By Taroue Brooks
Photos: Provided by Advanced Eye Care of New York
Dr. Daniel Laroche is a nationally recognized ophthalmologist and the former chair of the Ophthalmology Section for the National Medical Association. For the past 25 years, he’s been providing affordable, first class eye care in New York for people from around the world.
Top notch eyecare with excellence and blindness prevention are his areas of passion. He has written a plethora of articles and has given countless lectures on glaucoma, teaching other physicians and participated in symposiums throughout the United States, and the world including the Caribbean, Europe and Africa.
Here, Dr. Laroche talks wellness, economic empowerment and how COVID-19 has exposed a second pandemic of racism and what changes we need to make moving forward.
Why did you decide you wanted to specialize in ophthalmology?
With ophthalmology, you can look inside the eye, you can actually see how healthy someone is and what is going on in their body. You can see the effects of diabetes, hypertension and glaucoma. Coupled with being able to operate by removing cataracts to restore vision, and glaucoma surgery to lower intraocular pressure, I find it fascinating.
During my residency at Howard University Hospital in Washington, DC, I saw and learned that glaucoma was the leading cause of blindness in the Black community. When I started practicing, I wanted to become an expert in this area to treat people and help prevent blindness. In addition to ophthalmology, I further specialize in glaucoma. I want to identify what we can do to help and preserve people’s vision.
How has your practice changed in the wake of COVID-19? Have you implemented telehealth?
During the pandemic shutdown in New York, our office actually stayed open. We were open part time, four hours a day, because we knew people would still need to come in on emergency basis, for post-operative care and urgent situations. We needed to have a place in the community where people could come for their eyecare needs.
Before the U.S. Surgeon General made the announcement, we already knew COVID-19 was an airborne disease. We were wearing masks before that. Due to the shortage of masks, we were using double layer Bounty paper towels with tape for anyone who came into the office. Now, we have masks. We have hand sanitizer at the front desk. We take temperatures with a touchless thermometer. Anyone who has a temperature above 99 degrees, we consider it a fever and ask them to reschedule their appointment, unless it’s an emergency and we refer them to the hospital. We try to keep our office COVID-free.
We practice social distancing. All seats in the waiting area are six feet apart. Before, we had a waiting room that seated 30 people, now it seats four to five. We have to move people to the back of the office when the waiting room gets crowded and have them wait out in their car until they are ready to be called in.
We do deep cleanings in our office with a solution that is 70 percent alcohol, in between each patient, on chairs and equipment to make sure there is no contamination.
We ordered a UV light. At the end of the day, we have it on in the waiting area; it kills COVID-19 contamination. We have a gas atomizer disinfectant that we spray at the end of the day as well as an ozone machine that kills COVID-19, and any bacteria and flu in the air. The only thing about it is you can only use it after hours when no one is in the office.
We have plexiglass at the front desk to serve as a barrier to help reduce transmission of COVID-19. We’ve made a lot of changes to protect our patients. We want our seniors and our elderly patients to feel safe.
We have also started to do telehealth where we contact patients at home over the phone and video. The problem that we have with telehealth is that many of our seniors don’t have smartphones and email addresses. Medicare has now eased restrictions and allow reimbursements for just telephone health when video isn’t available. We encourage our patients to work with their kids to get them a smartphone because moving forward, telehealth is going to increase whether it’s an appointment with your eye doctor, your internist, your gynecologist. We use a variety of platforms. I can engage with patients on Pulse One, Skype, Zoom FaceTime and WhatsApp. I also use this opportunity to educate patients on technology and COVID-19 in addition to addressing their healthcare needs.
Should Hydroxychloroquine be used to treat Coronavirus? Does it affect the eye?
What are hydroxychloroquine and chloroquine?
- These oral medicines, taken as pills, have been used for decades to treat malaria.
- Hydroxychloroquine is also prescribed for rheumatoid arthritis, systemic lupus erythematosus and other autoimmune disorders.
- The US Food and Drug Administration recently approved these drugs for the emergency treatment of coronavirus disease (COVID-19).
Are hydroxychloroquine and chloroquine safe?
