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Medical Forum / Diseases and Disorders / Glaucoma / June 2006Statistics
Official medicine: high pressure in the eyeball is treated with pressure-lowering medications (eye drops). Question: is there sufficient support from the statistics that the benifits off this treatment overweigh the drawbacks? In the BusinessWeek of last week (dated MAY 29,2006) there is on pages 72-79 an article (Medical Guesswork by John Carey) describing several common medical treatments which seem to be more based on traditions and vested interests than on scientific facts. I cite from page 75: "Appointed a full professor at Stanford, then recruted as chairman of the Center for Health Policy Research & Education at Duke Unversity, Eddy proved again and again that the emperor has no clothes. In one study, he ferreted out decades of research evaluating treatment of high pressure in the eyeball, a condition that can lead to glaucoma and blindness. He found about a dozen studies that looked at outcomes with pressure-lowering medications used on millions of people. The studies actually suggested that the 100-year-old treatment was harmful, causing more cases of blindness, not fewer. Eddy submitted a paper to the Journal of the American Medical Assn. (JAMA), whose editors sent it out to specialists for review. It was amazing, Eddy recalls. The tom-toms sounded among all the ophthalmologists, who marshaled a counterattack. I felt like Salman Rushdie. Stanford ophthalmologist Kuldev Singh says: Dr. Eddy challenged the community to prove that we actually had evidence. He did a service by stimulating clinical trials, which showed that the treatment did slow the disease in a minority of patients." Comments? I would suggest that the author supply the statistics on thse patients who are not helped by the drops. There are several classes of drops, the newest of which are the prostogladins like Xalatan, and Lumigan and Travatan which lower pressures over 20%. Studies show that high pressures over long periods of time will slowly kill the retina and leave you first with tunnel vision and then total blindness. Studies also show that the use of eye drops and/or oral medications have been shown to effectively lower and control the prssures. There are obviously cases that may require surgery to keep the pressures under control. My experience is that these are the exception rather than the rule. One needs to consult their doctor before even considering such a measure. --Dr. Tom > Official medicine: high pressure in the eyeball is treated with > pressure-lowering medications (eye drops). [quoted text clipped - 26 lines] > > Comments? Perhaps things are more complex. From the following 3 articles it seems that it is not clear if the benefits of early treatment always outweigh the harms. http://www.ahrq.gov/clinic/uspstf05/glaucoma/glaucrs.htm http://www.ahrq.gov/clinic/uspstf/uspsglau.htm http://www.scientificamerican.com/article.cfm?chanID=sa003&articleID=000EF2AE-7C 3F-1D0A-8E49809EC588EEDF BB >I would suggest that the author supply the statistics on thse patients > who are not helped by the drops. There are several classes of drops, [quoted text clipped - 52 lines] >> >> Comments? |
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