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Dr. Hady Saheb
McGill University Health Centre, Montreal, QC

Dr. Hady Saheb is a glaucoma surgeon whose ophthalmology practice is focused on medical and surgical glaucoma care, as well as cataract and complex anterior segment surgery. He’s also the Director of the Glaucoma Fellowship at McGill University. For Dr. Saheb, the most rewarding part about treating glaucoma is helping patients understand their disease and engaging them in their treatment to help preserve their vision.

Ready to learn more?

Watch our glaucoma video and read about common risk factors, diagnosis and treatment.

Ahead of World Glaucoma Week, we asked Dr. Saheb some of your questions about glaucoma to help bring awareness to this leading cause of blindness, provide tips to those living with glaucoma, and educate Canadians about ways we can lower our risk of vision loss from this serious eye disease.

What exactly is glaucoma?

Glaucoma refers to a group of eye diseases that affect the optic nerve, which connects your eye to your brain. Glaucoma is often related to the pressure inside the eye, known as intraocular pressure. When the eye fluid doesn’t drain properly, pressure builds up in the eye. This increased pressure can damage the optic nerve fibers, leading to a loss of peripheral vision and sometimes even complete vision loss.

I’m in my 40s and have never really given glaucoma much thought. What should I know?

I think it’s really important for everyone to know that glaucoma can lead to blindness if not treated early. In fact, it’s one of the most common causes of blindness both in Canada and worldwide. It’s equally important to remember that vision loss from glaucoma is preventable with early diagnosis and treatment. The best thing that you can do to protect yourself from glaucoma-related vision loss is to be screened regularly for glaucoma. Every adult should have a comprehensive eye exam with an eyecare provider every 1-2 years.

I’d urge Canadians to be aware of the risk factors for developing glaucoma. People over 50 years of age, who have a family history of glaucoma, or from certain ethnic groups (e.g., those of African descent) are at higher risk of developing glaucoma. Those individuals should be screened earlier and more often, at a minimum of once a year.

I’ve just been diagnosed with glaucoma. Does that mean I’m going to go blind?

Recognizing how highly most people value their sense of sight, the thought of going blind is scary, so your question is common and an important one to ask. Glaucoma is a serious eye disease and remains one of the most common causes of blindness. What’s helpful to keep in mind is that in looking at studies of glaucoma around the world, most patients who go blind either started treatment when their glaucoma was already at a severe stage, or they struggle with adhering to treatment and follow-up. In many cases, if patients are engaged in their treatment and follow-up, the chances are very good that we’ll be able to maintain their vision throughout their lifetime.

I have glaucoma but I’ve never seen an ophthalmologist. What role does an ophthalmologist play and when should I be referred to one?

Glaucoma care is complex and may involve an optometrist, ophthalmologist, or sometimes both working together. As medical doctors with extensive training, ophthalmologists have a unique and specialized expertise in managing patients with glaucoma. We also have the training required to perform laser and surgical procedures as well as manage any potential complications safely and quickly. In general, if they are not already seeing an ophthalmologist, patients with glaucoma should be referred for evaluation or treatment in the following cases:

  1. Worsening glaucoma despite treatment
  2. Difficulty lowering eye pressure despite treatment
  3. Difficulty tolerating current treatment
  4. High risk for glaucoma deterioration (e.g., younger age, strong family history of glaucoma-related vision loss, other eye conditions, etc.)

I’ve been on prescription eye drops for glaucoma for over a year. I know I need to use them regularly, but I really don’t like them. Is there anything else that can be done?

The short answer is yes – something else can almost always be done so it’s really important to share this feedback with your eye care provider. Prescription drops can be extremely effective for managing glaucoma, but some have side effects, such as increased dryness or irritation of the eyes. We know that patients who are bothered by their drops are less likely to take them regularly, so we want to work with you to help you find a treatment option you’re comfortable with. That could mean switching to a different kind of eye drop or considering other treatment options like laser or surgery. The key is to keep those lines of communication open with your eye care provider so they can find an option you’re likely to stick with.

Looking ahead to the next 5-10 years, what new advancements are on the horizon that will improve glaucoma care in Canada?

Ophthalmology is a medical discipline that’s constantly evolving and within glaucoma care specifically, there is a lot to look forward to in the next few years. The surgical space in glaucoma is continuing to evolve and there are new procedures expected to become available to patients that will improve surgical outcomes and safety. We’re also seeing laser treatment playing an increasing role as patients are looking for alternatives to eye drops to lower eye pressure. There’s also some exciting innovation still in the research phase looking at reversing glaucoma, rather than the current approach of preventing or stabilizing damage from the disease. Lastly, the COVID-19 pandemic has really accelerated the uptake of virtual glaucoma care and moving forward we’re likely to see more telehealth options available to make glaucoma care more accessible and convenient to patients.

Dr. Phil Hooper
Ivey Eye Institute, London, ON

Dr. Phil Hooper is a leading Canadian ophthalmologist with a clinical focus on uveitis and retinal diseases. He currently serves as the Chair, Council on Advocacy at the Canadian Ophthalmological Society (COS).

We asked Dr. Hooper your questions about eye injuries to help us better understand how they happen and steps we can take to help keep our eyes safe as we head outside for the summer.

What are the some of the most common causes of eye injury that you see during the spring and summer months?

