In this episode, Kerri Fitzgerald speaks with Dr. Cathleen McCabe, an ophthalmologist and cataract surgeon in Florida who runs the nonprofit Sight for Life, which provides eye care for people in St. Vincent and the Grenadines. In recognition of January’s Glaucoma Awareness Month, Kerri and Dr. McCabe discuss the lasting impacts the organization has had on the Caribbean island over the last 20-plus years, bringing residents impactful treatment and novel innovations, as well as educating the local clinical community that cares for the patients year-round.
Key Highlights:
- Hear about the work Dr. Cathleen McCabe does for Sight for Life.
- Learn more about the impact of glaucoma, which is the second-leading cause of blindness and the “silent thief” of site.
- Hear about ways you can help or get involved iwth Sight for Life.
- Be inspired by the feedback Dr. McCabe has received for her work in St. Vincent and the Grenadines from patients, their families, and local doctors.
Transcript
Kerri Fitzgerald:
Hello and welcome to another episode of My Hero 360. My name is Kerri Fitzgerald, and today I’m joined by Dr. Cathleen McCabe, an ophthalmologist and cataract surgeon. Dr. McCabe, welcome and thank you for being here.
Cathleen McCabe, MD:
Hi, it’s a pleasure to be here. I’m a cataract and refractive surgeon on the west coast of Florida, and I’ve had a passion for global ophthalmology really since I started in practice over 25 years ago. We’ve been leading really a surgical mission, and it’s also a clinical mission, in Saint Vincent and the Grenadines for more than 20 years. It’s really our passion. My entire family is involved in it, as well as some colleagues who really come and help every single year. None of this would be possible without our partnership with industry as well. We’re really grateful for that.
Kerri Fitzgerald:
That’s excellent. We’ll get more into that organization that you talked about in just a moment. But I want to ask you, so January is Glaucoma Awareness Month. Can you talk a little bit more about glaucoma for people who may not be very familiar with it? What do you think is important for people to understand about the condition?
Cathleen McCabe, MD:
Yeah. Glaucoma is the second-leading cause of irreversible blindness. The sad thing is, and I had this happen in my practice in Florida not so long ago, it’s the silent thief of sight, because you may not have any symptoms until it’s very advanced. I had a patient come in who’s around 60 years old, never needed glasses, always had good vision, and felt like only over the last 6 months vision had been declining.
When we did his examination, he had very, very advanced end-stage glaucoma really in 1 eye. Once that happens, there’s nothing we can do to recover that vision again. It’s one of the primary reasons we need patients to be seen on a yearly basis. You won’t know if you have something that’s preventable, that’s stealing your vision, until you’re really in the very end stages of that. It’s not so common that people understand that importance. They may think I see well at distance. Maybe when they get into their 40s and they start losing their near vision, they think it’s important to have their eyes tested. But it’s important in every decade, every year really, to at least have that baseline examination done.
Kerri Fitzgerald:
You mentioned people may not be very aware of it, or it can take a while to even notice the impact to vision. Are there any particular comorbidities or just risk factors that people can be aware of for glaucoma in particular?
Cathleen McCabe, MD:
Absolutely. If you have a family history of glaucoma, that’s a big risk factor there. It’s definitely more prevalent the older we get. But there are 4 million Americans who have glaucoma with some degree of vision loss already. That’s actually a huge number. We can impact that if we screen for patients and we treat by pressure-lowering intervention. That might be a topical drop that the patient uses. It might be a long-acting medicine that we put in the eye, or it might be a surgical intervention or even a laser. We have so many solutions that can actually decrease the intraocular pressure, which we know has an effect on decreasing the progression of the disease.
Kerri Fitzgerald:
I want to talk a little bit more now that we’ve given information about glaucoma. In general, I want to talk more about the organization that you alluded to in your introduction. You are very involved with Sight for Life. It’s an organization that helps the underserved in Saint Vincent and the Grenadines, as you mentioned, receive life-altering eye care. Can you talk a little bit more about Sight for Life, the mission, and particularly the work you’re doing there as it relates to glaucoma?
Cathleen McCabe, MD:
Yes. Sight for Life is the name of our nonprofit. It is focused on providing that care in Saint Vincent and the Grenadines. The population there is about 120,000 and really has very poor access to consistent interventions and monitoring. The population in general in the Caribbean has a much higher risk of glaucoma. In fact, there’s been a couple of different studies. There was a study that showed that the prevalence in, I believe it was in Barbados, was about 12%. That’s much higher than it is in the US.
Of those patients, our typical intervention is glaucoma medicationIf you have poor access to being seen by the doctor, don’t really get good follow-up when you start a medication to know if it’s effective, that makes it very challenging on a chronic disease like glaucoma. In the United States, I would offer that patient maybe a laser treatment or I might offer them a long-acting medication that might last for 3 years where the patient doesn’t have to continually be putting it in, or they might have better access just to getting their topical drops.
We haven’t had a lot of those solutions that we’ve been able to take to these communities where really it’s so much more important. With the help of some of our industry partners, we’ve been able to bring that really life altering for those patients who cannot maintain a topical drop regimen.
Kerri Fitzgerald:
What are some of those treatments that are being donated through industry to this population that you’re helping?
Cathleen McCabe, MD:
One of the things we can do is a minimally invasive glaucoma surgery. With that, what we do is a surgical procedure. Patient comes in, we identify their glaucoma and the fact that their intraocular pressure is elevated. We then, during the week that we’re there, we’ll provide surgery with a procedure that either adds a very small stent, so a pathway to the drainage system for the fluid that’s produced in the eye, and that results in long-term pressure control. Or we might put a long-acting medication in the eye as well, which could last for up to 3 years of pressure control. That is so impactful for these patients in a way that nothing we can provide as far as topical drops will actually do the same thing.
