INNOVATIONS IN GLAUCOMA TREATMENT – HOW EMERGING TECHNOLOGY IS CHANGING PRACTICE

Glaucoma remains the leading cause of irreversible blindness worldwide. The disease is often asymptomatic until a significant amount of vision is affected, which is usually in a late stage of the disease. Because of the subtle and often deceptive natural course of this illness, it is important to detect its signs as early as possible and immediately initiate treatment if necessary.

What’s New in Glaucoma Diagnosis?

To prevent irreversible vision loss, we aim to identify patients who are at risk of developing glaucoma before significant clinical changes occur. While eye pressure, visual field exams, and clinical evaluations of the optic nerve are vital to diagnosis, changes can be subtle and difficult to detect. An additional very important tool is optical coherence tomography (OCT) of the retinal nerve fiber layer and ganglion cell layer. OCT analysis allows the physician to assess death of cells in these layers, which are specifically damaged in glaucoma. The advent of machine learning and artificial intelligence (AI) will soon allow us to detect even the smallest changes in these layers and immediately stratify patients as either high or low risk for developing glaucoma. By identifying these patients early, we can offer treatments that may reduce the risk of developing vision loss from glaucoma.

What’s New in Glaucoma Treatment?

The mainstay of glaucoma treatment has always been pressure-lowering eye drops — and in more severe cases — invasive surgery to lower eye pressure. After the Laser in Glaucoma and Ocular Hypertension Trial (LiGHT) found that selective laser trabeculoplasty (SLT) yielded the same results as eye drops, eye care providers often turn to laser therapy as a treatment for glaucoma prevention. As an analogue to eye drops, we can also now offer sustained-release implants of eye pressure-lowering drugs — which remain in the eye and secrete medication over 2 – 3 years. In cases where a more definitive eye pressure lowering is needed, we also offer minimally invasive glaucoma surgery (MIGS) through the use of specialized medical devices. The future of glaucoma treatment is bright, as there are treatments in the pipeline that target the optic nerve through neuroenhancement, which could potentially reverse damage that was previously thought to be irreversible.

While we still have a long way to go before we can cure glaucoma, it is reassuring that we have therapies that can significantly slow its onset and progression in high-risk patients. It is important to undergo routine eye exams and speak with your eye care provider about your risk of developing glaucoma. Doing so can save your vision.

Sarangdev Vaidya, MD
Cataract Surgery, Glaucoma Management,
Refractive Surgery, Comprehensive Ophthalmology
Atlantic Eye

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