Vol. 47 No. 2 Guest Editorial PDF

Philippine Glaucoma Society (PGS): Celebrating 25 Years of Achievements

1Philippine Eye Research Institute, University of the Philippines, Manila
2Cardinal Santos Medical Center, San Juan City, Metro Manila

Correspondence: Patricia M. Khu, MD, MS
Clinic Address: Premiere Eye Referral Center, YKM Building, United Nations Avenue corner Alhambra Street, Ermita, Manila
Contact Number: (02) 8282-8099
Email Address: pmkang@yahoo.com

Disclaimer: The author reports no financial relationship or conflict of interest.

The Philippine Glaucoma Society (PGS) was founded in 1997 with the vision of collaboration among different stakeholders, and the commitment to improve the diagnosis and management of glaucoma with the ultimate aim of preserving sight for all afflicted with the disease. In order for glaucoma specialists to provide quality glaucoma care, they must be updated and knowledgeable in the latest and most cost-effective management of the disease. Banding together as a group and recognizing each other’s unique experiences and sharing them with others are what constitute a professional society–one that is founded on the principles of sharing, trust, and camaraderie, and in doing so benefits glaucoma patients who need quality care to preserve their vision for a lifetime.

When like-minded individuals met in the evening of December 1997 to discuss how to form a society, issues raised were the need for diversity of training among the members, different institutional affiliations, different practice areas in the Philippines, and willingness to work for the society at large. Being an ophthalmologist and a glaucoma specialist entail not just diagnosing and treating patients, but most importantly educating them and their families so that the disease is better understood leading to more successful treatment. Educational posters and brochures, including glaucoma awareness through social media, are some of the avenues to educate the public.

With so much work to do, the founding members (Figure 1), headed by Mario V. Aquino and Manuel B. Agulto, met for the next several months to craft the PGS mission and vision, its Articles of Incorporation, membership eligibility, initial and long-term projects, collaboration with the Philippine Academy of Ophthalmology (PAO) and other subspecialty societies, and connections with international organizations with the aim of recognition for the Philippines and PGS. Each of the founding members had the opportunity to lead the society for 2 years, starting with the founding president, Mario V. Aquino, who laid the groundwork for PGS to function and flourish; followed by Manuel B. Agulto, who led the group to Bangkok, Thailand to attend the inaugural meeting of the Southeast Asian Glaucoma Interest Group (SEAGIG) International Conference in 2000 and bid to host the 2nd SEAGIG International Conference in 2002. PGS was one of the founding members and participated in the formation of SEAGIG in 1999.

The First 25 Years

So much has been accomplished in the first 25 years of PGS, an era of building the infrastructure that defines the society. There are several aspects that were emphasized.

Figure 1. Founding members of the Philippine Glaucoma Society (PGS).

Education

Education is the lifeblood of physicians who must constantly upgrade themselves with new knowledge and technology by reading journals and attending conferences. However, attending meetings without more in-depth interactions may not be enough for physicians to fully grasp the complexities of a disease such as glaucoma. Small-group discussions and meetings provided by subspecialty societies fill this gap since teaching and exchanging of ideas and experiences will enrich the knowledge not just of the general ophthalmologists and ophthalmology residents but the specialists as well. Interactions among glaucoma specialists, particularly sharing of experiences and discussing the appropriate management of difficult cases, will further enhance the knowledge and spur future researches.

Throughout the years, PGS has participated in the PAO conference held every year in November or December by organizing symposia and workshops on specific topics for the general ophthalmologists, allied ophthalmic technicians, and nurses. Well-known international speakers have been invited, together with the local glaucoma experts, to bring up-to-date information in the different aspects of glaucoma. They are well-attended with enough time allotted for open discussions. Once a year, the PGS is in charge of the Lifelong Educational Access Program (LEAP) sponsored by PAO and is usually held during the Glaucoma Month in March. Lectures on interesting topics are given, including debates, during the 3-hour event held in the evening.

