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Glaucoma diagnosis challenging when associated with myopia
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OVIEDO, Spain — Glaucoma and myopia often coexist, making management challenging, according to a speaker at the second European Meeting of Young Ophthalmologists.
Epidemiological data show that myopic individuals have about a 90% increased risk for glaucoma, and in high myopia the risk increases up to 2.5 times.
Anthony Khawaja
This association makes the diagnosis of glaucoma sometimes very challenging.
“We diagnose glaucoma based on optic disc appearance and visual field but high myopes often have anomalous, weird discs or large optic discs and visual field changes. Deciding what is myopia and what is glaucoma is difficult,” Anthony Khawaja, MD, PhD, said.
With increasing prevalence of glaucoma, this comorbidity is becoming more and more of an issue.
Khawaja advised his colleagues to observe rather than treat patients with early glaucoma to avoid unnecessary side effects from medications. After a maximum of 3 to 5 years of follow-up with no changes, patients should be discharged, he said.
“In the U.K., we are fortunate to have very good optometrists in the community who can follow up these patients,” he said.
Khawaja also recommended caution with surgery because hypotony is more likely in myopic individuals.
“If you do trabeculectomy, make sure everything is water-tight,” he said. – by Michela Cimberle
Reference:
Khawaja A. Glaucoma associated with myopia. Presented at: European Meeting of Young Ophthalmologists; June 24, 2016; Oviedo, Spain.
Disclosure: Khawaja reports no relevant financial disclosures.