Interventional glaucoma consensus treatment protocol
Christine M. Funke, Deborah Ristvedt, Arkadiy Yadgarov, J. Morgan Micheletti
Abstract
Introduction Topical medications are a common treatment for glaucoma, but a number of caveats limit their long-term utility and sustainability. In recent years, as a wider variety of treatment options has become more widespread for glaucoma – such as laser trabeculoplasty, minimally invasive glaucoma surgery (MIGS), and sustained-release procedural pharmaceuticals – it has become increasingly possible to manage the disease procedurally and at earlier stages. This evolution in care has been termed ‘interventional glaucoma’ (IG).Areas covered The present paper reviews the evidence behind the IG revolution, then turns to a central question: determining the optimal treatment algorithm at each patient stage within the IG paradigm, from ocular hypertension to severe glaucoma. The paper summarizes the consensus opinion of 10 glaucoma experts committed to IG principles and advancing patient care.Expert opinion Within this consensus protocol, each glaucoma stage has its own stepwise, logical procession of treatment(s), with rationale behind each step. The resulting framework is intended to be a practical guide or starting point for providers seeking to incorporate IG principles into their practices.