This article is more than 5 years old. Information may no longer be current.
Stepwise approach useful for medical treatment of open-angle glaucoma
Click Here to Manage Email Alerts
BEIJING — Establishing a target pressure, choosing the appropriate medication or combination of medications, and addressing compliance issues are the necessary steps to treating open-angle glaucoma patients with medical therapy, a physician said here.
"The few things we're going to consider, in the stepwise approach, [are] the degree of desired lowering, IOP target pressure, effectiveness of the medications, compliance and other barriers to compliance that exist with patients," Douglas J. Rhee, MD, said at the 25th APAO Congress.
He said the first step in treating open-angle glaucoma patients is to set a target pressure, considering glaucoma severity, untreated baseline IOP and risk factors including age, race, family history and central corneal thickness.
The second step is choosing the most appropriate primary medical treatment from the many medications available, including the effective class of prostaglandin analogues and combination agents.
The third step is being aware of poor compliance rates, Dr. Rhee said. Patients' medication use decreases over time, and adherence falls when additional medications are prescribed. Minimizing the number of glaucoma medication bottles that a patient uses can assist in increasing compliance, he said.
The last step is understanding how cost and side effects can be barriers to medical compliance.