On its own, PGS organized two congresses to showcase the expertise of local glaucoma specialists, supplemented by renowned international speakers, who shared their knowledge and experiences with other experts and general ophthalmologists. Both had over 800 local and international attendees.

The 1st Philippine Glaucoma Congress (Figure 2), spearheaded by Norman M. Aquino, in celebration of the 10th anniversary of PGS, was held in Edsa Shangri-La Hotel Manila on February 8 and 9, 2008, with the theme, “Demystifying the Issues.” Renowned experts from the United States and Australia, such as Eve Higginbotham, M. Bruce Shields, M. Roy Wilson, Joel S. Schuman, Ivan Goldberg, and Kuldev Singh, among others came to impart information on the risk factors for glaucoma, landmark clinical trials in glaucoma and their implications, correlation of structure and function in glaucoma tests and intraocular pressure, ocular imaging, and current management in different types of glaucoma. To foster friendship and camaraderie among the members of PGS and establish international connections, the guests were treated to a weekend in El Nido, Palawan (Figure 3).

The 2nd Philippine Glaucoma Congress (Figure 4), headed by Ma. Imelda R. Yap-Veloso, was held in Edsa Shangri-La Hotel Manila on March 10 and 11, 2012 with the theme, “At the Crossroads of Glaucoma: New Perspectives.” World-renowned experts such as Nathan Congdon (United Kingdom), Jonathan G. Crowston (Singapore), Peng T. Khaw (United Kingdom), Christopher Leung (Hong Kong), Ki Ho Park (South Korea), and Robert Stamper (USA) were invited, imparting up-to-date knowledge on glaucoma imaging and new technologies, new methods to detect glaucoma progression, maximizing medical treatment and improving adherence, improved techniques in glaucoma surgeries and new surgical approaches. After the congress, the group spent the weekend in Boracay (Figure 5).

To bring glaucoma education to those who cannot come to Manila regularly, the PGS, spearheaded by Manolito R. Reyes, conducted a series of workshops by bringing different PGS teams to the different parts of the Philippines, giving basic lectures on glaucoma evaluation and management to general ophthalmologists from 2009 to 2010 and beyond. These were well attended, establishing linkages with the local chapter societies.

Figure 2. First Philippine Glaucoma Congress 2008, Manila Philippines.

Figure 3. El Nido get-away with special guests 2008, El Nido, Palawan.

Figure 4. Second Philippine Glaucoma Congress 2012, Manila, Philippines.

Figure 5. Weekend get-away 2012, Boracay, Aklan.

Every third week of the month, PGS, in collaboration with different training institutions, has been conducting round-table discussions (RTDs), spearheaded by Manolet S. Delfin Jr. and assisted by Cynthia V. Verzosa. These sessions are primarily geared toward educating the residents and fellows with special lectures and case presentations, held in different institutions before the Covid-19 pandemic and later converted to monthly webinars. Every quarter, there is a glaucoma fellows’ rounds conducted online, handled by Rainier Victor A. Covar, and participated in by 5 institutions. Many of the PGS members are part of the training faculty of these fellowship programs. Videos of special topics in glaucoma have been recorded and uploaded to YouTube by Ma. Hannah Pia U. De Guzman for local and international consumption.

International Collaboration

An organization cannot thrive in isolation. It needs interactions with the outside world to stimulate and to persevere in its drive for improvement. The PGS, spearheaded by Manuel B. Agulto, hosted the 2nd SEAGIG International Congress in Manila on September 26-28, 2002 with the theme, “Glaucoma: Global & Southeast Asian Perspectives” (Figure 6). This international meeting not only brought to light the expertise of the local glaucoma specialists, but also international collaboration and recognition to Philippine glaucoma. Renowned speakers from all over the world, such as George L. Spaeth, Paul F. Palmberg, Julian L. Rait, Albert Weijlang, Ravi Thomas, Ivan Goldberg, Gerhard Zinser, Tetsuya Yamamoto, Prin Rojanapongpun, Michael S. Berlin, Robert Ritch, Robert L. Stamper, Paul T.K. Chew, Gus Gazzard, Robert J. Noecker, among others, participated in this 3-day event, bringing to Manila all the experts under one roof to discuss the complexities of glaucoma. It was attended by more than 1,200 local and international participants, plus representatives from many international and local pharmaceutical companies. This event set the stage for the society to collaborate with international societies and leaders in the glaucoma world, such as the World Glaucoma Association (WGA) and the Asia-Pacific Glaucoma Society (APGS), the offshoot of SEAGIG, whose convention occurs once every 2 years. PGS, together with APGS, participated regularly in the annual Asia-Pacific Association of Ophthalmology (APAO) congress held in different regions of Asia with symposia, debates, and workshops. PGS will be the host for the 7th APGS international congress to be held in Manila in 2024.

