How does one treat glaucoma? Of course, the only proven therapy at this point in time is lowering intraocular pressure (IOP). My favorite answer to this question has always been that the goal of glaucoma treatment is to maintain the patient’s vision-related quality of life without decreasing the patient’s quality of life. With this goal in mind, the practical answer is to lower IOP in a way that maximizes the patient’s overall quality of life.
The day that a patient begins topical therapy for glaucoma has been suggested to represent the most significant quality of life decrease for that patient, by bringing them into the world of daily drop applications and their potential side effects. As topical therapy continues, side effects mount, dry eye begins, financial costs accumulate, and the time required to apply drops becomes more meaningful. For the right patient, however, these quality of life costs are certainly worthwhile if topical therapy is the only way to save their vision.
In clinic, I need to get to know my patients a little better to know what is important to their quality of life. I am consistently amazed at how each individual’s life satisfaction can be impacted uniquely. I think some patients want to take eye drops because it gives them a sense of control over their disease. Some patients view interventions as a sign that they are getting worse rather than an opportunity to feel better. And I have learned that some patients have side effects from eye drops that you have never heard of, but are real for them.
This is the journey of modern-day glaucoma treatment, recognizing that each patient has unique personal and disease characteristics and learning to do the best for that whole person, given their age, disease severity, and other factors. Each patient’s journey will be unique and will require a tailored approach. In this scenario, more treatment options will help. Given that so many of the quality of life detractors mentioned above have to do with traditional topical therapy, we are particularly interested in the new options of interventional glaucoma.
Always at Glaucoma Physician, as in this issue, we strive to bring a plethora of unique and diverse treatment options to our readers to bring to their patients. Enjoy. GP
