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Every physician has a wish list of treatments, equipment and medications that would improve patient care and quality of life. For the medical team in the Glaucoma Service at the Massachusetts Eye and Ear Infirmary (MEEI), their list includes one big item: they want to establish the Glaucoma Center of Excellence, where patients can get individualized diagnoses and treatments. With continued research and proper funding, this vision could become a reality within the next five years.
Teresa Chen, M.D., Cynthia Grosskreutz, M.D., Ph.D., Louis Pasquale, M.D., Douglas Rhee, M.D., and Janey Wiggs, M.D., Ph.D., are the members of what is one of the most comprehensive glaucoma teams in the nation. They hold five competitively awarded research grants from the National Institutes of Health. They are a collaborative team of physician-investigators who bring a broad range of multi-disciplinary expertise to treating the disease of glaucoma.
Glaucoma affects 66 million people around the world. By the year 2020, that number is expected to be near 86 million. The disease results from deterioration of the optic nerve, which is like a cable connecting the eye to the brain. Eye drops, laser treatments and surgery are the current forms of treatment, but there is no cure. Approximately half of all people with glaucoma in the United States are unaware that they have the disease. If untreated, glaucoma causes irreversible vision loss. It is the second leading cause of blindness among African-Americans and the third leading cause among Caucasians.
Patients with glaucoma require treatment for the rest of their lives and the costs are becoming exceedingly high — both financially and personally. If we could find more rational treatments for the disease, all of these costs would be significantly reduced,” said Dr. Pasquale, who co-directs the Glaucoma Service with Dr. Grosskreutz.
The vision of the Center is that the MEEI team will pioneer major improvements in patient diagnosis and treatment in glaucoma, paving the way for patient care that will be tailored to the specific biology and genetics of each individual patient.
MEEI will establish an Eye Diagnostics Center to offer patients the most advanced early detection testing so that treatment can begin when it will be the most effective. MEEI will also establish an Ocular Genetics Center, where patients will be screened for genetic susceptibility to glaucoma, age-related macular degeneration, and other hereditary eye diseases. Susceptible patients will be given individualized counseling on lifestyle modifications that will help protect them. Regular follow-up testing will be scheduled to closely monitor them for the earliest detectible signs of disease.
Each physician is conducting critical research that would benefit patients who come to the Center. Current projects address these questions: Who is at risk of developing glaucoma? What environmental factors could contribute to its onset? What causes retinal cells to die? How can elevated eye pressure be reduced? How can glaucoma be detected earlier, enabling the optic nerve to be preserved and protected?
Genetics is a major component in glaucoma research at MEEI. Dr. Wiggs and her laboratory team are working to identify the genes that are commonly associated with glaucoma.
Early diagnosis of glaucoma is a key to saving vision. The classic and current method to monitor structural changes caused by glaucoma is optic nerve photography. Dr. Chen and Johannes de Boer, Ph.D., have researched and developed a revolutionary imaging machine, which allows for unprecedented imaging of the optic nerve.
Dr. Chen is also studying pediatric glaucoma, which affects newborns, infants and children. For almost 10 years she has collaborated with David Walton, M.D., an internationally renowned pediatric glaucoma specialist. The types and treatments of this glaucoma are vastly different from adult glaucoma. Further research into understanding how the mechanism of pediatric glaucoma differs from adults would enable better treatments for this devastating group of diseases.
Glaucoma causes blindness by killing retinal ganglion cells — the cells that make up the optic nerve. Dr. Grosskreutz is focusing on studies that identify why the ganglion cells die and to finding ways to stop this death.
Environmental risk factors can affect glaucoma. Identifying these risk factors so that at-risk glaucoma patients can modify their lifestyles in time to preserve their vision is one of Dr. Pasquale’s projects.
Dr. Pasquale is also developing a computer program that will enable individuals to self-administer a simple test on their own personal computers to determine if they may be developing glaucoma.
Lowering eye pressure is the only clinically proven treatment for glaucoma. Dr. Rhee is conducting studies to investigate how eye pressure can be regulated by glaucoma medications and selective laser therapy. “If we are successful, patients with glaucoma can have their eye pressure lowered in a more efficient manner,” he said.
The glaucoma physicians hope that ongoing research will lead to a better quality of life for patients.
With the goal of saving vision from glaucoma through better diagnosis and personalized treatment, MEEI will expand its current clinical and research programs to establish this new center. An investment is required to expand the existing glaucoma laboratory and accelerate the groundbreaking research efforts described earlier. New funding is required to hire staff to launch the Eye Diagnostics Center until reimbursements are established with insurance companies.
“We were all drawn to this hospital because we’re interested in discovering new methods for diagnosing and treating glaucoma and for working with new ideas,” said Dr. Wiggs. “There are many places where one can practice ophthalmology and specialize in glaucoma, but there are only a handful of places in the world where there are enough resources and the right intellectual environment to allow for exploration of novel ideas. MEEI is the perfect place for the Glaucoma Center of Excellence.”
