Matching treatment to goal is key in glaucoma

DANA POINT, Calif. — Preserving the glaucoma patient’s quality of life by preventing further damage to the optic nerve should be the physician’s main treatment goal, said Jonathan S. Myers, MD.

Dr. Myers presented a review of treatment options for patients diagnosed with glaucoma at the Ocular Drug and Surgical Therapy Update meeting here.

Current research on new glaucoma treatment modalities may some day offer “new and promising treatments,” Dr. Myers said, “but we don’t have those now, so it is best to concentrate on lowering IOP.” IOP can be lowered through medical, laser or surgical therapies, Dr. Myers noted, and currently medical treatment is “overwhelmingly the first choice” among both patients and physicians.

“It is easy to see why patients don’t choose incisional surgery,” he said. “But in a survey, almost half of glaucoma surgeons would prefer to have a trabeculoplasty over medication. So there is this amazing dichotomy for how we view the disease and treatment.”

Surgeons should tell patients what their goals for treatment goals are, what the patient should expect if treatment is not given and what the possible side effects of treatments might be, Dr. Myers said.

If pharmaceutical treatment proves ineffective, he recommended that laser therapy should be tried next, followed by trabeculectomy.