation or open-angle glaucoma, the future that I hope I'll live to see and maybe help bring around is what we call disease-modifying therapy, where we understand what the disease process is and directly interrupt it," said Douglas Rhee, M.D., Massachusetts Eye and Ear Infirmary. "I think that's what the future holds, but we're not going to be there in 3 years, we're not going to be there in 5. We might see the inklings of it in 7, but it's the 10-15 year period where we hope to see that come to fruition; we're get- ting there." In the meantime, Dr. Rhee stressed that general ophthalmolo- gists should keep pseudoexfoliation glaucoma on their radar, as the condition can be easily overlooked in early stages. "The biggest thing to me is to look for it and to be thinking about it whenever you see a patient who doesn't dilate well," he said. "Obvi- ously if you see the target lesion on the lens, that's an indication. But sometimes you don't see that. The target lesion can be easy to miss. In early cases it can be very subtle." Currently there is no genetic test available for the LOXL1 gene, so physicians have to diagnose pseudoexfoliation glaucoma the old- fashioned way. That, said Dr. Rhee, is probably for the best. "Even if you have a gene that predicts very high for something, it AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY 4000 Legato Road, Suite 700, Fairfax, VA 22033 • 703-591-2220 • www.ASCRS.org doesn't mean that people are predes- tined," he said. "Genes are very im- portant for predicting health and disease, but it's not the only thing. We want to make sure we accurately portray risk, but risk does not imply finality." EW Editors' note: The doctors mentioned have no financial interests related to this article. Contact information Pasquale: louis_pasquale@meei.harvard.edu Rhee: dougrhee@aol.com An ASCRS Membership For every stage of your career Whether you're just beginning or experienced in cataract and refractive surgery, ASCRS is the professional society that's right for every stage of your career. Mentors and Innovators As an experienced anterior segment ophthalmologist, you've come to understand the importance of innovation and collaboration. It's through collaboration that ophthalmology improves and expands—at times in great leaps and at times through subtle change. Through its many educational and networking services, ASCRS provides an effective forum for the debate of new ideas and the incremental improvement of technique and outcomes. ASCRS offers the means and the unrestricted opportunity to advance the profession and yourself. Join ASCRS today! The Society for Surgeons