It’s been a nightly ritual since Doris Winn was diagnosed with glaucoma four or five years ago: the administering of eye drops to reduce pressure inside the eye.
It’s not a routine she’s particularly fond of.
“It’s a pain in the butt,” the Colorado Springs woman says, citing the challenge of getting the drops squarely in her eyes vs., say, her cheek.
So Winn, 81, was eager to become one of the first in Colorado — and in the United States — to undergo a treatment aimed at eliminating the need for those daily drops. In March, the Food & Drug Administration approved Durysta, a tiny pellet that is injected into the eye and releases medication over a matter of months. The Colorado Eye Institute, on the north side of the Springs, became the first in the state to offer Durysta as it began performing the procedure last week. (The Colorado Eye Institute also has a location on the south side of town, but the new procedure will be done at the surgery center at the north office.)
Dr. Roman Krivochenister, a glaucoma specialist at the Colorado Eye Institute, considers Durysta “a game changer.”
With Durysta, “patients don’t have to use the drops, and that’s a very big deal. For glaucoma, one of the biggest issues is compliance,” he says — the drops can be expensive depending on insurance; patients may forget to use the drops; and they often struggle, like Winn, with getting the drops in properly.
“If you’ve ever tried to put a drop in your eye, you know it’s very difficult,” says Krivochenitser, who’s known simply as Dr. Krivo to his patients. “Now imagine doing it every day for the rest of your life.”
Glaucoma is a progressive eye disease that affects more than 3 million Americans. The most common type, as explained by the American Academy of Ophthalmology, is primary open angle glaucoma, in which the eye fails to drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve and, if untreated, can ultimately result in blindness; glaucoma is a leading cause of irreversible blindness worldwide. Most people with glaucoma have no discomfort or symptoms early on. It’s most commonly detected through regular eye exams.
“There are many risk factors for glaucoma,” Krivochenitser says, including age and family history. “The only risk factor we can control is the pressure in the eye.”
Winn’s procedure last week was quick; she had only one eye done and the longest part was waiting for numbing drops to take effect in the eye. After that, Krivochenister injected the tiny, rod-shaped implant into her left eye; while he placed it near the center of the eye, “with gravity, the pellet sinks to the bottom of the eye,” he explains. Winn, who felt no pain, was sent home with instructions not to bend over for a week so that the pellet stayed lodged in the proper spot.
Winn says she wasn’t bothered by the idea of an injection into the eye; others might not be as easygoing.
“The concept of having a needle in your eye or something sharp in the eye is very scary to many people,” Krivochenitser acknowledges. “But we do this all the time; one of the most common treatments in all of medicine is injecting things into the eye.”
Winn will have the other eye done in a month or so. The treatment, which is covered by Medicare, typically lasts three to four months; patients can then get another injection.
“We’re just very excited to be on board with it,” Krivochenitser says, “and I really do think this is going to be the future of treatment.”