Glaucoma Medications
The OHTS study has refined the way we
evaluate glaucoma risk assessment.
Also see: What Does the Ocular Hypertension
Treatment Study Mean to Practicing Optometric Physicians?
Patients
with glaucoma represent some of the most poorly cared-for people
in the U.S., and probably the world. If there is one area where
optometry can make a major contribution to public health, it
is in the care of these patients.
We have "inherited" hundreds
of patients with glaucoma over the years, and it has been the
rare patient who was not being over-medicated. This leads to
increased side effects, poor compliance, and excessive costs.
This chapter will address these three areas and others that,
when understood and embraced in practice, can dramatically elevate
the level of care patients with glaucoma receive.
Conversely,
we have inherited patients who have glaucoma, or are at high
risk for developing glaucoma, who were completely unaware of
their situation. Given that half of glaucoma patients remain
undiagnosed, it is incumbent upon all of us to be vigilant in
our examination and care of our patients, especially so that
significant risk of glaucoma—or evident glaucoma—is not missed.
The biggest news surrounding glaucoma patient care came from
the publication of the Ocular Hypertension Treatment Study (OHTS).
A succinct description of the clinically relevant findings from
this study can be found by clicking
here, but allow us to recap
the biggest pearls from the study:
- Reducing IOP can indeed prevent
the development (or worsening) of glaucoma.
- Measuring central
cornea thickness via pachymetry can provide clinically significant
modifications to applanation tonometric readings.
- Subnormal
corneal thickness is a newly discovered, major risk factor
for glaucoma. To wit, patients with thin corneas give falsely
low IOP readings and can lead the doctor into believing the
IOP is acceptable when in fact it may be too high for the health
of this patient’s optic nerves.
It has indeed been a time of
calm in the area of medications for glaucoma care. Xalatan
continues to be the “standard-bearer” in the prevention and
treatment of glaucomatous optic neuropathy. Xalatan enjoyed
two major milestones this past year: It became the first
in its class to be approved for “first-line” therapy, and
it was the first ophthalmic drug to exceed the billion dollar
sales mark. Our two prime concerns in selecting a glaucoma
drug are efficacy and compliance. The safety of any medication
is a major factor, as well. Cost is a less critical concern,
since the cost of most glaucoma therapies are not markedly
different. Besides, the price of blindness is not measured
in dollars.
Click here to see Topical Glaucoma Drug
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