Up close with Dr. Aleksandra Gocheva Jercikj
“Positive emotions should always prevail in communication with the patient”
- What part of ophthalmology is your specialty?
I completed my specialization in ophthalmology in Sofia, where I had the opportunity to learn from the best retinologists and retinal surgeons in the region. It is at that time when retinal diseases became my favorite part of ophthalmology. I think that a retinal examination can reveal a lot, not only in terms of eye diseases, but also the health of the whole body. In the eye we have a unique, one of a kind opportunity to live monitor the retinal circulation and thus see the blood vessels, which are representatives of the blood vessels in the brain.
- You run the diagnostic center of Sistina Ophthalmology in Bitola. What does such a professional engagement mean?
My engagement, together with the other colleagues in Sistina Ophthalmology, is for the hospital in Bitola to be a regional diagnostic and therapeutic center for the treatment of retinal diseases. We are headed that way and the goal is almost certain.
- What are your experiences with laser diopter correction?
At Sistina Ophthalmology we have been doing this intervention very successfully since 2015. We are the only center in Macedonia, which specializes in performing all methods for laser diopter correction. Patients who have had this type of surgery are actually young and healthy people who want to remove the need of glasses or contact lenses. It is a real refreshment for ophthalmologists, because after a two-hour examination, with a laser correction that lasts about fifteen minutes, the patients are forever free from the aids and leave happy.
- What is macular degeneration?
It is a disease that leads to progressive reduction of the central vision. It attacks the macula, the middle part of the retina, which has millions of photoreceptor cells that capture light pulses, the image we see. Over time, these cells lose their function and die, mainly as the eye ages. The disease has two forms: dry and wet. In the dry form, there is an accumulation of remnants of retinal metabolism over the years leading to a slow decline in vision. In the wet form, new abnormal blood vessels grow in the space below the retina and they disrupt its structure, progress and cause swelling and bleeding. The disease affects people over the age of sixty, more often in the female population.
- What are its symptoms and what are the risk factors?
The first symptoms are felt when patients look at objects, letters, people with distorted or blurred focus, the ability to distinguish fine details is lost, followed by the appearance of a gray spot in the center that gradually spreads and becomes dark, opaque. Peripheral vision is not affected, so fortunately this disease rarely leads to complete blindness. As the disease progresses, difficulties in dealing with ordinary everyday things such as reading, driving, recognizing people begin and people become more dependent on their loved ones. The disease is closely related to age, hence its name – age related macular degeneration. Proven risk factors are genetic predisposition – the gene responsible for this disease is isolated and is usually activated after the age of sixty. Other risk factors are: smoking, obesity, high blood pressure.
- How is macular degeneration diagnosed and treated?
The diagnosis is made by ophthalmological examination which includes determination of visual acuity, thorough examination of the fundus, retinal tomography. It often remains undiagnosed at an early stage, as it is not common practice to dilate the pupils and look at the fundus in patients who do not complain of image distortion or difficulty when reading. The treatment of the wet form in the last fifteen years has experienced a real revolution with the introduction of drugs that are administered intravitreal, i.e. injections into the eye. Injections are painless, we use local anesthesia in the form of drops.
- Can it be prevented?
We cannot influence the genetic nature of the disease. The main prevention is a change of habits, lots of vegetables and fruits in the diet, physical activity and control of blood pressure, glycaemia and blood fats. With early detection and adequate therapy, the quality of life of people suffering from this disease can be significantly extended.
- Do both eyes suffer from the disease at the same time?
Quite often both eyes suffer, but at different stages of the disease. Unfortunately, patients come to us when one eye is in a very advanced stage.
- How do patients react when they hear the diagnosis?
Patients come with suspicion of aging curtains or diopter changes, and many are first diagnosed with macular degeneration. Patients need to be explained in detail so that they understand how serious it is, and what the consequences are if left untreated.
- What is your approach to them?
The approach to patients depends on what emotions they have. The most important thing is to overcome the fear and solve the dilemmas they have. This can only be achieved through open conversation in which positive emotions prevail.
- Bitola is the host city of the famous international film festival “Manaki Brothers”. Do you like to watch movies and do you follow the festival’s program?
I am a big fan of movies and until a few years ago I followed everything that was happening in the film industry, I watched a lot of new and interesting movies. Lately I often find myself “stuck” binge watching a series. Of course, due to my husband’s profession, we visit the “Manaki Brothers” Festival almost every year and follow a large part of the program.
- The Bitola Theater is one of the best in our country. Do you watch theater plays?
I think that the Bitola Theater is the best theater in our country. I look forward to every new production. Unfortunately, in this time of pandemic, the pleasure of watching theater plays has diminished and I can’t wait to enjoy the magic of the theater again.
- Your sister is the famous singer Karolina Gocheva. Do you have affinities related to music and what kind of music do you listen to?
I have never had a musical affinity as a professional engagement, but of course I love music. In recent years, children have been dictating our music choices. In the car, apart from “Auntie”, they want to listen to Foltin, as well as the currently world-renowned Billie Eilish and Dua Lipa.
- How do you define a woman’s style?
A smile, a sense of humor and the ability to have a nice chat with her.