If you would like to learn more about the Glaucoma Center of Excellence, please contact the Development Office at 617-573-3342.
For more information contact the MEEI Glaucoma Service.
Hearing difficulties can impact everyone from infants to seniors. Age, exposure to loud noise, disease and medications that are toxic to the auditory system are all potential causes of hearing loss, but the bottom line is the same: difficulty communicating. Implantable devices can give hope and hearing to many people.
Hearing is a complicated process. “For the majority of people with hearing loss, the problem is in the cochlea, a small, snail-shaped structure in the inner ear,” explains Donald Eddington, Ph.D., who is the Director of the Cochlear Implant Program and the Cochlear Implant Research Laboratory at the Massachusetts Eye and Ear Infirmary.
MEEI patients have four implant options: an implantable hearing aid, a cochlear implant, a bone-anchored hearing aid (BAHA), and an auditory brainstem implant (ABI).
Jennifer Smullen, M.D., an Instructor in Otology at Harvard Medical School who came to the MEEI in 2005, can perform several different implant procedures, but her passion is for cochlear implant surgery. “There are a few things in life where you can really make a difference,” she said. “For me, it’s seeing someone who hasn’t been able to hear ever — or for a very long time — begin to hear little bits of sound when the implant is turned on.”
Cochlear implants are recommended for people with severe sensory hearing loss. In addition to Dr. Smullen, members of the MEEI hospital-based staff who perform these procedures include Joseph B. Nadol., Jr., M.D., Chief of Otolaryngology at MEEI and Chair of Otolaryngology at Harvard Medical School, and senior staff members Steven Rauch, M.D., Saumil Merchant, M.D., and Leila Mankarious, M.D.
Although cochlear implants have been around since the 1960s, they have improved considerably over the past decade. The clarity of hearing has improved dramatically and surgical techniques have also improved.
Dual cochlear implants have recently been approved for coverage by Blue Cross and Blue Shield for children ages eight and under. “Children who get two implants as early as possible do very well because the young brain can develop the ability to process information,” said Dr. Eddington.
For patients who can’t wear a standard hearing aid, the bone-anchored hearing aid (BAHA) is an option. “This implant is a hearing aid for patients who just need to have sounds louder,” explained Dr. Smullen. “Adults and children over the age of five who have chronic ear disease with a draining ear, who lack a natural ear canal, or who don’t have an ear on the outside of their head can benefit from this.”
Drs. Merchant and Smullen perform BAHA surgery.
Thanks to a generous grant, a joint MEEI and MGH program will be the first in New England to offer the auditory brainstem implant (ABI). This device will help persons who cannot benefit from a cochlear implant.
Ronald de Venecia, M.D., Ph.D., and Christian Brown, Ph.D., are part of the team that will offer clinical and research support for this new program. The equipment has arrived and the audiologists are trained. Selecting a patient is the next step.
Although strides have been made in implantable hearing devices, researchers at the MEEI continue to explore all avenues of investigation into improving and restoring hearing.
*Image courtesy of Advanced Bionics.
To learn if you're a candidate, contact the MEEI Audiology Department.
Neurotologist Michael McKenna, M.D., started his medical career at the Massachusetts Eye and Ear Infirmary (MEEI). Today he is a Harvard Medical School Professor in the Department of Otology and Laryngology.
Dr. McKenna is often hard at work in his National Institute of Health-funded lab, where he seeks better ways to treat sensorineural hearing loss caused by otosclerosis, a disease where abnormal deposits of bone form in the ear.
In addition to his research, “teaching is a critical and essential responsibility and essential to the future of medical care,” says Dr. McKenna, who is the director of MEEI’s neurotology fellowship program. The fellowship provides advanced training in the diagnosis and treatment of diseases that affect the auditory and vestibular systems, facial nerve, temporal bone, lateral skull base and related head and neck structures. Many of MEEI’s neurotology fellows continue to learn as they assist with research in Dr. McKenna’s lab.
While he acknowledges the importance of teaching and research, Dr. McKenna says, “My primary responsibility, above all else, is patient care.”
Dr. McKenna’s dedication to patient care and research came together in his involvement in the development of MEEI’s Auditory Brainstem Implant (ABI) Program. The Auditory Brainstem Implant is a surgically implanted electrical device that provides input to the auditory system for people without functioning auditory nerves. The device has been FDA approved for those who have hearing loss as a result of Neurofibromatosis, Type II. An ABI research facility is currently under construction at the MEEI and will contain areas for clinical care and basic science research, headed by MEEI neurotologist Ronald de Venecia, M.D., Ph.D., and Christian Brown, Ph.D. The facility is the first of its kind in the New England area.
