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Focus on Carla Siegfried, MD

Carla Siegfried, MD is an associate professor in the department of ophthalmology and visual sciences. She is a specialist in the diagnosis and treatment of glaucoma.

Dr. Siegfried sees patients at the Center for Advanced Medicine, 4921 Parkview Place, 12th floor, Suite C and Barnes-Jewish West County Hospital, 10 Barnes West Drive, Suite 201.

TO MAKE AN APPOINTMENT PLEASE PHONE 314 362-3937 (4921 PARKVIEW PLACE) or 314 996-3300 (BARNES-JEWISH WEST).

What happened in medical school to make you choose ophthalmology?

Because I liked a lot of other specialties, it was actually fairly late in my training when I chose ophthalmology. I knew I wanted to do something microsurgical, and in the end it was a choice between neonatology and ophthalmology. I just fell in love with the field. When I did my ophthalmology rotation as a medical student, I saw what an impact we can have on patients’ lives – I knew this was my calling.
Dr. Siegfried and family at the Grand Canyon



What brought you to Washington University?

I am a native St. Louisan -- born and raised here. A great opportunity became available at Washington University at the same time I decided I wanted to move back to St. Louis. They have a wonderful program and this was a natural choice for me.

Which aspect of your practice is most interesting?

Patients. I love my patients. I truly have a passion for taking care of people. Although that might sound trite, I really love my day-to-day patient interaction. It can be hard sometimes, especially when there is bad news to give and I know things aren’t going in the right direction. Most of my patients are referred to me for advanced specialty care or surgical techniques when their primary ophthalmologist (and sometimes even other glaucoma specialists) are at the end of their skill set and comfort level. We get the most complex cases. But this is what I really love to do.

There is a new and exciting development in your field -- can you explain it?

Glaucoma surgery, for many years, has been focused on making a new outlet for drainage -- because fluid builds up and increases the eye pressure. For years we have had procedures which are focused on making the natural drainage pathway work better. But now we are also using surgical techniques to ablate (destroy) the tissue that is causing the obstruction to outflow.

This new procedure is called an ab interno trabeculotomy – utilizing a Trabectome™ (an instrument that is specially designed precisely for this procedure). Although the trabeculotomy doesn’t get pressures as low as a traditional glaucoma filtering surgery (which has been the gold standard for many, many years), recovery time is faster and it is a less invasive procedure.

Do you think there will be a trend towards performing more trabeculotomies?

No, I still see a lot of people that have advanced disease or have a type of glaucoma that requires very low pressures. We’re still not getting those low pressures with this procedure. In those individuals who do have the criteria for this procedure, it’s a wonderful option. We’ve had so few options in glaucoma surgery. Glaucoma cannot be cured and only time will reveal the long term success of these newer procedures.

Is there a particular award or achievement in the most gratifying for you?

I think the greatest award is from my patients who are happy with my care. It’s that look on their face when we’ve had a successful procedure. Also, the thanks that I get from family members because we’ve improved the quality of life of their loved ones – that is worth more than anything else.
What do you do when you’re not working?

I’m with my family – it doesn’t have to be doing anything special. We love to go hiking and just spending time together. I have two young children. I enjoy being at home with them – my husband too. He laughs and says he’s my third passion – my kids, my job, my husband. But in my heart it is my family that truly does come first.

What is the best advice you’ve received?


When dealing with issues in my personal life, I always remember this advice -- love is to accept with enthusiasm that which is less than perfect. I’ve also had some great mentors in my medical career who have taught me “how to think”and not simply “what to do.”

What lifestyle change could most benefit our health?

In terms of eye care, our greatest effort is prevention. At age 40, a comprehensive eye exam for everyone is appropriate. Unfortunately, half the patients who have glaucoma don’t know they have it. Advanced damage is avoidable if we can detect disease early. There is little reason for people in the United States, or anywhere in the world, to go blind from glaucoma. It’s a treatable condition in the vast majority of cases.

In terms of general lifestyle – exercise, eat right, and be happy.

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Copyright 2014 Washington University School of Medicine