At American University of the Caribbean School of Medicine (AUC), we devote time to glaucoma awareness every January. Glaucoma is an eye disease that damages the optic nerve. It is a leading cause of vision loss and blindness in the United States and around the world. But because glaucoma has no symptoms, only about half of people with glaucoma are aware they have it. In an effort to spread awareness and learn more about this disease, we sought the wisdom and advice of AUC grad Valerie Garden, MD ’89, an ophthalmologist and oculoplastic surgeon in Santa Rosa, California. We also sought her thoughts on National Women Physicians Day, which takes place February 3.
Q: What exactly is glaucoma?
A: Glaucoma refers to a group of eye diseases with common characteristics of optic neuropathy (damage to the optic nerve). Glaucoma is characterized by a buildup of aqueous humor — the clear liquid in the front part of the eye — which increases intraocular pressure (IOP), which can damage the optic nerve. If left untreated, glaucoma can cause permanent visual field loss. The two main types of the disease are open-angle glaucoma and angle-closure glaucoma. In open-angle glaucoma, the most common form of the disease, the eye’s drainage canals become clogged over time. In angle-closure glaucoma, the iris is not as wide and open as it should be, and the outer edge of the iris bunches up over the drainage canals.
Q: What are the signs or symptoms of glaucoma?
A: Higher than normal eye pressure (ocular hypertension) can put people at risk of developing glaucoma, but most people show no signs or symptoms until late in the disease — which is too late. That is why yearly eye exams are essential for people over 40 or for those with a family history of glaucoma.
Q: Who is at risk of getting glaucoma?
A: Anyone can get glaucoma, but people have a higher risk than normal if they:
- Are age 40 or older
- Have a family history of glaucoma
- Are of African, Asian, or Hispanic heritage
- Have high eye pressure
- Are farsighted or nearsighted
- Have had an eye injury
- Have used long-term steroid medications
- Have corneas that are thin in the center
- Have thinning of the optic nerve
- Have diabetes, high blood pressure, migraines, poor blood circulation, or other health problems
Many people are unaware of these factors, so it’s important to talk with an ophthalmologist about your risk of getting glaucoma. The chances increase if you have more than one of these risk factors.
Q: What tests and treatments are there for glaucoma?
A: A complete eye exam will tell you if you have glaucoma. During this exam, the doctor measures eye pressure, inspects the drainage angle, examines the optic nerve, tests peripheral vision, and measures the thickness of the cornea. Treatments for glaucoma are very effective at controlling the disease. They include medication (usually eye drops) and various types of surgery. But remember that glaucoma damage is permanent. Early detection is key to keeping your eyesight. Encouragement is very important for anyone with newly diagnosed glaucoma.
Q: What drew you to ophthalmology? What do you find most rewarding about your work?
A: Ophthalmology is fascinating in many ways, but I think it was the surgical intricacy of ophthalmic procedures that won me over. Also, I love the variety of subspecialties within ophthalmology.
The practice of ophthalmology is both interesting and rewarding in itself, but perhaps my favorite thing is the ability to improve a patient’s vision and therefore their quality of life, which helps individuals maintain their independence as they age. Also, as a sole proprietor, I enjoy being my own boss. It allows me to take care of my patients in the way I feel is best for them while maintaining some work/life balance. My patients are very gracious; their attitude makes my day pass quickly.
Q: In what professional activities do you participate?
A: I participate in Operation Access, a wonderful organization that provides medical and surgical care for those without insurance or with no ability to pay for much-needed services. The director of the surgery center where I operated approached me to participate in the program. For the past 10 years, I have worked with Operation Access to treat patients and perform cataract, pterygium, and various eyelid surgeries. I’m also on the management board of the Providence Ambulatory Surgery Center in Santa Rosa and part of northern California’s Meritage Medical Network.
Q: As a female doctor, what are your thoughts on National Women Physicians Day coming up on February 3?
A: My mother, who was a pharmacist and one of two women in her class at the University of California San Francisco, inspired both my sister and I to pursue careers in previously male-dominated fields. Wisely, our mother scheduled all our appointments with female professionals; we were never exposed to men as providers of medical or dental care. Our family physician was a woman whom I greatly admired. She delivered me and took care of all our family’s healthcare needs until she retired. Always a supportive role model, our physician was delighted when I graduated from AUC. We remained friends until she passed away many years later.
Q: What advice do you have for female physicians as they begin their medical careers?
A: Most importantly, discover what area of medicine most excites you. If you are passionate about a particular field, no obstacles are insurmountable. There will always be people or situations that cause you to doubt yourself, but don’t worry about what others think; instead, concentrate on your commitment to your studies, your patients, and your work. Never hesitate to seek out and ask for guidance or help.
Q: The AUC campus is in Sint Maarten now, but in your day it was in Montserrat. What do you remember best?
A: The culture and people of Montserrat were wonderful. The island is beautiful albeit very small. Staying on island during the breaks allowed me a greater appreciation for the abundant outdoor activities, for which there was little time during the semester. As for studying medicine there, at first, being so far away from home, it was a bit overwhelming. But after class started, there was a camaraderie among the students that made being away from home not so important. We were all in the same boat, away from home, doing our best to learn everything we could in Anatomy Lab, looking forward to the “care packages” from home, supporting each other, and really enjoying any free time we may have had. All the professors were not only accessible but actually enjoyed spending time with students, both teaching and socializing. This was unique to AUC and the island campus and one of my most positive memories.
Learn more about Glaucoma Awareness Month through the National Eye Institute and check out their National Eye Health Education Program (NEHEP). Also, don’t forget to encourage anyone at higher risk for glaucoma to get a dilated eye exam. It could just save their eyesight.
At AUC School of Medicine, we’re training future ophthalmologists and other specialist physicians. Our 2022–2023 MD graduates achieved a 97% first-time residency attainment rate* and are now beginning their post-graduate training across 24 specialties. Learn more about AUC and its MD program, as well as the requirements for admission. Thank you, Dr. Garden, for furthering the cause of both glaucoma awareness and female physicians!
*Percentage of students attaining a 2023–2024 residency position out of all graduates or expected graduates in 2022–2023 who were active applicants in the 2023 NRMP match or who attained a residency position outside the NRMP match.