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We’re delighted to introduce Gloria Wu, MD,  a distinguished board-certified ophthalmologist who has joined the Brown & Toland Physician network.

With her impressive academic background from Harvard University and Columbia University’s College of Physicians and Surgeons, Dr. Wu brings over three decades of expertise in ophthalmology. Currently serving as a clinical instructor at UCSF School of Medicine and president of the Santa Clara County Medical Association, she sat down with us to share her insights on eye health and patient care.

Q: As a retina specialist, what are some common conditions you treat, and what should primary care physicians know about referring patients for retinal care?

Let me tell you about something I see quite often in my practice. Many diabetic patients come in for their annual exams who have never seen an eye MD before. Medicare has really emphasized the importance of screening for diabetic macular edema – and with good reason. It’s like an early warning system for your body.

When we spot diabetic macular edema, it’s crucial to examine the entire retina and eye for diabetic damage. Here’s something fascinating – there’s actually a one-to-one correspondence between diabetic retinopathy in the eye and early kidney disease. It’s like looking at two pages of the same book. That’s why we also look at the HbA1c, which I think of as a three-month report card of blood sugar, versus the daily fasting blood sugar, which is more like a 24-hour snapshot.

The most important advice I can give to primary care physicians is this: don’t just tell your diabetic patients to ‘go to any eye doctor.’ Often, patients will see an optometric specialist (OD) and might not get to a retina specialist until there’s severe vision loss. We really need to see these patients at least once a year.

Let me share some key warning signs to watch for: difficulty reading, wavy-appearing letters, sudden vision loss that returns (which could be a Transient Ischemic Attack – essentially a retinal stroke), or new floaters that might indicate vitreous hemorrhage.

Q: You’ve dedicated significant time to patient education, including hosting a health talk show. What are some of the most important things you wish all patients knew about maintaining their eye health?

You know, it’s interesting – 85% of Americans take their car in for an annual oil change. I’d love to see the same statistics for eye check-ups! The challenge is that many people wait until they’ve lost vision or can’t read at all before seeking care. And nowadays, with Google and ChatGPT, people often try to self-diagnose, which can be risky.

I always tell my patients this: you can get a new spouse, a new car, new knees, new hips – but you can’t get new eyes. We need to care for our eyes just like we maintain our cars.

Q: With diabetes being a growing concern in our community, how do you approach diabetic eye care and what preventive measures do you recommend to patients?

Prevention is absolutely key. Let me break it down into simple steps: watch what you eat, especially carbs and oils – because both oil and bread convert into sugar molecules. Walking is crucial – 25 minutes a day is good, but 45 minutes is even better for protecting your hips and knees while building leg strength.

For diabetic patients, I emphasize knowing two key numbers: your fasting blood sugar and your Hemoglobin A1c. The A1c is particularly telling because it measures glucose molecules stuck in your red blood cells over a 90-day period. I advise aiming for 6.0 – at this level, you’re much less likely to develop eye or kidney disease. You can be up to 6.5 as an interim goal, but 6.0 should be the target.

Here’s what many young people don’t realize: you might feel great and ignore diabetes when you’re young, but after 3-5 years of elevated HbA1c (8% or 10%), you’re silently damaging your kidneys. Then suddenly one day you’re facing renal failure and dialysis three times a week. While we can treat diabetic retinopathy with eye injections and medications like Metformin, Ozempic, or Mounjaro, there’s no real solution for saving the kidneys once they’re damaged.

Your diabetic retina exam can tell us so much about your overall health – when the HbA1c is high, it affects the smallest blood vessels in your feet and fingertips, leading to loss of sensation. It’s all connected.

Q: Many patients are concerned about floaters and other age-related eye conditions. How do you help patients understand and manage these common problems?

Let me walk you through the three leading causes of blindness that we can diagnose as retina specialists:

First, there’s glaucoma – the leading cause of blindness across all age groups, from birth to old age. We can identify this through our imaging machines that examine the optic nerve. In severe cases or congenital glaucoma, we work with our glaucoma colleagues for surgical intervention.

Second, for working-age Americans (21 to 65), diabetic retinopathy is the primary concern.

Third, for those 55 and older, we look at Age-related Macular Degeneration (AMD). Thanks to our advanced cameras, we can often diagnose this even without dilating the eyes, though a dilated exam gives us even more information.

Let me explain AMD in more detail. The early stage, called dry AMD, appears as yellow dots called ‘drusen’ – a Dutch word meaning stone. It accounts for 90% of AMD cases. These drusen, which we now know are lipid-filled and related to cholesterol, can often be managed with statins like Lipitor or Crestor.

The more serious form, wet AMD, occurs when these drusen cause bleeding. Think of dry AMD as a potential time bomb – it can turn wet at any time. While only 10% of cases are wet AMD, these require regular anti-VEGF injections every one to three months. Since we introduced these injections in 2006, they’ve revolutionized treatment – we’re literally preventing blindness and helping patients maintain their independence and ability to drive.

My final piece of advice? If you have a family history of eye problems, get evaluated by a retinal specialist. We’re like mechanics looking under the hood of your car – visit us once a year if you have any concerns about diabetes or AMD or your eye care in general.

To schedule an appointment with Dr. Wu, please contact:

Dr. Wu
2550 Samaritan Dr.
Suite C
San Jose, CA 95124
Phone: 408.356.5553