EP 1139B - Conquering Glaucoma and How to Treat it

Guest Info & Links: Dr. Daniel Laroche, M.D. , Glaucoma Specialist, President Advanced Eyecare of New York
Summary: What is Glaucoma? How can it be treated?
Air Date: 3/14/23
Duration: 10 Minutes
Guest Bio: Dr. Daniel Laroche, M.D. , Glaucoma Specialist, President Advanced Eyecare of New York
Dr. Daniel Laroche is a glaucoma specialist in New York, Director of Glaucoma Services and President of Advanced Eyecare of New York. He is affiliated with the New York Eye and Ear Infirmary of Mount Sinai, New York University, and Island Eye Surgical Center. He is a Clinical Assistant Professor of Ophthalmology with the Icahn School of Medicine at Mount Sinai Medical Center. Dr. Laroche is a nationally recognized ophthalmologist as the former Chair of the Ophthalmology Section for the National Medical Association. Dr. Laroche has taken care of thousands of patients from New York, and specializes in the diagnosis and treatment of glaucoma. Dr. Laroche has performed thousand of glaucoma surgeries using the latest techniques and helped broaden many young surgeons understanding of the latest in the medical, laser and surgical treatments of glaucoma.  Dr. Laroche is an expert in interventional glaucoma including trabeculectomy and glaucoma tube shunt surgery.  He is a microincisional glaucoma surgery (MIGS) innovator and instructor, and offers patients the Hydrus StentKahook Dual Blade Goniotomy, , G6 micropulse laser..  He is the innovator of the Intrascleral Ciliary Sulcus Suprachoroidal Microtube  Technique to lower intraocular pressure with improved safety.  This vast experience gives Dr. Laroche the very unique ability to customize the most appropriate therapies, both medical and surgical, to the glaucoma patients that he serves. He is able to identify patients at high risk of developing glaucoma and prevent it with early cataract surgery and microinvasive glaucoma surgery when needed.  He has been voted one of the top doctors in New York several years in a row and one of top Doctors in America. He is an exceptional glaucoma specialist and who possesses the best traits one would want in a medical doctor. He and his staff are always available whenever you have a concern. His entire staff is professional, courtesy and very competent. Because of his excellent reputation there is occasionally a wait to get a routine appointment but he and his staff always responds to phone calls and his staff will always get you in if you think your intraocular pressure is high with same day visits. He approaches his patients with care and respect, listening intently and asking questions to ensure that he fully understands their needs, and fully explains his course of treatment to encourage a positive experience.

Dr. Laroche received his bachelor’s degree from New York University and medical doctorate with honors in research from Weil Cornell University Medical College. He underwent a medical internship at Montefiore Hospital and completed his Ophthalmology residency at Howard University Hospital in Washington DC where he was the chief resident in his 3rd year. Dr. Laroche subsequently completed his glaucoma fellowship at the New York Eye and Ear Infirmary with Glaucoma Associates of New York with Robert Ritch MD and Jeffrey Liebmann MD and David Greenfield MD.

Dr. Laroche is board certified and a Diplomat of the American Board of Ophthalmology, a Fellow of the American Academy of Ophthalmology and a member of the American Glaucoma Society and New York Glaucoma Society. Dr. Laroche is the past, Director of the Glaucoma section of the National Medical Association Ophthalmology Section and past Chair of the Ophthalmology Section. Dr Laroche has also written many articles and lectured on glaucoma, teaching other physicians and participated in symposiums throughout the United States, and the world including the Caribbean, Europe, and Africa. Dr. Laroche is also the President Emeritus of the Empire State Medical Association, the New York State affiliate of the National Medical Association and has been an advocate for health care excellence, equality, justice, and diversification of the healthcare workforce. He has also received the Secretariat Award from the American Academy Of Ophthalmology, awards from the City Council of New York for Outstanding contributions to New York City, Aesclepius Medical Society Outstanding Leadership, Network Journal, among many others. Dr. Laroche is a supporter of the Glaucoma Foundation, New York and a Fellow of the New York Academy of Medicine, New York. Dr. Laroche has also volunteered on several medical missions to Haiti and Jamaica, West Indies, Ethiopia, Africa.  His offices are conveniently located in Southeast Queens (718-217-0424) and Uptown, Manhattan (212-663-0473) in New York City around the corner from the World famous Sylvia’s.
    EP 1139B - Conquering Glaucoma and How to Treat it
    WHAT IS GLAUCOMA and how can you treat it?

