Gaining Insights Into POAG

HOT TOPIC

Key Genes and Cell Types May Have Role in POAG Formation

In a recent study published in Nature Communications, researchers at Massachusetts Eye and Ear discuss a comprehensive study they conducted that combined genetic discoveries from a large, cross-ancestry, genome-wide association study meta-analysis of primary open-angle glaucoma (POAG), and a large, meta-analysis of IOP with genetic regulation studies and single-cell expression measurements in glaucomatous eye tissues. The study has uncovered key genes, biologic processes, and cell types that may affect the development of POAG.

According to the researchers, these genes are often found in the biologic pathways involving elastic fiber formation and extracellular matrix organization, vascular development, and neuronal-related processes. (Read more here and here.)

My Two Cents

It’s quite the mouthful describing how Mass Eye and Ear conducted the study, and I don’t know what all that terminology means; however, I do know that the idea of having isolated some genes that could play causal roles in POAG formation is a big thing. Any information that we can get that helps us determine which of our patients are at a higher risk for developing this blinding disease could be used to improve patient care and the practice of medicine. This is definitely something to keep tabs on!

OUTSIDE THE LANE

Compound in Tree Bark Could Prevent Eye Infections Related to CL Wear

A recent article in Antibioticsexamines the potential benefits of hydroquinine (not hydroxyquinoline), a compound found in some species of tree bark, to prevent eye infections, particularly those associated with contact lens wear.

The article discusses the challenges associated with standard contact lens cleaning regimens and identifies hydroquinine as a naturally occurring disinfecting solution that effectively fights corneal infections. The article also indicates that previous studies on contact lens wear and care have shown that existing disinfecting solutions are ineffective at preventing biofilm clusters of bacteria that adhere to lens surfaces.

The research teams, from the University of Portsmouth in England and Pibulsongkram Rajabhat universities in Thailand, examined the antibacterial, anti-adhesion, and anti-biofilm properties of hydroquinine-formulated multi-purpose solutions (MPSs) and compared them with two commercial MSPs: Opti-Free Replenish Solution (Alcon) and Q-Eye Multipurpose Contact Lens Cleaning Solution (I don’t know anything about that second brand). The natural compound was found to kill 99.9% of bacteria at the time of disinfection. (Read more here.)

My Two Cents

To me, this is yet another reminder of the superiority of daily contact lenses. With daily lenses, the doctor typically doesn’t have to recommend MPSs to their patients, as each morning, the patient is greeted with a pair of fresh, clean lenses. However, having the opportunity to suggest a more “natural” lens cleaning regimen to our patients who continue to wear either the 2-week or monthly replacement modalities would benefit all involved.

CAN YOU RELATE

Last week, I was performing an IPL session on a patient, and one of our superstar technicians, Seth, was in the room with me. Seth is a country boy from just outside Lafayette, Louisiana, in the heart of Cajun Country, and he was blessed with an incredible gift of gab. He could talk a woman in a white dress into buying a ketchup popsicle. Not only that—he’s a respectful young guy. The type of team member you dream of having. He’s so great that he’s comfortable sharing his thoughts and opinions to help me do my job better.

Case in point: At Williamson Eye Center, I perform a lot of IPL therapy. We built a huge dry eye clinic from the ground up, and we’ve been involved in IPL since the early days. However, my patients have been complaining lately that the procedure is much more painful than it had been before. They seem to be getting more whiney. I looked at all my machine settings, made sure my handpieces were in working order, and checked that the ultrasound gel was being applied correctly. Indeed, the patients were getting “softer.”

Nope, that wasn’t the case. It’s me, hi, I’m the problem. I was going too fast. As our clinic continued to get busier and busier, I gave our patients the same number of IPL “shots;” however, I wasn’t letting the crystal stay on the patient’s face to offer some cooling relief. I immediately took the crystal off and headed to the next shot location to increase my pace. Just before one apprehensive patient’s IPL session, Seth mentioned that her last session was painful, and suggested that I hold that crystal a little longer. He also commented that I had been going much faster recently. (Seth was right.)

This story is a great example of why it’s important to empower your team members to offer suggestions on how to run your clinic to its fullest potential. You may be considered the expert, but experts can skip steps, rush the process, and not realize that these actions effect patient outcomes.

IMAGE OF THE WEEK

Acute posterior multifocal placoid pigment epitheliopathy.

QUOTE OF THE WEEK

“It doesn’t make sense to hire smart people and then tell them what to do; we hire smart people so they can tell us what to do.”

— Steve Jobs