Figure 6. Second SEAGIG International Congress 2002, Manila Philippines.

In the early beginnings of PGS, one of its missions was to establish international linkages. PGS was accepted as a member of the Association of International Glaucoma Societies (AIGS) and participated in its inaugural meeting in Vienna Austria led by Patricia M. Khu (Figure 7) in 2005. It was involved in the Global AIGS Consensus Meeting on “Glaucoma Diagnosis: Structure and Function” in San Diego, California, USA in 2004 and on “Angle Closure Glaucoma” in Fort Lauderdale, Florida, USA in 2006. PGS also contributed to the formulation of the first and second edition of the SEAGIG Asia-Pacific Glaucoma Guidelines in 2004 and 2008. Manuel B. Agulto was elected vice president of SEAGIG in 2005 and president in 2007. Norman M. Aquino was elected to the executive board of SEAGIG in 2009 and APGS in 2010 up to the present and Secretary General from 2020 to 2024. Joseph Anthony J. Tumbocon was elected to the executive board of APGS in 2020 up to the present and is a member of APAO Ophthalmic Education Committee from 2016 to the present.

Figure 7. Inaugural AIGS Meeting 2005, Vienna, Austria.

Glaucoma linkages have also been established with different glaucoma societies in the Asian region, spearheaded by Benjamin M. Abela Jr. The first was with the Japanese Glaucoma Society in 2017 and the second was with the Vietnamese Glaucoma Club (VGC), with the aim of training glaucoma specialists and holding joint meetings. The first joint PGS-VGC symposium was held during the 8th World Glaucoma Congress in Helsinki, Finland on June 28 to July 1, 2017, with speakers such as Aung Tin, Do Tan, Benjamin M. Abela Jr, and Rommel D. Bautista. Several PGS members were also invited to Vietnam to participate in several activities of VGC in 2017 and 2018; lectures were given by Benjamin M. Abela Jr., Rigo Daniel Emmanuel C. Reyes, Ma. Margarita Lat-Luna, Patricia M. Khu, Pamela C. Allarey, among others. Other members participated in the Korean Glaucoma Society meeting in 2017.

Three international glaucoma experts have been inducted into the society as honorary members for their roles in training several of the PGS members in Singapore and Sydney Australia, and in assisting the society with its educational programs. These are Paul T.K. Chew, Ivan Goldberg, and Aung Tin.

Service & Glaucoma Awareness

March is Glaucoma Month in the Philippines and the second week of March is World Glaucoma Week as set by the WGA and participated in by different glaucoma societies all over the world. During this time, the public is made aware of the effects of glaucoma and as a cause of irreversible blindness. Slogans, such as “Glaucoma Can Blind You: Get Help, See Your Eye Doctor”, are plastered on billboards, buses, and cars. Morning and evening talk shows participated in by PGS members regarding signs and symptoms of glaucoma and its management were aired for public awareness. Hospitals and clinics conduct free glaucoma check-ups, with discounts for glaucoma tests. On-site lectures to the public are also initiated for patients in the waiting rooms, including running videos on glaucoma, how it is diagnosed, and how it is treated. PGS was acknowledged by the WGA as having the most World Glaucoma Week activities during the World Glaucoma Congress in 2015 and was the recipient of the APAO Outstanding Service in the Prevention of Blindness Award during the 31st APAO Congress in Taipei, Taiwan, under the leadership of Joseph Anthony J. Tumbocon. These activities have been ongoing since 2008.

