For 20 years, Louise Leonard endured her worsening glaucoma -- a life-long, degenerative eye disease that gradually steals sight without warning and often without symptoms.
As her vision slowly deteriorated -- despite the use of medication and traditional laser treatments -- she continued to work, take care of her home and raise her young grandson.
But two years ago, her condition became very serious. At 56, Mrs. Leonard was having trouble seeing well enough to fulfill her responsibilities at work, and she could not drive at night. What's more, she could no longer tolerate the severe allergic reaction to her medication, which caused her eyes to become so swollen and red.
"I was desperate," she said. "I knew I couldn't go on like this. My eye doctor took one look at me and sent me to Dr. Jindra."
One of Long Island's six fellowship-trained glaucoma specialists, with advanced degrees in vision science (Rockefeller University) and medical science and technology (Harvard), Lawrence Jindra, MD, is on Winthrop-University Hospital's attending staff. He recognized the urgency of Mrs. Leonard's condition and immediately performed Selective Laser Trabeculoplasty (SLT), the state-of-the-art laser therapy used to manage glaucoma patients.
Affecting between 3-5 million Americans, primary open angle glaucoma -- the most common form of the disease -- occurs when the eye's drainage canals become clogged over time and the correct amount of eye fluid cannot drain out properly through the spongy tissue at the front of the eye. When that tissue is blocked, the inner eye pressure rises, reducing blood flow to the optic nerve and resulting in vision loss; if untreated, blindness is inevitable.
Dr. Lawrence Jindra prepares patient for SLT procedure.
Optimal fluid pressure inside the eye is 12-to-14. When Dr. Jindra first examined Mrs. Leonard, her pressure was 40; after her first SLT treatment, it dropped to 18, which she sustains today. "He saved my life. I would have had to give up working," she said.
Traditionally, glaucoma patients are treated with eye drops to lower and control the pressure. But, the medication can be very expensive. It can also be a nuisance to use effectively, and is often accompanied by uncomfortable side effects. Additionally, the drops cannot always control the condition. If that happens, patients may require glaucoma filtration surgery -- a high-risk, invasive procedure -- to create a new drainage channel.
While they may be a better alternative, conventional laser treatments also have drawbacks. "They can cause scarring and the ability to retreat the eye is limited," said Dr. Jindra.
SLT triggers natural process
SLT is a major advancement over other laser therapy. It works by using short pulses of low-energy laser light, which target specific cells that stimulate the body's natural healing mechanisms to help fluid drain out of the eye and lower the pressure.
This space-age procedure is used for patients first diagnosed with glaucoma, for those who have not benefited from traditional laser treatments or eye drops and for those, like Mrs. Leonard, who require, what Dr. Jindra described as rescue therapy. "Without SLT, Mrs. Leonard's condition would have continued to decline, and, in all likelihood, she'd be very close to being blind today," said Dr. Jindra.
"Our goal is to drop the pressure, keep it controlled, stabilize the deterioration of the optic nerve and avoid glaucoma filtration surgery," he explained. "This laser is remarkable. It lowers pressure without burning or scarring tissue, has none of the side effects of the medication, and may even reduce the need for the life-long use of expensive eye drops or other medications."
He continued. "This is a gentle, pain-free procedure that takes minutes to perform on an outpatient basis. Most patients go home with pressure reduced by as much as 35 percent after just one treatment. The eyes can also be retreated several times without harm."
Dr. Jindra treats many of his patients in Winthrop's Ambulatory Surgery Center. "We're really doing innovative procedures here," he said. "My patients get wonderful care because the staff is extraordinary. I've scrubbed with the best around the world. They're as good as it gets."
While Dr. Jindra has performed more than 1,000 SLT procedures, he stresses that prevention is the best medicine. "Vision loss from glaucoma is permanent, but the key to controlling it is early diagnosis and treatment," he said.
"Since there's no way to determine if glaucoma exists or is under control by the way a person feels, testing for glaucoma on a regular basis by a professional is very important -- especially for people over age 40," he stressed.
"Today's diagnostic technology is astounding. We use the most advanced eye scanners and ocular blood flow analysis, as well as other incredible computerized equipment, which enables us to diagnose glaucoma much earlier than just five years ago."
For more information about SLT or an appointment call 1-866-WINTHROP.