New Directions in Glaucoma Detection and Management

In this interview from the ARVO 2013 Annual Meeting, Dr. James Tsai shares his outlook for glaucoma detection and intervention. Because up to a third of glaucoma patients maintain a normal IOP, glaucoma is a silent disease that often goes unchecked until vision is affected. As a result, diagnostic approaches are evolving beyond visual field tests and toward objective methods that detect risk earlier in the disease process. Such approaches include visual evoked potentials, pattern ERGs, methods of measuring pressure over a 24-hour period, and telemedicine to screen for the abnormal optic nerve. Treatment must also be managed more aggressively and earlier in the disease trajectory, says Dr. Tsai. Combination drop therapies and less invasive laser and surgical interventions are currently in practice. Compliance remains a challenge, however, and the cost associated with regular drop therapy is an obstacle to care in the developing world. Dr. Tsai expects nanotechnology and sustained release drugs to ease the burdens of compliance and access, especially if a single treatment can provide treatment for several months or longer.