Meet a Specialist: Iryna Falkenstein, MD
Inspired by the work of world-famous ophthalmologist, Svyatoslav Fyodorov, who first treated nearsightedness by surgically re-shaping the cornea (radial keratotomy), Dr. Iryna Falkenstein was drawn to ophthalmology early in her medical training. Today, she is an expert in the treatment of glaucoma and cataracts who cares for patients at Mass. Eye and Ear’s Charles Street and Longwood locations.
Glaucoma is caused by a build-up in pressure in the eye that occurs because ocular fluids are not draining properly. The increase in intraocular pressure can interfere with the functioning of the optic nerve and lead to progressive irreversible vision loss. Reflecting back on her choice to specialize in the treatment of glaucoma, Dr. Falkenstein notes, “There’s no magic bullet or cure for this disease. Treating glaucoma requires long-term care and follow-up with patients and that kind of commitment is exactly what appealed to me.”
At Mass. Eye and Ear, Dr. Falkenstein provides both medical and surgical treatment for adult patients with glaucoma, including primary open-angle glaucoma (POAG), the most common form, as well as pigmentary glaucoma, acute-angle closure glaucoma, pseudoexfoliation glaucoma, and neovascular glaucoma.
“We still don’t know what exactly causes glaucoma in many cases,” Dr. Falkenstein says. “It’s a chronic, progressive disease with roots that are both genetic and environmental, but with the appropriate care, we can often help patients preserve their vision for many years.”
One of the difficulties in diagnosing glaucoma is that patients are typically asymptomatic until very late in the disease. “Patients often come to us after the disease has already begun to affect their central vision,” explains Dr. Falkenstein. “Glaucoma constricts the visual field from the periphery, but by the time a patient notices, the disease often has progressed.”
“That’s why a regular eye exam—including a check of your eye pressure—is so important, especially after age 55,” notes Dr. Falkenstein. “Abnormal pressure is the sign that enables us to intervene early with glaucoma.”
Describing her clinical approach as “conservative,” Dr. Falkenstein says that, whenever possible, she first recommends trying medical treatment with eye drops or laser procedures to ameliorate the disorder. If neither provides the necessary relief, Dr. Falkenstein helps her patients decide on the appropriate surgical approach.
“We have to discuss every aspect thoroughly,” she explains, “because patients need to have realistic expectations. The goal is to reduce pressure in the eye and preserve existing vision as long as possible, but unfortunately we cannot restore lost vision. And that means careful attention to post-operative care, as well.”
While glaucoma is challenging to treat, Dr. Falkenstein is encouraged by the progress she has seen in the field. “We have far more treatment options than we had just 20 years ago—more available types of medications, new laser techniques, and improved innovative surgical procedures. We see fewer complications, outcomes are more successful, and we can definitely help our patients.”
Dr. Falkenstein completed her initial training at Crimea State Medical University in Ukraine before completing a three-year research fellowship at Shiley Eye Center at the University of California in San Diego and her ophthalmology residency training at the University of Texas in San Antonio. She completed one year of clinical fellowship to specialize in glaucoma at the University of North Carolina with Dr. Donald Budenz. Today she is a Board-Certified ophthalmologist, a full-time member of the Mass. Eye and Ear Glaucoma Service, and a Harvard Medical School Instructor in Ophthalmology. In addition to English, she is fluent in Russian and Ukrainian.
Contact Dr. Falkenstein’s office at 617-573-3670.
View Dr. Falkenstein’s online bio for more information.