Patients need to understand pros, cons of interventional glaucoma treatment
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Switching patients to an interventional glaucoma treatment paradigm offers benefits, but ophthalmologists must be aware of how to effectively minimize drawbacks, according to a presentation at Real World Ophthalmology.
“It is more of a proactive approach rather than reactive. It’s beautifully patient centric. It’s customized, and thankfully we have great data now to back up some of these safer minimally invasive options,” Lori Provencher, MD, said. “But every beach has its falling coconuts and palm fronds. Nothing’s perfect.”
Drawbacks include an increased risk for iatrogenic complications, increased chair time, and the possibility of intervention failure being perceived by patients as surgeon failure, Provencher said.
Ophthalmologists must be aware of the possible barriers that patients may face when considering a shift in treatment approach.
“I’ve encountered issues with cost or insurance coverage, but more commonly, I actually experience patients who are fearful of intervention or have a sort of decision paralysis,” Provencher said. “And I think that boils down to poor understanding of the ‘why.’”
To set realistic expectations, ophthalmologists must be prepared to define problems that patients face with their current treatment and pinpoint specific goals. Additionally, when discussing risks with patients, it is best to keep the conversation simple.
“I think a lot of times we as doctors treat ourselves by overexplaining the risks to kind of cover ourselves, and that can be overwhelming for the patient,” she said. “You don’t want to invoke decision paralysis.”
Ophthalmologists should involve their staff in educating patients and use educational materials such as websites, handouts and visual tools to minimize chair time.
When faced with the decision of whether to switch to an interventional treatment approach, ophthalmologists should consider the state of the patient’s glaucoma and how traditional treatment has affected their quality of life.
“It might make their vision better, and it might even slow their disease progression over time,” Provencher said.
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Provencher L. Interventional glaucoma: Doctor & patient perspectives. Presented at: Real World Ophthalmology; Sept. 30, 2023 (virtual meeting).
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