    Glaucoma is the leading cause of blindness in African Americans and people from the Caribbean, and the simple way to prevent the devastating effects of glaucoma is to maintain regular eye visits.

    “Eyesight or human vision is one of the most important senses,” Dr. Laroche said. “By protecting the eyes, people will reduce the chance of blindness and vision loss while also staying on top of any developing eye diseases, such as glaucoma and cataracts.”

    Dr. Laroche is a glaucoma specialist who takes patient education seriously. He wants people to be aware that glaucoma, cataracts, macular degeneration and retinopathy can begin to surface between the ages of 40 and 70, and that any vision changes should be evaluated by your eye doctor immediately.“Over time, these diseases can lead to blindness, so it’s best to address them as soon as possible,” said Dr. Laroche. “We have new treatments with earlier surgical options that can help preserve (or restore) their vision with faster recovery times.”

    What is Glaucoma? Glaucoma is a disease of the eye characterized by three components:
    1) Damage and loss of the retinal ganglions cells and optic nerve described as cupping
    2) Loss of visual field
    3) Usually increased eye pressure (pressure may be normal at times)

    Glaucoma is a leading cause of blindness in the world today. There are over three million people with glaucoma in the United States today and over 1 million do not even know it. There are over 80,000 people that go blind from glaucoma every year. It is the leading cause of preventable blindness in African-Americans and people from the Caribbean.

    People at risk for glaucoma include the elderly, blacks, and people with elevated eye pressure primary relatives with glaucoma, persons with high myopia, high hyperopia, history of eye trauma, and diabetes. Blindness from glaucoma is insidious. In most cases, there is no pain, and the loss of vision occurs slowly from peripheral to central. The central reading vision is not affected until the end thus most people do not realize it until they have lost a substantial amount of their peripheral vision. In low or normal pressure glaucoma the central vision may be affected first.

    In many cases, glaucoma optic nerve damage occurs from high eye pressure. Nerve damage can usually be stopped or slowed by lowering the eye pressure. Most glaucoma treatment, with medicines, laser, or conventional surgery, is designed only to lower the eye pressure. Some eyes with glaucoma optic nerve damage continue to deteriorate despite having the lowest possible eye pressures. It is not known why this happens. Intensive research around the world is now directed at understanding the cause of the damage in these patients and to develop new treatments to preserve the optic nerve.Many different eye disorders cause high eye pressure. After measuring the eye pressure, your ophthalmologist attempts to determine the cause of the elevation. Nearly always, some form of “clogging” or blockage of the drainage of internal fluid within the eye (aqueous humor) causes increased eye pressure. Since the eye continually produces this fluid, obstruction of the drainage causes the eye pressure to increase. Almost any eye disorder associated with aging, inflammation, bleeding, injury, tumor or even birth defects can raise the eye pressure. However, in most cases of glaucoma, the eye has no specific abnormality and is said to have primary open-angle glaucoma. In other cases, the eye may be unusually small or exhibit other minor shape abnormalities that cause closed-angle glaucoma. In closed-angle glaucoma, the drainage system is totally blocked instead of just being clogged. At least fifty different mechanisms have been described that can raise the eye pressure, but all produce similar damage of the optic nerve. All methods of treatment are designed to lower the eye pressure to a level that will prevent further optic nerve damage.