By Marianne Kligman
Holmdel Happenings – Feb., 2004
Dr. Surekha Collur recently purchased the practice of Dr. Anthony J. Micale, renamed Bayshore Ophthalmology. Dr. Collur hopes to increase the amount of surgery performed in her practice, with a specialty in Glaucoma care, a specialty in which she is trained.
For years, Dr. Anthony Micale has operated a very successful and robust Ophthalmology practice in Holmdel and Tinton Falls. After thirty years of practice in Northern Monmouth County, he has opted for semi retirement and recently sold his business to a young Glaucoma specialist, Dr. Surekha Collur. He will remain to practice two days a week at both office locations in Dr. Collur’s employ.
Dr. Collur, a mother of two young sons, graduated from medical school in her native India. She emigrated to London, and soon after, to America to continue her medical training.
Dr. Surekha Collur recently purchased the practice of Dr. Anthony J. Micale, renamed Bayshore Ophthalmology. Dr. Collur hopes to increase the amount of surgery performed in her practice, with a specialty in Glaucoma care, a specialty in which she is trained.
In 1995 she completed an internship at the Presbyterian Medical Center at the prestigious University of Pennsylvania. During her residency at Suny-Brooklyn in 1999 she was recognized with the best resident research award.
She continued to complete a fellowship in Glaucoma at the Tuft’s-New England Eye Center. She is published in many major journals and is well versed in the latest medical and surgical advances and trends in ophthalmology, in particular glaucoma.
Dr. Collur is delighted to establish a practice in Holmdel, as area where she feels very comfortable both personally and professionally.
“I appreciate the cultural diversity of this area of New Jersey, but also its less harried pace than New York City,” she explains.
Although the practice she has purchased is 70% general ophthalmology care and 30% surgical, she looks forward to increasing that ratio to about 50% ophthalmology and 50% surgery with an emphasis on glaucoma treatment. She has procured state-of-the-art equipment to aid in the early detection of eye disease, which is key to prevent future vision loss. She will continue to perform cataract surgery and lid surgery where vision is impacted. She has also performed some lasik surgery.
Dr. Collur believes she is well situated to attain her goal of transforming her practice into one reknown for glaucoma treatment, since there is only one other glaucoma expert in the area, practicing in Red Bank.
Dr. Collur has already begun to network by giving seminars on eye disease and free glaucoma screenings. She has most recently visited the Willows Assisted Living facility and has spoken to physicians at Bayshore Hospital. She will soon give a seminar at the Bayshore Recreation center, where she is a member of the Physician’s Advisory Board.
Diabetes a Risk Factor for Eye Disease
With the incidence of diabetes increasing in America, mostly due to obesity and an increasing sedentary life style, the rate of eye disease is also increasing.
Diabetic eye disease affects approximately 10.3 million Americans with half at risk for vision loss, because those affected are often not aware that they have the disease.
Eye diseases pertaining to diabetes include diabetic retinopathy, cataracts and glaucoma.
As with glaucoma, diabetic retinopathy is asymptomatic in its early stages, and a patient may not be aware of their vision loss until it is profound. In the disease, high blood sugar levels associated with diabetes damage the blood vessels inside the eye leading to the leakage of fluid into the retina and obstruction of blood flow. Both occurrences may result in the loss of vision.
The Diagnosis of Glaucoma
Glaucoma, which also results from diabetes, increases with age. In this country 80,000 people go blind from glaucoma annually and it is considered the major cause of blindness in the United States. While it is encountered in only 2% of the population under 40 years of age, it increases to 3% until the age of 65 and 5 to 7% at 75 years of age or older. A type I diabetic, a person who is diagnosed in childhood, has twice the incidence of developing glaucoma than the regular population.
Besides diabetes and old age, the risk factors for glaucoma include African Americans, and family history. Dr. Collur explains that the thin cornea is characteristic of glaucoma, a physical trait found in the African American population.
Need for Testing
Since glaucoma is a gradual loss of peripheral vision, it is most often not noticed, and therefore, certain guidelines are recommended for testing. Patients possessing any of the listed risk factors should be checked once a year, but patients between 40 and 50 years of age are recommended to have a glaucoma screening every one to two years. After 50, patients should be tested annually. Testing for glaucoma involves checking eye pressure, corneal thickness and full examination of the optic nerve. With state-of-art equipment and very sensitive computer software, Bayshore Ophthalmology is able to catch glaucoma in very early stages of progression where loss of vision can be significantly slowed.
There are two types of glaucoma, open and closed angle. The vast majority of patients suffer from open angle where the natural drainage of the eye (this drainage occurs within a closed system in the eye, not to be confused with the tear duct) becomes damaged, either from age where it works less efficiently over time, or from diabetes induced eye pressure problems.
This condition had been most often treated with expensive eye drops, which could have unpleasant side effects. Such side effects may include: stinging sensations or redness to the eyes; changes in energy level and pulse and heartbeat; dry mouth; changes in sense of taste; headaches; blurred vision; and change in eye color. Traditional laser surgery could also be employed to facilitate drainage.
Dr. Collur claims that the improvement in laser surgery has made that option preferable to eye drops. A new glaucoma treatment called SLT (Selective Laser Trabeculoplasty) selectively stimulates or changes only specific pigmented cells to activate increased fluid drainage. This works better than traditional laser surgery, which may cause scarring and tissue damage. SLT is very beneficial in that it can be repeated without negative effects and can reduce the need for lifelong use of expensive eye drops and other medications.
Age Related Macular Degeneration
While untreated glaucoma causes a more gradual loss of vision, and is more prevalent in African Americans, Age related Macular Degeneration (AMD) is the leading cause of blindness in Caucasians and people over 65 years old. Approximately 13 million people have AMD. There are also two types of AMD, dry and wet.
Dry AMD affects about 90% of the population. Unlike glaucoma, AMD does not gradually rob vision so as to be undetectable. Immediate eye problems are prevalent such as blurry vision, or a dark or empty area appearing in the center of vision. Straight lines may begin to look curved and distorted.
As glaucoma, AMD cannot be cured but its progression can be slowed. According to Dr. Collur, it may take years to reach a critical stage in dry AMD. Vitamins and protection from UV light are often prescribed; good nutrition is also key.
Wet AMD is much more critical where blood vessels leak fluid and blur the central vision. In this case, laser surgery can be employed. Otherwise the vision loss can be rapid and severe.
Risk factors and AMD include family history, gender (post menopausal women may be more at risk due to lower estrogen levels in their body); diet, heart disease, smoking and significant cumulative exposure to the sun.