The Philippine Glaucoma Foundation (PGF) was set up in 2008 by PGS to help fund glaucoma education activities, public awareness campaigns, and subsidize the surgeries of indigent patients. Trabeculectomy and glaucoma drainage device implantation were the two most common surgeries funded, particularly in public institutions. The foundation bought glaucoma drainage devices, such as Ahmed, AADI, Baerveldt, and Molteno to support patients in need. It accepted donations from private groups (Figure 8) and raised funds through 2 golf tournaments in 2012 and 2017, together with the sale of TW steel watches.

Figure 8. Philippine Glaucoma Foundation fund-raising dinner 2017, Manila Polo Club, Makati.

Social media is becoming an important avenue to provide glaucoma information. The younger members of the society are active in answering queries regarding the disease in the PGS Facebook and the PGS website. Headed by Ernesto C. Pangalangan Jr., it has conducted several podcasts to enlighten the public on glaucoma.

Throughout the years, PGS has assisted PAO in its mission to serve Philippine ophthalmology and its ophthalmologists. Several PGS members have been members of the Executive Council, notably Ma Margarita Lat-Luna who was its President in 2020-21 and served in the council as officer in different capacities (Vice President 2018-19, Secretary 2016- 17, Treasurer 2014-15, Chair of the Committee on Ethics and Professionalism 2016-17) for the past 12 years; Patricia M. Khu served in the council for 8 years (Secretary 2012-13, Treasurer 2010-11, Chair of the Committee on Ethics and Professionalism 2020-21) and as Editor-in-Chief of the Philippine Journal of Ophthalmology (PJO), the official journal of PAO, from 2004 to 2016 for which she was given the Outstanding Service Award by the Academy in 2019; and others, such as Benjamin M. Abela Jr (Councilor 2000-01), Rainier Victor A. Covar (Councilor 2020-21, Treasurer 2022-23, Co-chair Research Committee 2020-23), Joseph Anthony J. Tumbocon (Councilor 2008-09, 2014-15), Nilo Vincent dG Florcruz II (Councilor 2014-17), and Cynthia V. Verzosa (Councilor 2020-21, Chair of Committee on Constitution and Legislation 2020-21) have contributed significantly to the workings of PAO in dealing with its stakeholders. The Philhealth rates for glaucoma procedures were studied and proposed under the leadership of Jose Ma. G. Martinez in 2014.

Several PGS members have served in high positions in different hospitals and institutions, looking after the welfare of doctors, patients, students, and staff. Manuel B. Agulto served in several capacities at the University of the Philippines (UP) Manila: Chancellor 2011-14; Director, Institute of Ophthalmology 2000-2011; Chairman, Department of Ophthalmology & Visual Sciences 2000-06. He was Medical Director of the Eye Referral Center (ERC; 1986 to 2010), the first eye center in Asia established in 1980; a member of the Philippine Board of Ophthalmology (PBO) since 2005, and has received several awards (1997 Distinguished Service Award from APAO, 2010 Outstanding Educator Award from PAO, 2004-06 Dr Geminiano De Ocampo Professorial Chair Award from UP-PGH). Mario V. Aquino was Chairman of the ophthalmology department in several hospitals (St. Luke’s Medical Center 1995- 2000, Philippine General Hospital [PGH] 1985-87, Cardinal Santos Medical Center 1978-1987, Manila Central University Hospital 1971-77), a member of PBO since 2005, and delivered the Jose Rizal Memorial Lecture as keynote speaker in the 2011 PAO convention. Ma. Margarita Lat-Luna has served as Deputy Director for Fiscal Services for PGH since 2011. Other leaders serving as Medical Directors or Chairman in ophthalmology departments include Patricia M. Khu (ERC 2008- 2016, Premiere Eye Referral Center 2019 to present), Mario M Yatco (University of Santo Tomas Hospital 2013-15), Manolito R. Reyes (Far Eastern University 2014-18), Benjamin M Abela Jr (Asian Hospital and Medical Center 2002-05, Makati Medical Center 2011-17), Jose Ma. G. Martinez (East Avenue Medical Center 2021 to present), Norman M. Aquino (American Eye Center 2018 to present), Pamela C. Allarey (Catanauan in Quezon 2022 to present).

