Eyeworld

Ring Removal Ring Placement ™ t emen lac P ing R al v emo ing R R There was a time, when bur when e . xpanding pupils meant using time c e consuming, ing is low prole, easy to use ough a 2.2mm incision, and is pr e with an ergonomic disposable or in every package. alyugin Ring pupil expander e s a e l p o F o use, ts ough a 2.2mm incision, and is provided gonomic disposable xpander, in both m o c . l a c i u s - t s m w w : t i s i v e s n o i t c u r t s n i t e s l l a r alyugin Ring pupil expander 6.25 and 7.0mm pupil sizes . xpander, in both . ™ Reference: 1. David Results in 30 consecutive cases. JCRS; ence: F. Chang, MD, Use of Malyugin pupil expansion Results in 30 consecutive cases. JCRS; 34:83 41 expansion device for intraoperative floppy 1 (May 2008) y-iris syndrome: e inf or mor F tion: 1.888.279.3323 inf ma Patents Pending om .c ical g osur o@micr tion: 1.888.279.3323 inf ™ EW FEATURE 62 lence are already located in these areas so new construction isn't re- quired, only additional resources. "I think with further improve- ments in training, things that can be done for glaucoma in developed countries can be done in centers of excellence and in the capitals of any developing country," Dr. Quigley said. "As further research makes glaucoma easier to diagnose and as longer-term treatments that don't involve daily eye drops, for example, begin to be developed, it will be much more practical to do things in the developing world that we're doing well in developed countries." Panelists and attendees of the African Glaucoma Summit didn't simply muse over what could be done, they decided what would be done and developed action plans based on the results of the discus- sions. At the end of the meeting, a committee was designed for each topic to propose routes to take in order to begin the action plans rec- ommended. The committees will re- port on their progress at the World Glaucoma Congress in Paris in June. "All we need to do right now is follow up on this," Dr. Melamed said. "We need to do the things we decided upon, repeat, and make sure that all we talked about is carried out." The African Glaucoma Summit covered an enormous amount of 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 com- mittees and these committees are working on their issues," Dr. Shaarawy said. "We hope that in a couple of years we can put into mo- tion a target for 2012 to start having byproducts of the action plans. "One thing that has already started that I can report very opti- mistically is that for the first time we have a network of people who are concerned with glaucoma from within Africa," Dr. Shaarawy contin- ued. "We have identified new lead- ers of glaucoma from within Africa and those people are very clever, very enthusiastic. We created a net- work of people that will work to- gether to provide change. This is something that did not exist prior to this meeting." "How to implement all these recommendations is a big chal- lenge," Dr. Melamed said. "If only 10% of all we want to do is imple- mented, 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 U.S. doesn't have the human re- source issues of Africa, but it does have screening, diagnosis, and ad- herence difficulties. Adherence to therapy is one aspect of glaucoma that Dr. Quigley and his team at Johns Hopkins have examined thor- oughly through studies such as the "Glaucoma Adherence and Persist- ence Study" published in 2007, dis- covering that on average, glaucoma patients using eye drop therapy only take about 70% of the medicine. "This is not an issue of the pa- tients 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 forget- ting. These patients actually think they are taking them." The fall-off rate of people re- newing prescriptions and continu- Glaucoma continued from P. 61 continued on page 64 GLAUCOMA February 2011 58-81 Feature_EW February 2011-DL2_Layout 1 2/4/11 2:27 PM Page 62

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