One way or another, Mona Kaleem has been caring for glaucoma patients all her life. Growing up, Kaleem witnessed how glaucoma affected multiple generations of her paternal family. Seeing the effects of the disease on her family members inspired her to pursue a career as an ophthalmologist with a subspecialty in glaucoma.
Kaleem, who recently joined Wilmer Eye Institute, Johns Hopkins Medicine as an associate professor of ophthalmology, is a native Marylander, but her family hails from India. She cites the profound impact her Eastern heritage has had on the way she thinks about medicine. She comes from a long line of physicians and practitioners of Unani medicine, most notably her great-grandfather, Hakim Ajmal Khan, who revolutionized Unani medicine by integrating it with allopathic medicine. “Whenever anyone came to him for advice on an ailment, he’d tell them about various herbal remedies, physical postures and even prayers, to help them recover. In India, there are a lot of people who still believe in the power of complementary and alternative medicine,” she says.
Awareness of these approaches led Kaleem to explore the potential benefits of integrative medicine for people living with glaucoma. “I will always support the use of good, evidence based medicine, which is what we practice here in the U.S. And I’m seeing that more evidence is emerging about how lifestyle factors can impact disease prognosis.”
Today, Kaleem has developed a reputation for teaching others about how to live a better life with glaucoma, often incorporating her knowledge of integrative medicine into the discussion. She speaks frequently on the topic and has developed a podcast, Diagnosis Glaucoma, with Wilmer colleague Harry Quigley as a resource for patients. “Glaucoma is a chronic condition, so we need to teach our patients how to live comfortably for the short and long term with the vision they have. If there are little adjustments people can do to make their home safer, read more comfortably or feel more independent, I want to help them do that,” she says.
Kaleem is at once student and teacher. Last year, after attending a presentation on meditation and glaucoma at the World Glaucoma Conference, she conducted a literature review on the topic and presented her findings at the Maryland Society of Eye Physicians and Surgeons annual meeting. “My colleague Elyse McGlumphy is doing a research study on this subject, and I am excited to hear about what she finds,” says Kaleem.
With her patients, Kaleem routinely broaches the topic of anxiety, including the anxiety people feel when they receive a diagnosis of glaucoma. “After we talk about my recommendations for medications and surgeries, I’ll discuss meditation, dietary changes and exercise with those who are interested,” she says. “Everything I talk to my patients about, I’ve researched on my own, and I can point them to the best sources for further information.”
Recently, the coronavirus pandemic has created an interest in home monitoring for patients with glaucoma, and Kaleem is among those at Wilmer investigating its potential use. For example, she’s trying out one version of a home-based visual field test used to check peripheral vision in glaucoma patients. While such devices won’t replace the need for patients to be seen in the clinic, Kaleem hopes they may allow doctors to track what’s going on with patients’ vision between appointments, and perhaps allow those appointments to be spaced out.
Another area of research for home monitoring is contrast sensitivity testing. “I’m very interested in how people function and the problems they have on a daily basis,” says Kaleem. “With a visual field test, you can see exactly where a defect is, but contrast sensitivity assesses overall vision and allows you to identify functional deficits earlier.” Kaleem recently moderated a webinar for the Maryland Society of Eye Physicians and Surgeons on glaucoma home monitoring tools, featuring two of her Wilmer colleagues, Tom Johnson and Alan Robin.
Kaleem says she’s excited for the many opportunities for growth and collaboration at Wilmer. “It’s truly a pleasure to work with people whose work I have learned so much from on my path to becoming a glaucoma specialist,” she says. As a child, Kaleem lived in the same neighborhood as noted ophthalmologist Sheila West and has been lifelong friends with West’s daughter. “We lost touch after we both moved out of the neighborhood. I didn’t know that Sheila West was who she was,” says Kaleem. “I just knew that she was my friend’s mom and that she worked at Johns Hopkins. I had no idea that she was such a giant in the field of ophthalmology.”
As a first-year resident, Kaleem ran into West at the Association for Research in Vision and Ophthalmology annual meeting, and West invited her to participate in a research project. “Sheila introduced me to people in the glaucoma division early on and encouraged me to join Hopkins. It was incredibly meaningful that she had so much faith in me and my capacity for success at one of the world’s leading eye institutions. She was the first person I told, after my parents, that I’d accepted a job at Wilmer.”
Image: Dr. Mona Kaleem – taken from the Wilmer Eye Institute article
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