Hydroxychloroquine and chloroquine have been used for decades to treat other health conditions and are generally considered safe. Side effects may include stomach pain, nausea, vomiting, headache and sometimes itchiness.
These drugs can cause health complications, including retinal damage, in some people. Patients with psoriasis, heart arrhythmia, kidney disease or liver disease may be at risk of complications from the drugs. If you have any of these conditions, let your doctor know before starting treatment.
However, preliminary studies have shown that Chloroquine and hydroxychloroquine likely are not effective against the novel coronavirus, please discuss with your doctor.
Will these drugs damage my retina?
Patients who rely on these drugs to treat autoimmune conditions such as lupus rarely experience eye damage. Only about one to two percent of patients develop retinal problems during a five-year course of treatment.
But COVID-19 patients are being given roughly double this dosage, though for only one to two weeks, bottom line: if you are older than 50 and have a history of retinal disease, macular degeneration or have been exposed to the breast cancer therapy tamoxifen, discuss these drugs with your doctor. You may be better off considering an alternate treatment.
Can coronavirus cause pink eye?
If you see someone with red eyes, don’t panic. It doesn’t mean that person is infected with coronavirus. At this time of the year, it can be most likely to allergies. But a recent study from China suggests that up to one third of people hospitalized with coronavirus experience eye problems, such as viral pink eye or conjunctivitis. It’s important to know that the virus can spread by touching fluid from an infected person’s eyes, or from objects that carry the fluid.
What is the connection between glaucoma and lifestyle? What role does genetics play?
Wellness is important in everything. Eating healthy, lots of salad and vegetables. Eating baked food versus fried food. Drinking water. Minimizing sugar intake. Exercising 30 minutes a day. Relaxation. Meditation. Reducing stress. If you can do all of those things, it will be dramatically beneficial in keeping you healthy and minimizing disease development. As you age, some things are just going to develop despite all above. As it relates to genetics, some people have a genetic predisposition to things like cancer, glaucoma; and two, there are age-related changes that happen with the body as well.
What causes glaucoma?
Specifically, with glaucoma, the lens inside your eye increases in size with age. It often narrows the drainage angle and leads decreased outflow of fluid raising the eye pressure. This goes on to damage the optic nerve and leads to loss of vision. When you get over the age of 50, it’s really important to get an eye exam to check your eye pressure to get ahead of glaucoma and prevent vision loss.
As a leader in the medical community and a business owner, is there anything additional you’d like to share?
One thing that I’d like to address is the death of George Floyd, who died at the hands of police, with the knee on his neck. That was very troubling to me. This type of behavior is really in my opinion aligns with the concept of White Supremacy. The media is not doing enough to acknowledge that. The FBI had previously announced there was a tremendous amount of White Supremacy infiltration in law enforcement. We are not holding people accountable.
As a community, we have to take the power back in our hands. We have a lot of economic power. We should use this time during the pandemic of COVID-19 … and the American pandemic of racism to really look at starting our own businesses, invest in and support our own businesses and to try and use our economic power to promote political, legal change and accountability. Political power is very important. Voting is important. But economic empowerment must come first. This is very important and not spoken of often enough. I speak as a business owner. I have 15 employees and we have been able to support each other throughout this pandemic and we’re able to be in control of our own destiny. As a community, we have to be in control of our destiny, our economics, and use our trillions of dollars of economic power globally to support our communities. If a business does not support your community don’t spend your money there. We should dictate and contribute to how our society should be for a more fair and just society. We should also demand that corporations that we do business with have a diverse representation that includes Black people in the inner decision-making circles at the top to ensure all racist structural barriers are removed. It is not enough for people to say they are not racist. Everyone has to be against racism and willing to actively expose and eliminate it.
Dr. Laroche is board certified and a Diplomat of the American Board of Ophthalmology, a Fellow of the American Academy of Ophthalmology and a member of the American Glaucoma Society and New York Glaucoma Society. His offices are conveniently located in Southeast Queens and Uptown, Manhattan in New York City around the corner from the world-famous Sylvia’s restaurant. Manhattan office 212-663-0473, Queens office 718-217-0459. Website: www.advancedeyecareny.com.