The most common eye injuries I see around this time of year stem from accidents that occur during home repair projects – misadventures with drills, hammers, and cutting tools. Another surprisingly common way people injure their eyes in the spring is from sticks and branches as gardeners prune their way into the season. The incidence of sports-related eye injuries and workplace injuries remain fairly constant throughout the year.

With many public gatherings cancelled this year due to COVID-19, we’re looking forward to celebrating summer holidays with our own fireworks. What should I know about fireworks and eye safety?

Fireworks are a great way to celebrate a holiday but it’s important to be aware of the risks and follow recommended safety precautions. If not handled properly, fireworks can cause burns and injuries, including serious eye injuries. Fireworks-related eye injuries tend to be especially severe because fireworks combine force, heat, and chemical exposure – they can cause anything from burns to ruptured eyeball and retinal detachment. Even sparklers, which many people assume to be safe for kids to play with, burn hot enough to cause serious burns. In the United States, more than half of fireworks-related injuries in children under 5 are caused by sparklers.

 

To help ensure your fireworks displays with families and friends are fun and memorable (for the right reasons!), there are some simple safety precautions you can follow: 

  • Keep your distance – even bystanders can be injured by fireworks
  • Wear safety glasses when handling and lighting fireworks
  • Make sure everyone holding a sparkler is at least 5 years old and kids are closely supervised
  • Hold lit sparklers at arm’s length and away from other people

If you do experience an eye injury from fireworks or a sparkler, get medical attention right away.

A stone got kicked up from my lawn mower and hit my eye. Now the eye is bloodshot, but my vision seems normal. Should I see a doctor?

Eye injuries can sometimes be more serious than they appear, and serious injuries can lead to vision loss or even blindness. In general, any eye injury other than small scratches or grit in the eye may be potentially serious.
If you’ve damaged some of the structures inside your eye, you might be more likely to experience severe consequences such as glaucoma, retinal detachment, or development of cataracts. Even if you think an injury is minor or you aren’t sure you’ve injured your eye, it’s a good idea to get checked out by an ophthalmologist or other medical doctor. An ophthalmologist can assess the severity of the injury and provide the appropriate treatment to help reduce the risk of long-term vision loss.

Ever since spending yesterday at the beach, it’s felt like there’s something in my eye. Should I be worried and what should I do?

The feeling you describe, of something rubbing against your eye when you blink, is called foreign body sensation. While it can be caused by a number of eye conditions, it’s also possible you’ve scratched your eye. If you have, you might also be noticing redness, irritation, and excessive tearing. Eye scratches and corneal abrasions are common and can be caused by anything from sand or sawdust in your eye to your pet’s claws. The good news is that most are minor and will heal on their own within a few days. Still, it’s always a good idea to see your eye doctor if you think you’ve scratched your eye. They might prescribe an antibiotic eye drop to help prevent infection and steroid eye drops to reduce inflammation and lower the chance of scarring. You might also be given lubricating eye drops to help reduce discomfort.

There are things you can do to help provide some relief while the injury is healing. Blink often and rinse your eye with saline solution or clean water. You might notice that your eye is sensitive to light, so wear sunglasses when heading outdoors. Try not to rub or touch your eye and avoid wearing contact lenses until your eye is fully healed. If you notice persistent or worsening pain, vision changes, or are worried about your eye, head to the emergency room. 

I heard that a partial solar eclipse will be visible from some parts of Canada on June 10, 2021. Is it safe to look at it?

While it can certainly be tempting to watch a solar eclipse unfold, looking directly at the sun can be extremely harmful to your eyes. Without proper protection, exposing your eyes to the sun during a solar eclipse can cause a type of damage to your retina called solar retinopathy or “eclipse blindness.” This damage can be permanent, and it occurs without any pain or discomfort, so it can be anywhere from a few hours to a couple days after viewing a solar eclipse to realize that you’ve injured your eyes. Kids and young adults are most at risk of severe damage – the lens of their eye is so clear that it lets more ultraviolet (UV) rays reach the back of the eye. 

The only way to safely look directly at the sun during an eclipse is with a special-purpose solar filter. Ordinary sunglasses or devices like a camera, telescope, or binoculars just don’t provide adequate protection.

If you’ve looked directly at the sun during an eclipse, you might notice blurry vision, a blind spot in your central vision, distorted vision, or changes in the way you see colour. See an ophthalmologist as soon as possible if you’re concerned you might have damaged your eyes. 

What can I do to help keep my family’s eyes safe from injury?

Eye injuries are common and while accidents happen, the reality is that most are preventable. The easiest step you can take to reduce your risk of eye injury is to wear proper protective eyewear. It can prevent up to 90% of all eye injuries! Look for CSA-certified safety glasses and use them whenever you’re doing anything risky around home – yard work, home repairs, or even using chemical cleaning products. Not only will you help keep your eyes safe, but you’ll also be acting as a good role model for your kids and instilling safety habits in them.

Ensure both you and your kids wear sports eye protection – especially for high-risk sports and recreation like baseball, basketball, racquet sports, hockey, and paintball. Keep in mind that the sun can cause injury to your eyes, too. Shade your family’s eyes from harmful UV rays with sunglasses that offer 100% UVA/UVB protection – that goes for kids and babies, too. You can still enjoy all that summer has to offer and protect your eyes from injury – it’s one of the simplest things you can do to maintain lifelong healthy vision.

Learn about other eye conditions

AMD

Glaucoma

Diabetic retinopathy

Eye injury