A Clear Focus

Patricia Caulfield enjoys painting clouds. She finds them elusive. She likes how they constantly change in shape and mood. Her paintings of cloudscapes and seascapes are displayed in galleries throughout the mid-Atlantic.

Glaucoma also changes constantly, and its cure remains elusive. Once vision is lost to the disease, it cannot be regained.

But for Caulfield, a glaucoma diagnosis hasn’t stopped her from pursuing a career in art, thanks to a decade of care from glaucoma specialists at Wilmer Eye Institute, Johns Hopkins Medicine.

Caulfield was given an unexpected diagnosis of glaucoma during a routine checkup with her local optometrist in York, Pennsylvania. After receiving the news, Caulfield, who is originally from Baltimore, knew where to turn next: Wilmer Eye Institute. “There was no other choice for me once I was diagnosed,” she says. “I knew I would be in the best hands.”

At the time, Caulfield was a kitchen and bath designer who taught classes in interior design at night. The diagnosis took her by surprise. This is not unique to Caulfield, says glaucoma specialist Elyse McGlumphy, M.D., who has treated Caulfield at Wilmer. “People are generally not aware of their glaucoma in the early stages of disease, which highlights the importance of routine eye examinations,” she says.

At Wilmer, Caulfield was prescribed a medication that stabilized her glaucoma for five years. At that point, the medication was discontinued by the manufacturer, and a switch to another eyedrop proved to be ineffective. Caulfield experienced extensive vision loss in her left eye and a spike in eye pressure, which can cause worsening of glaucoma. As a result, she returned to Wilmer, where a Baerveldt shunt was placed in Caulfield’s left eye. In this surgery, a plate and tube are implanted in the eye as a way to lower the eye pressure.

Caulfield’s condition remained stable for another two to three years, but then things drastically changed. She again experienced elevated eye pressure and began to lose more of her vision. By then, she had lost more than half her vision, including the top half of the field of vision in her left eye and the central vision in her right eye. “The thing about glaucoma is you don’t feel worse. You don’t feel anything,” she says. “Glaucoma just takes your vision without asking, so I didn’t even know that this was happening.”

Caulfield moved quickly to preserve her remaining vision. Caulfield says eyedrops were problematic for her — many patients struggle to adhere to a regimen of eyedrops or have difficulty using them — so she returned to Wilmer and underwent a trabeculectomy in both her eyes. This glaucoma surgery creates a new pathway for fluid inside the eye to be drained. An outpatient procedure, it is used to prevent worsening of vision loss due to glaucoma by lowering eye pressure.

McGlumphy says a trabeculectomy is a very effective procedure to get the pressure low, sometimes allowing patients to get off medications. “It’s a bigger glaucoma surgery — it’s not minimally invasive — but the reward can be really large, and it can keep glaucoma well controlled. That has been the case for Patricia.”

As Caulfield was at retirement age, she ended her career in kitchen and bath design following her procedures, but the decision turned into an opportunity. Her newly found free time allowed her to devote more time to painting and taking art classes, focusing on abstract work. “Things seemed to really have taken a turn for the better,” she says. “It was something I wanted to do my whole life, and ironically, what made it possible was glaucoma.”

Caulfield is grateful for the decade of care she has received from the faculty and staff members of Wilmer’s glaucoma care team. “I’ve been so fortunate that I’ve had such wonderful physicians at the Wilmer Eye Institute who knew what to do when I needed help or when I needed their intervention,” she says.

Caulfield believes, based on her experience, that glaucoma is a disease that is misunderstood by the public, and that many people, when they are first diagnosed, don’t know what to expect. She says the care she initially received from Wilmer’s glaucoma team put her at ease. “When I was first diagnosed with it, I was in a panic. I thought I’d go blind, and this is the end of my life,” she says. “I will never forget when the doctor looked at me point blank and said to me, ‘You will not go blind. We will manage this,’ and I was greatly relieved.”

McGlumphy says many patients come to her having been told they’re going blind, and she says that is a scare tactic that can be damaging to patients. “I find it really encouraging when someone with moderate to severe glaucoma is still doing what she loves and isn’t letting it rule her life,” she says.

Now, Caulfield’s glaucoma has stabilized, and she does not take any medication for it. She visits Wilmer every six months for a checkup. She shares her experiences to encourage others who have been diagnosed with glaucoma, and tries not to let glaucoma stop her from doing what she wants in life. “Patricia has taken a role in the community to provide patients with hope that they can live with glaucoma and still have meaningful lives and partake in their hobbies,” says McGlumphy.

Earlier this year, Caulfield established an art auction in California, with proceeds going toward glaucoma research. “I never really thought five years ago I would be spending time getting together an art auction and trying to create awareness for glaucoma, but it’s really become a clear focus for me,” she says. “I wouldn’t have it any other way.”