Published: Aug. 5, 2009
Updated: Aug. 5, 2009
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Reprinted with permission from Durham Magazine. Download the original article (PDF).
The Duke Eye Center, already one of the nation’s top eye hospitals, is concluding research that could help cure glaucoma and set the center head and shoulders above its peers.
By Samiha Khanna
Durham Magazine, Aug/Sept 2009
After 15 years of hunting for the genes linked to a common form of glaucoma, researchers at the Duke Eye Center say they're on the verge of a ground-breaking discovery that could lead to a cure.
They're so close.
"If we were looking for a light bulb somewhere in the U.S., it's like we know it's at the Home Depot on Mt. Moriah Road," says Dr. Cecilia Santiago-Turla, the project's manager.
In their quest, the researchers have scoped thousands of pairs of eyes. They have traveled as far as Ghana and remote islands in the Philippines in hopes of finding genetic clues to the disease, which often affects the elderly and stems from improper drainage of the fluids that flow through the eye.
The Duke doctors race not only against a disease that affects 70 million people worldwide -- robbing 10% of their sight - but also against other top eye hospitals who are hoping to put their name behind the discovery.
Two different national surveys have ranked Duke among the country's top 10 eye hospitals. The center's reputation draws patients and students from around the world, and as much as $25 million in government and private money each year. In addition to boasting a department for genetics research, the center also is home to several pediatric ophthalmologists, which are often hard to find.
Over the past 10 years, researchers around the world have drawn significant conclusions on the genes that cause different types of glaucoma. But there is much more work to be done.
Dr. Rand Allingham, a lead researcher at the center, hopes his team's work will identify the genes that cause a type of primary open-angle glaucoma, and show how those genes work differently when comparing American patients of European heritage to those of African descent.
The study will show that different genes cause the same type of glaucoma in both populations, but Americans of West African descent often are hit harder. They develop glaucoma as many as three to four times more frequently, and with greater severity, Allingham says.
Narrowing in on why this happens will be a key to prevention, reaching patients early, diagnosing their risk factors and saving their sight. One day, Allingham says hopefully, it could lead to a cure.
"If you take care of people with glaucoma, you realize how important vision is," he says. "What's frustrating is the number of people who go blind who don't have to. No we'll be able to determine the risk for glaucoma before people even develop the disease."
The finished report will comprise DNA data from 2,000 people with and without glaucoma from around the world. The data will be available to researchers worldwide.
Meanwhile, here in Durham, at the $10 million project already has brought unexpected benefits to hundreds of people who don't even have glaucoma. It has afforded them free eye care, glasses and even free surgery they could not otherwise access.
It started in the spring, when the researchers began gathering a control group for their study. They needed data on people without glaucoma for comparison.
Santiago-Turla and her associates started spreading the word at churches, transitional homes and shelters in Durham. The team enlisted a church volunteer who offered to drive patients to and from the hospital on Erwin Road. They also gathered information on community programs to which they could refer uninsured patients in need of glasses, medications and surgery.
Their efforts were timely. Rates of the unemployed and uninsured in Durham and Chapel Hill have exceeded 8%, almost double what they were the same time last year, according to the federal Bureau of Labor and Statistics.
Patients poured in from all over the city.
One was Deveriell Gardner, 56, who heard about the free eye exams from a family friend. When the doctors looked at his right eye, Gardner knew they would find a cataract, a reversible clouding of the eye's lens. It was the dimmed vision in that eye that last year had crushed his hopes of becoming a school bus driver - a job that promised health insurance, a pension and more than the $7.90 an hour he made as a part-time stocker at WalMart.
What Gardner didn't expect was that Santiago-Turla, the friendly doctor peering into his eyes, had connected with other resources in the county, and would be able to find him free cataract surgery.
"I am really grateful to all these people who have taken concern and helped me," says Gardner, whose slight accent reveals his Jamaican heritage. "I am happy that my sight has been really taken care of now." Now, there's little stopping him from getting that bus-driving job.
Since they started recruiting patients without glaucoma to add neutral data to their study, Santiago-Turla says, she and her team of researchers have examined more than 300 people in Durham. None have had glaucoma. Gardner and another patient had cataracts and received free surgery through Project Access, a program through which Durham medical specialists volunteer their services. Another 160 people have been referred to New Eyes for the Needy, a nonprofit group that gets glasses for those who can't afford them.
Though helping the uninsured in Durham was never an intention of the long-term study, it ties to the reasons members of the research team are working so hard to find a cure for a debilitating eye disease - to improve the lives of others, both now and in the future.
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