Practical approach to medical management of glaucoma

Abstract

Primary open angle glaucoma (POAG) is usually a chronic, slowly progressive disease. At present, all resources are directed towards reduction of intraocular pressure (IOP), the only known causal and treatable risk factor for glaucoma, and medical management is frequently the first choice in most cases. With the introduction of innovative tools for early diagnosis and newer medications for treatment, decision-making in diagnosis and treatment of glaucoma has become more complex. The philosophy of glaucoma management is to preserve the visual function and quality of life (QOL) of the individual with minimum effects on QOL in terms of cost, side effects, treatment regime, follow-up schedules as well as socioeconomic burden. Our aim should be not to treat just the IOP, optic disc or visual field, but to treat the patient as a whole so as to provide maximum benefit with minimal side effects. In this article, we describe the scientific approach to medical management, mainly of POAG.

Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency

“…A study that evaluated these QOL issues categorized patients mainly into two groups based on their main priorities as “reading and seeing detail” and “outdoor mobility”, the latter changing to the former with increasing visual field loss and an increased willingness to trade time off for therapy thus resulting in a situation of forced compliance (Aspinall et al 2008). Considering this, it is remarkable how, the entire viewpoint of treating glaucoma has gradually changed to preserving “visual function” while ensuring minimal effects on QOL in terms of cost, treatment regime, follow-up schedules as well as socio economic burden (Janz et al 2001; Parikh et al 2008). …”

Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital

“…[5] With the introduction of innovative tools for early diagnosis and newer medications for treatment, diagnosis and treatment of glaucoma has became more complex. [6] The newer glaucoma medications have advantages like increased efficacy, reduced dosing frequency, and improved side effect profile. Studies related to drug utilization in glaucoma reported from India are scarce.…”

Comprehensive Glaucoma Management: Importance of Follow-up

“…In our own clinical routine: we use the "Overview" and glaucoma progression analysis (GPA) programs. 3 Eyeballing the overview we get a feel for whether field deterioration is due to generalized sinking of the hill of vision or whether it is due to glaucoma. GPA is based on the pattern deviation plot and is better option to diagnose progression.…”