This article was originally published in a sponsored newsletter.
As far as things stand today, glaucoma is not curable. It is a chronic, lifelong disease that will be positively impacted by the early treatment decisions we make. In other words, when and how we choose to intervene will affect patients’ futures. So, if we are thinking about improving the continuum of care, we must pay close attention to these early decisions.
Increasing evidence shows that early interventional choices lead to better outcomes for patients. For instance, the LiGHT trial demonstrated that selective laser trabeculoplasty (SLT) appears to be a better option than topical treatment in terms of visual field progression and quality of life. That’s not to say topical agents don’t have a place; they can be used for specific cases or to bridge the gap between therapies. But research increasingly demonstrates that topical treatments may not be the best foundational approach to glaucoma care.
The fact that the number of available MDs remains stagnant while the number of patients grows adds complexity to the issue. This imbalance puts more pressure on the collaborative relationship between MDs and ODs. Our optometric colleagues may only have topical drops in their toolbox, so we need to have conversations about collaborative approaches that best support patients. This is an evolving issue, but we need to ensure these conversations center around patient wellbeing.
Finally, it is important to emphasize that patients should not miss follow-up treatment visits when managing their glaucoma. Again, this is a lifelong disease that requires long-term management, but patients who are initially put on drops sometimes get discouraged and begin to miss visits or stop adhering to their treatment regimen altogether, particularly if they have side effects and feel worse than they did before they started treatment. Solving this problem circles back to delivering better options early on. This is an opportunity to be interventional, not just because it’s something that separates us from other doctors, but because it’s the right thing to do. Early intervention leads to better outcomes.