Research

To be an expert, one has to do research to fully understand the complexities of a condition. Research trains the mind to discern differences in different situations as local factors may affect the presentation of a disease including its management. Glaucoma specialists need to investigate the incidence and prevalence of the different types of glaucoma among Filipinos, factors affecting their presentation that may be different from those reported elsewhere, and factors influencing disease management that may be affected by local customs. In areas where modern equipment may be lacking, a good clinical eye is important to give the initial treatment to avoid blindness and make the necessary referrals. Such in-depth studies on conditions endemic to the local population are being conducted by the Research Committee of PGS, with the aim of disseminating information to Filipino ophthalmologists and the public through publication. This commemorative issue on the 25th anniversary of PGS is one such example.

Manolet S. Delfin Jr. has initiated the protocol development of a Filipino population-based study on glaucoma, together with the Research Committee headed by Edgar U. Leuenberger and John Mark S. De Leon, with some assistance from Singapore National Eye Institute and Edward Ryan A. Collantes of Boston, Massachusetts USA in connection with genetic studies. Robert Edward T. Ang, an internationally-renowned PGS member, has presented and published numerous articles in refractive and glaucoma research and is actively involved in testing several minimally invasive glaucoma surgery (MIGS) devices, new multifocal and extended depth-of-focus (EDOF) intraocular lenses, and presbyopia laser treatments. He has been a faculty for many local and international workshops and has received numerous awards (2013 Certified Educators Award from Asia-Pacific Association of Cataract and Refractive Surgery, 2018 Powerlist 100 from Ophthalmologist Magazine, 2019 Presidential Recognition Award from International Society of Refractive Surgery). Together with Patricia M Khu, both received the Dr Geminiano De Ocampo Outstanding Researcher in Ophthalmology Award given by PAO in 2021.

The Next 25 Years

The PGS, registered with the Securities and Exchange Commission since 2016, has so many achievements in its first 25 years primarily because the members respect each other, recognize the value of each member and their contributions, work harmoniously as a team to accomplish more. To promote the cohesiveness of the society, out-of-town strategic planning activities were conducted over the years to design year-long projects and foster camaraderie (Figure 9), bringing the members to different parts of the Philippines, and rekindling ties with the local ophthalmologists in the area.

Figure 9. The Amazing PGS Race strategic planning workshop 2006, Tagaytay Highlands.

When Covid-19 struck and caused limitations in mobility and face-to-face gatherings, webinars became the norm, both in teaching and discourse. Zoom meetings were held monthly with local and international speakers, with the aim of maintaining connections and bringing up-to-date information on the latest in glaucoma management. PGS shifted to digital online exchanges that became popular as a means of communication to achieve the goals of education, international collaboration, spreading glaucoma awareness, and research dissemination.

As the society moves forward to the next 25 years, spearheaded by Nilo Vincent dG. FlorCruz II and the younger members with more innovative ideas, there is no doubt that PGS will stay its course in its objectives and achieve greater successes. As the society “ages” (becomes more mature), its accomplishments and ongoing programs will continue. Many PGS members are educators occupying key positions in academic institutions, training residents and medical students.

As the founding members of the society look back to what has been achieved and look forward to what will still be accomplished, memories of a life well-spent as an ophthalmologist and a glaucoma specialist who not only provide services to his patients but also to the public at large, are certainly more fulfilling. One of the founding members, Mario M. Yatco (1956-2015), will surely look down from the heavens with satisfaction at what the PGS has achieved. The PGS 25th anniversary commemorative watch is testament to the driving power of the society that time is of the essence in all that it has accomplished and will achieve in the future.