Kerri Fitzgerald:
It’s important for people to hear that access is a problem as it is, and then access to medication. These options that you are able to provide these patients give them that longer-term treatment and that helps address those access issues, right?
Cathleen McCabe, MD:
Yeah. We do partner with a local ophthalmologist there. We are able to have these patients follow-up to make sure that the intervention that we did is effective. But there’s much less interaction that’s needed with those patients when we don’t have to continually monitor compliance. It takes the compliance part and the part that they need access, continual access to medication, away from part of the treatment paradigm.
Kerri Fitzgerald:
That’s great that you’re partnering with local clinicians there. You’re also probably, I’d imagine, helping with that sort of infrastructure with the local healthcare system, right?
Cathleen McCabe, MD:
We are. To go back to what we do, we usually go for 1 week every year. During that week, we’ll see about 1,000 clinical patients, and we’ll distribute somewhere around 600, 700 pairs of glasses, and we do a little over 100 surgeries. A good percentage of those patients, more than 20%, have some degree of glaucoma, either undertreated or not treated at all, or maybe not even diagnosed before. It’s a significant number. The number of surgeries we do during the year can equal the number of surgeries that those patients are treated with throughout the rest of the year.
In 2020, we purchased a building in Saint Vincent that we’ve been renovating, and we will have that as a facility that allows some of the local doctors to have better access to technology so they can treat more patients when we’re not there. We’re hoping to have multiple missions during the year as we get that building up and running.
Kerri Fitzgerald:
That’s amazing. Are there any memorable either patient cases or just feedback you received from, whether it’s a patient or a local doctor there, that’s really made this whole mission really worthwhile and really special for you?
Cathleen McCabe, MD:
Yeah. I mean, every day when we’re there, we see patients who are impacted immediately by cataract surgery. We’ve had a lot of patients that come in, they need their family member to guide them just to ambulate. You can see that they’re needing constant care by their family member. After their cataract surgery, we see them come the next day, they’re walking by themselves, they’re smiling, they’re interacting with everybody around them, and that is always extremely rewarding. It’s the gratitude of the family member sometimes exceeds that of the patient even. Because now the family member is helping take care of others in the family, maybe even without needing so many resources.
Glaucoma is such a long disease. It’s hard to have that immediate gratitude and effect on vision. But one of the things I remember is we were working with a local anesthesiologist there, and equally, he did not have access to really great options for glaucoma. We treated him with his very difficult-to-control IOP, and we’re able to see him on a yearly basis. He was able to keep practicing for quite some time, and we collaborated with him while we were there. It was actually great just being able to bring the technology to him as well.
Kerri Fitzgerald:
I’m sure it’s really rewarding to see the work and just how appreciative and grateful the people are who you’re treating there. Are there any sort of outcomes or goals that Sight for Life as an organization has achieved or that you’ve witnessed during your time working there?
Cathleen McCabe, MD:
Well, over the years, and with that 20 years, initially there were no local doctors that were providing indigent care. As the time has gone on, we actually have supported some of the education of some of the doctors who now are there taking care of the patients for the rest of the year. Currently, there are 4 doctors. Three of them are general ophthalmologists. One’s a retina specialist. Seeing that evolution and elevation of what they feel comfortable, they didn’t do any phaco when we started. Now they’re feeling more comfortable providing phaco and advanced technology procedures. That education of the local doctors and seeing how they’re willing, more comfortable, and more excited about doing more complex cases has been great, I think.
Then we also see that we see less severe cases when we’re there. Initially, every case was like the worst case I ever saw. Currently, even though there are challenging cases, they’re more selected by those local doctors as cases they need help with. I’ve seen really an advancement in what’s available locally, and we hope to continue with that education and opening up new opportunities.
Kerri Fitzgerald:
That’s great. It sounds like over the course of the 20-plus years, you’ve made investments that have kind of come home to roost, so to speak, in terms of you’re able to see the fruits of what this company has done there. That’s really amazing. Are there ways that other people can get involved in the organization, whether it’s through missions or perhaps supporting financially?
Cathleen McCabe, MD:
Yeah. Thank you for asking. Because of course, as a nonprofit, we’re always looking for support. We have big ideas, and we need support to make those a reality. We do have sightforlife.org. You can go there and donate. We’re happy to have donations of time and effort as well. If anybody wants to come, we have obviously doctors, including surgeons and optometrists, that come along, nurses who come along to help in the OR.
But we have a significant amount of the team, probably 50%, who tell me they’re “unskilled labor.” But they’re skilled. Their skills are just different that we can help utilize within the mission to really make a difference. Donating time is great. Then the third thing is donating equipment. If any of the doctors out there have equipment that they’re upgrading and they would like to donate what they’ve already had, we are a 501, so it is a tax implication there as well, and we are more than happy to take those kind of donations.
Kerri Fitzgerald:
That’s awesome. Well, hopefully more people will go and visit the website, learn more about what you all are doing, this incredible work, this meaningful work that’s really bringing change to people, which I’m sure is just amazing to see.
Thank you again, Dr. McCabe, for coming onto My Hero 360, and telling us about this incredible work you’re doing. Thank you for the work that you’re doing. It’s awesome to see people take their time and skills and knowledge and be able to extend the reach of the help they’re able to provide. Thank you.
Cathleen McCabe, MD:
Well, thank you so much for shining a light on Sight for Life. It’s been a pleasure. Come join us sometime, Kerri.
Kerri Fitzgerald:
Yeah, I’d love to. Awesome.
—
Learn more about Sight for Life: https://sightforlife.org/
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