03:38am Friday 24 November 2017

First Study on Haitian-American Glaucoma Rates Stresses Need for Awareness and Screening to Prevent Vision Loss

Glaucoma is the leading cause of irreversible blindness worldwide, disproportionately affecting African Americans and Latinos living in the U.S. A disease characterized by slowly progressive optic nerve atrophy, glaucoma is typically a painless and silent blinding disease that can be easily screened for in a community setting and treated to prevent further vision loss and blindness.

Richard K. Lee, M.D., Ph.D., associate professor of ophthalmology, cell biology and neuroscience, and Richard K. Parrish, II, M.D., professor and Edward W.D. Norton Chair of Ophthalmology, led the study with medical student Christine Bokman and members of the Ophthalmology Interest Club. “Glaucoma Screening in the Haitian Afro-Caribbean Population of South Florida” is published in a recent issue of PLOS ONE.

Using data from community health screenings in Little Haiti, the team found that not only do older patients suffer from signs of the disease, but also younger patients less than 40 years old have disease warning signs such as high eye pressures and suspicious changes to the optic disc. Of the entire study population, 32 percent had eye pressures above normal (>22 mm Hg), which can ultimately cause severe damage to the eye and lead to blindness.

To improve ophthalmic care, several efforts were made during and after the study to provide counseling and follow-up for this population to help decrease disease progression. Participants were given referrals with their test results for follow-up with their primary care providers and recommended ophthalmologists within the community, regardless of insurance status.

The U.S. Preventive Services Task Force does not recommend for or against screening for glaucoma, but Lee says these findings should start that shift. “Overall, this study highlights the need to create awareness of differential glaucoma risk within ethnic communities of the U.S. to prevent further eye disease and blindness,” said Lee. “This study along with previously published studies on the rates of glaucoma in specific populations stresses the need for targeted screening within communities and has implications for policy changes in the approach for ocular disease screening to prevent blindness.”

Louis Pasquale, M.D., from the Massachusetts Eye and Ear Infirmary/Harvard Medical School, was a collaborator in the data analysis. Project Medishare and the Bernard Mevs Hospital Eye Clinic, where Lee is volunteer medical director, will translate these findings to be more aggressive in screening for and treating glaucoma in the Haitian population in Port-Au-Prince.

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