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News Summer 2020 / No.75 Our Mission Is to Eliminate Glaucoma Blindness

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News Summer 2020 / No.75 Our Mission Is to Eliminate Glaucoma Blindness Glaucoma News Summer 2020 / No.75 Our mission is to eliminate glaucoma blindness Aussie rock star Kirk Pengilly to raise awareness Australia’s Kirk Pengilly (from INXS), will leverage disease, he was fast-tracked to a pioneering his fame to help increase awareness of glaucoma Australian ophthalmologist who quickly treated his and encourage Australians to get their eyes tested, deteriorating sight and prevented further damage during World Glaucoma Week 2020, March 8-14. to his vision. Until that point he had no idea what Kirk’s own glaucoma experience is the driving force glaucoma was. behind his new role as Glaucoma Australia “When I got glaucoma it really hit home and I Ambassador. Kirk shared his story on Channel 7’s realised how important sight was to me – and, The Morning Show in November and encouraged obviously, to everyone. It was a real wake-up call. As Aussies not to ‘turn a blind eye’ when it comes to a result I’m certainly more aware of my eyes, my eye having regular eye checks. health and the importance of regular eye exams.” In 1987, Kirk came within an inch of losing his sight Kirk Pengilly because of glaucoma. Due to the severity of the 1800 500 880 [email protected] glaucoma.org.au PO Box 420 Crows Nest NSW 1585 In the News Feature From the CEO Happy New Year! I Meet our new Patron, hope you have Medication-Induced Glaucoma enjoyed a relaxing the Governor-General break over the holiday season and are feeling fresh and rejuvenated for the year ahead. For those in fire affected areas, our thoughts and prayers go out to you at this difficult time. 2020 will be a huge year for Glaucoma Australia as we are committed to strengthening the support and value of our patient education. I am delighted to share that our Glaucoma Referral Pathway is now being strongly utilised by our eye health Glaucoma Australia is thrilled to announce our professionals nationally. Close to 400 new patron, the Governor-General, His people are currently joining our Patient Excellency General the Honourable David Support Journey monthly which is great Hurley AC DSC (Retd). news as they can now access free support The Governor-General will serve as Patron of and resources at the earliest opportunity. Glaucoma Australia, promoting the Written by Dr Shweta Kaushik make your open-angle glaucoma worse or Following World Glaucoma Week, we will organisation, its mission to eliminate glaucoma be launching a new website which you will blindness, and the patient centred services it This article looks at those medications that we your angle-closure glaucoma worse. However, find easier to navigate. It will be designed provides. take for other health conditions and their role in certain medications can create closed-angle glaucoma regardless of the type of glaucoma to integrate with the phone and email “I am delighted to become Patron of Glaucoma elevating the eye pressure, which may assistance provided by our orthoptist Australia” said the Governor-General. eventually lead to glaucoma. Sometimes the you have. These reactions are called educators and will include new and eye pressure can decrease once these ‘idiosyncratic’ or random individual reactions. “Since being founded in 1988, Glaucoma updated resources written by our highly Australia has increased community awareness medications are ceased, without any Your eye doctor can let you know if your type valued Ophthalmology, Optometry and of glaucoma, supported patients and their development of glaucoma. Most medications Pharmacy Committee members. of glaucoma fits into either of these groups. are safe in glaucoma, but there are some to be families and funded critical research. This is an Brand names are not used in this document, so We are thrilled that His Excellency General important mission and their impact has been mindful of. If you have any concerns about the look for the ‘generic’ name for the medication. the Honourable David Hurley AC DSC (Retd) significant. medications you are taking or about to start, has agreed to be our Patron. Along with our One medication may have several brand “The hard work of those involved, their then speak to your ophthalmologist. new Ambassador Kirk Pengilly (INXS), their supporters and the researchers they fund and names. You will find that most medications high profiles will go a long way to extend There are many different types of glaucoma. collaborate with has directly helped hundreds have the generic name or active ingredient our risk awareness campaign reach into the However, most glaucomas can be divided into of thousands of Australians. I look forward to listed on the box or information leaflet. general public. Mr Hurley will be a guest at being involved and working with them as two categories: open-angle glaucoma where our upcoming Patient Symposium in Your eye health professional is the best point of Patron.” the drain of the eye is wide open, and closed- Adelaide on the 13th of March