Skip to main content

Advertisement

Advertisement

Using my ears, as much as my eyes and hands, in treating glaucoma

Sometimes doctors say that each discipline attracts people with different personalities.

A woman receiving a glaucoma test. The author says glaucoma is a feared disease, and yet there is not enough awareness of it. Here, he shares his experience treating some patients.

A woman receiving a glaucoma test. The author says glaucoma is a feared disease, and yet there is not enough awareness of it. Here, he shares his experience treating some patients.

Follow TODAY on WhatsApp

Sometimes doctors say that each discipline attracts people with different personalities.

During my National Service days, I spent two years as a psychiatry medical officer before pursuing ophthalmology.

I learnt to listen to patients for hours on end before working with other team members like the occupational therapist, medical social worker and nursing teams to help keep patients well mentally and physically as well as engaged in society.

Now as an eye surgeon, I rely on my hands to help patients, but similarly it is the ears that make the difference, even in a discipline like glaucoma.

Glaucoma is a feared disease, and yet there is not enough awareness of it, even though the annual World Glaucoma Week — which ended this year on March 13 — has played a role in spreading the word.

An elderly woman I saw recently almost burst into tears with relief when I told her that she did not have glaucoma.

The weight off her shoulders was palpable. To her, getting this potentially blinding disease was akin to getting a death sentence.

And she is not the only one.

Surveys have shown that people are more willing to lose a limb, or even lose their lives than to go blind. 

This is what many people feel about getting glaucoma, but it does not have to be this way.

Let me share the experience of two young patients of mine.

THE ANGRY DEEJAY

Diabetes is the bane of the modern world, with significant numbers of people in Asia and elsewhere succumbing to this metabolic epidemic.

Like glaucoma, people may not feel much is wrong in the early stages but when complications occur, there are many serious consequences.

In many serious cases, the eyes are affected and this can result in a form of glaucoma known as neovascular glaucoma, which can be difficult to treat.

Thankfully, modern medicine has changed the face of this disease but the treatment of both is a partnership between the patient, his medical doctor and the eye surgeon.

My first story is about a young man, who has diabetes and glaucoma.

When I saw him, he was a deejay and bartender, working late into the night, with little concern for his health.

He drank a lot, ate like there was no tomorrow, and smoked like a chimney.

By the time he was 25, he had lost vision in one eye, and had multiple treatments for his condition elsewhere.

He was angry with life, the various restrictions on his diet, the many clinic visits, and the frustration of having to use many types of medications.

I took a multi-faceted approach for this young man. 

I put him in touch with our dietician to help him manage his meals, then simplified his medications, both oral and eye drops, especially since he had poor vision in both eyes at one point.

Most importantly, I listened, to find out what would motivate him to get his treatment.

He really liked being a deejay and I convinced him that if he got treated, he would see well enough to continue with what he loved.

With renewed determination, we began to work on his eyes and he endured painful lasers, surgeries, and many long hours in the clinics and rehabilitation.

But now I could see light in his eyes and an occasional smile.

When I saw him recently, he has retained good vision in his left eye, is free from eye drops and has begun a healthier lifestyle.

He has also taken up a part-time job as a social distancing ambassador during the downtime in the entertainment scene.

Despite the current challenges, he remains optimistic and takes the current Covid-19 crisis in his stride.

THE BOY WITH THE ENDLESS SMILES

A young patient of mine was born without any iris, a condition called aniridia. The six-year-old had high eye pressures which could not be controlled with eye drops.

Most cases of congenital glaucoma like his require surgery very early on in their lives.

Despite living with rather poor vision, he remains cheerful and playful.

I explained to his mum that it is a lifelong journey for the child, the mother and the doctors looking after him.

And throughout his life, there will be many operations, endless medication and need for lifelong care.

Even though his mother had already seen a few doctors and was probably aware of this, it still took a while to sink in.

When I first saw the child, he greeted me with a megawatt smile. He has one of those faces that could get away with murder.

He preferred females to examine him, so I knew he had some decent vision because he could definitely discern that I most certainly was not one!

Examining a child takes extra patience, and a lot of cajoling. I soon learnt to contort my body into various positions to examine the moving little body.

Some days, despite my best efforts, a child can prove too fretful to examine.

A good warmup with comprehensive stretching, some muscle rub after and a good cup of coffee are all part of the routine in examining children.

Ultimately, with rising eye pressures, we had to perform surgery on the boy — one eye at a time, to allow recovery before we go on with the other eye.

It is important to involve all caregivers, as they are the ones who will administer the eye drops for the child and keep him from rubbing his eye after any surgery.

I listened to the worries that his mother had to help her manage the care of her child, and talked her through the treatment plans.

The boy has had three surgeries, including a cataract surgery, and will be meeting with an occupational therapist in our low vision clinic to optimise his remaining vision.

He is starting school and continues to live a full life, which is vital for both his physical and mental health.

He has one younger sister, in whom the mother has inculcated a mentality of helping to look after one another so that the boy has a lifelong buddy and his journey will never go dark and lonely.

There are many challenges that lie ahead for the boy, but he is blessed with a sunny disposition and the support of a mother who will never give up on him.

That always makes my day even though I often get a sore back from trying to examine him in the clinic.

NOT A DEATH SENTENCE TO VISION

In a world of instant gratification, we often look for solutions which are fast and one off, but glaucoma is a disease that does not have a single pill or one surgery kind of solution.

It is analogous to hypertension, which can be controlled but cannot be eradicated.

It is a blinding disease, often with no symptoms. Even so, it can be treated.

Through the quarter of a century of practice thus far, I have journeyed with many patients and learnt a lot about listening.

I learnt that it is important to treat the disease and the sufferers in what would be a long term journey, and listen to their needs whilst providing suitable solutions that involve my eyes, ears and hands.

Together, I believe there is light at the end of the tunnel, and that vision of hope will not be extinguished.

 

ABOUT THE AUTHOR:

Dr Loon Seng Chee is head of glaucoma and senior consultant, Department of Ophthalmology, National University Hospital.

Related topics

Health

Read more of the latest in

Advertisement

Advertisement

Stay in the know. Anytime. Anywhere.

Subscribe to get daily news updates, insights and must reads delivered straight to your inbox.

By clicking subscribe, I agree for my personal data to be used to send me TODAY newsletters, promotional offers and for research and analysis.