Vision quest
Early diagnosis is vital in minimizing the impact of glaucoma, a degenerative optic nerve disorder that can result in sight loss or blindness if left untreated
Doctors call it the silent thief.
Glaucoma, a progressive eye disease that damages the optic nerve, doesn’t have obvious symptoms at first. When symptoms do present themselves, it is often too late and the damage —tunnel vision and even blindness —cannot be undone.
“If they’ve hit a certain point in their glaucoma, then it’s very hard to prevent it from getting worse,” says Dr. Christine Suess, an ophthalmologist in Cornwall, Ont. “you have to really intervene very quickly. There is no cure for glaucoma.”
Testing is the only preventative measure. With optical coherence tomography (OCT) —A scan used to examine and assess the retina and optic nerve—a diagnosis can be made and the level of damage can be determined earlier than ever.
But changes to OHIP billing announced last month are threatening patients’ access to testing and treatment. According to the Ontario Medical Association, the doctors’ reimbursement for OCT test- ing will be well below the actual cost of providing the test.
Dr. Suess worries that the changes would mean diagnosis and treatment of glaucoma will be delayed, leaving people with glaucoma and other eye diseases at risk. She says her patients are worried, too.
Dr. Suess recently used OCT to show several patients the progression of their glaucoma and to determine what treatment was required. “They said, ‘Oh my God! What if you couldn’t give this test and I had to wait six months or a year to have this test? I could be losing more vision during that time.’
“They’re quite concerned about how these cuts are going to limit access to their care,” says Dr. Suess, adding that she diagnoses a patient with glaucoma about three to four times each week. According to the Canadian Institute for the Blind, approximately 250,000 Canadians have glaucoma. It is the second most common cause of vision loss for seniors in Canada. “It’s one of the most common dis- orders we see,” says Dr Suess.
But it doesn’t affect only seniors. Dr. Suess says she has diagnosed younger patients as well. Family history, diabetes and ethnicity (glaucoma is more common among people of African descent) are all risk factors for the disease.
Glaucoma is caused by increased pressure in the eye (called intraocular pressure), which can’t be felt. Undergoing regular eye exams is the only way to diagnose glaucoma in its early stages.
“I, unfortunately, do have patients who were presented to me very late and we’ve done everything we can to prevent them from losing any more [vision],” Dr. Suess says. “It’s really disheartening and frustrating because you think, If only they’d seen me 10 years ago, if only someone had checked the pressure… Excuse the pun—but hindsight is always 20/20.
“As a physician, you hate to see anybody come in with a problem. I went into ophthalmology because I want to fix things. I want to make people better.”
The government plans to implement the OHIP changes by July 1. Dr. Suess will continue testing her patients until then, but she worries about what will happen afterwards.
“If we are unable to provide this care, people are going to lose vision,” she says. “There’s no doubt about it.”