and Mr angle glaucoma where the drain of the eye is contact if you have been prescribed these Pengilly will be strongly present in our ‘Don’t “The sense of sight is generally considered the partially or fully obstructed. Whether the drain medications. They can work with you and your be blindsided’ campaign which promotes most valued sense of all,” says Glaucoma of the eye is open or closed is important when prescribing doctor to check if you are at risk, eye health awareness and early detection. Australia President A/Prof Simon Skalicky. “His Excellency’s patronage will greatly assist we are examining medication-induced and if the medication can be continued or Glaucoma Australia by extending our reach glaucoma. This is because a medication can should be ceased. Annie Gibbins and capacity to eliminate glaucoma-related CEO blindness among Australians.” Glaucoma News 2 3 Glaucoma News Open-Angle Glaucoma Anti-Cancer Medication People with narrow angles may already be as amitriptyline, imipramine, and clomipramine Steroids Docetaxel and paclitaxcel are medications treated with a laser peripheral iridotomy. In this are weak anti-cholinergics. Selective serotonin case they are at very low risk of developing reuptake inhibitor anti-depressants such as Corticosteroids, or steroids, can raise eye used to treat some cancers. They can elevate sudden closed-angle glaucoma with the venlafaxine, paroxetine, citalopram, pressure, especially in those persons who have the eye pressure. medications described below and can in most escitalopram and fluvoxamine also have weak open-angle glaucoma, first-degree relatives of Oncologists (cancer doctors) always send cases safely take these medications. If in anti-cholinergic effects. Some anti-psychotics those with open-angle glaucoma, elderly and patients to an eye health care professional for doubt, it is best to check with an eye health have even weaker anti-cholinergic effects and young (<6 years) persons, those with type 1 an eye check after they commence a wide care professional. However, people with for closed angle glaucoma to result, usually diabetes and those with high myopia (short- variety of cancer medications. If you are undiagnosed narrow angles are most at risk of need to be taken with another anti-cholinergic. sightedness). All types of steroid formulation worried or haven’t been for a check-up, speak developing sudden closed-angle glaucoma. It is These medications include trifluoperazine, such as oral, inhaled or topical (drops or cream) to your general practitioner, oncologist or local important for all adults to get an eye health perphenazine and fluphenazine. can raise the eye pressure. A study that looked optometrist. check-up every 2 years. These medications also cause closed angle at nasal spray formulation of steroids Anaesthetic agents demonstrated that there was not an increased glaucoma by the method described above. Some medications used in general anaesthesia risk of elevated eye pressure with this method If you have any concerns about the Drops such as tropicamide, atropine and such as succinylcholine and ketamine can raise of taking steroids. medications you are taking or about to cyclopentolate cause the iris to swell also eye pressure, though it is usually temporary and start, then speak to your ophthalmologist. which also can help to create an environment Most patients will not have symptoms from does not cause permanent harm. where closed-angle glaucoma is more likely to elevated eye pressure associated with steroid Closed-Angle Glaucoma occur. use. If glaucoma develops, it may be years or Direct and Indirect Adrenergic Agents decades before the vision loss becomes A large number of medications can precipitate Botox injections detectable by the patient. Very occasionally if closed-angle glaucoma. Closed-angle Direct and indirect adrenergic medications Botulinum Toxin Injections can cause pupil the pressure is high enough to damage the glaucoma causes the drain in the eye to block include: phenylephrine, epinephrine, ephedrine, dilation when injected close to the eye. This cornea (front window of the eye), the patient completely resulting in very high eye pressures, dipivefrin, naphazoline, salbutamol, albuterol, can precipitate closed-angle glaucoma in the may get blurring of the vision, but this is rare. blurry vision, haloes, pain, red eye and nausea terbutaline, amphetamines, monoamine- aforementioned way, in high-risk individuals and vomiting. This can result in loss of vision oxidase inhibitors (tranylcypromine, phenelzine), Corticosteroids are a useful medication in the (those with narrow angles). and can be difficult to treat. Treatment usually apraclonidine drops and cocaine. treatment of many conditions, even life- Cholinergic agents involves laser, topical and oral medications, but These medications or drugs can dilate the pupil threatening ones. We recommend that patients Pilocarpine is an eye pressure lowering drop may involve surgery as well. and this can cause the iris (coloured part of the who are taking this medication, and have risk that has been around for some time.
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