“It gives me great pleasure to know that MEEI will have a hand in possibly improving this device and passing that knowledge on to future specialists and ultimately helping thousands of people with hearing loss,” says Dr. McKenna.
Dr. McKenna is seeing patients who would be potential candidates for this device. With further research, he and his colleagues hope to improve the function of the device, which currently offers hope to thousands of people with hearing loss.
As the summer holidays approach, remember that fireworks cause more than 12,000 eye injuries every year. Fireworks can rupture, burn, cut, scrape and severely bruise the eye, as well as facial areas surrounding the eye. Massachusetts Eye and Ear Infirmary (MEEI) physicians are reminding people to make eye safety a priority if they are going to use or view fireworks.
(Statistics gathered from the American Academy of Ophthalmology)
What to Do If an Eye Injury Occurs:
MEEI’s Eye Trauma Service provides specialized care to patients who have suffered severe and extensive eye injuries. The Eye Trauma Service is open 24-hours a day, seven days a week. For more information, contact the Eye Trauma Service at 617-573-3022.
Learn more about MEEI Emergency Eye Trauma Service.
The Massachusetts Eye and Ear Infirmary (MEEI) is hosting two free seminars this Fall that are open to the Public.
Have You Heard? Hearing loss is the most common human disability: one person in 10 is directly affected, and 40 percent of the population has a hearing-impaired friend or family member. Most of us have experienced first hand the communication difficulties that occur when people have compromised hearing. In our 7th Annual Public Forum on Hearing and Hearing Loss we will provide up-to-date information on medical and surgical interventions currently available to treat ears and hearing, updates on hearing aids and cochlear implants, and exciting research that provides hope for future cures. Our speakers, from the Departments of Audiology and Otolaryngology, and the Eaton-Peabody Laboratory at the Massachusetts Eye and Ear Infirmary, will be available to answer your questions during the morning sessions or at the speaker reception to follow. This event is tentatively scheduled for Saturday, Sept. 15, 2007 from 9 a.m. to noon. For a brochure or more information, call 617-573-3265.
Sinus infections and chronic sinus diseases are common ailments that are responsible for a large majority of visits to physicians. The appropriate diagnosis of these
disorders can be very challenging and treatments range from over-the-counter and various prescription medications to surgery. There are many misconceptions about sinus
diseases and the forms of treatment.
The sinus seminar scheduled for Saturday, Oct. 27, 2007 from 9:30 to noon is designed to educate the public on the anatomy of the nose and sinuses, the common ailments related to the sinuses, and the various forms of treatment including the latest advancements in sinus surgery. Call 617-573-3340 for a brochure or more information.
MEEI’s Director of Audiology Dr. Sharon Kujawa warned students at the Smith Leadership Academy, a charter school in Dorchester, Mass. about avoiding the dangers of
noise-induced hearing loss during a program at the school. Coverage of the program ran on the front page of the Boston Globe, and was featured on National Public Radio and
NewsCenter 5, Boston’s ABC affiliate.
Read the Boston Globe article.
Otologist Dr. Steven Rauch wants people to listen to what he has to say about sudden deafness. This condition can occur without warning, usually in one ear, and can lead to
irreversible hearing loss if it isn’t caught early. View the segment on Sudden Deafness which aired on NewsCenter 5, Boston’s ABC affiliate. MEEI is currently one of a number
of hospitals participating in an NIH-funded study to determine the best treatment for sudden deafness.
View the story transcript.
ABC’s “Primetime: Medical Mysteries” recently featured the work of Conrad Wall,
Ph. D., director of MEEI’s Jenks Vestibular Diagnostic Laboratory. Dr. Wall and his colleagues have developed a prototype of a wearable vest and socks to help people with
certain balance disorders to live a more normal lifestyle, despite their condition. These devices could also help the elderly and others who might be susceptible to falling.
View the story transcript.
To see more news visit the MEEI Public Affairs webpage.
The Massachusetts Eye and Ear Infirmary continues the fight to preserve and restore sight, hearing, voice and balance. Help the Massachusetts Eye and Ear Infirmary help people throughout the world by making your tax-deductible gift. There are many ways that you can contribute. Every gift, no matter the size, is important and is deeply appreciated.
Don't forget to include Massachusetts Eye and Ear Infirmary. Each year, bequests from our most thoughtful friends make an important impact on our mission of providing the finest patient care possible and searching for new treatments and cures through research. In the past year, alone, we received over $1,400,000 in bequests from 15 of these dedicated people.
We are often asked for sample bequest language. Here are the basics: “I give to the Foundation of the Massachusetts Eye and Ear Infirmary, Inc., a charitable organization located at 243 Charles Street, Boston, Massachusetts, 02114___________”
If you have questions or would like to discuss specific plans to designate your bequest to a physician or research area of your choice, please contact the Development Office at 617-573-3345. Thank you for your thoughtful consideration.
To learn more, contact the MEEI Development Office.
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