Our Summary

This research paper discusses the issues of glaucoma patients not following their prescribed treatments, which is causing their condition to worsen. Glaucoma is a disease that can lead to blindness, and one of the main risk factors is high eye pressure (IOP). The paper focuses on ways to make treatment more effective, particularly through a type of surgery called minimally invasive glaucoma surgery (MIGS). This surgery has been found to have fewer complications, especially when done with cataract surgery. It can also help reduce IOP, and in some cases, may even eliminate the need for glaucoma medication.

The paper discusses how, in the US, around 27% of all prescriptions aren’t taken as directed. This is an even bigger issue with eye pressure-lowering medications. Different methods have been developed to address this problem, including long-term drug delivery systems and laser treatments. Most recently, MIGS has become popular due to its safety, its effectiveness in lowering IOP long-term, and its potential to reduce or eliminate the need for medication.

The paper concludes by suggesting that MIGS could be a useful treatment option for optometrists to recommend to their glaucoma patients, especially those who struggle with following their prescribed treatment.

FAQs

  1. What is minimally invasive glaucoma surgery (MIGS) and how does it help in treating glaucoma?
  2. What percentage of glaucoma patients in the US do not adhere to their prescribed treatment?
  3. Why is MIGS considered a preferable treatment option for glaucoma patients who have difficulty adhering to their medication regimen?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to follow all post-operative instructions carefully to ensure a successful recovery. This may include using prescribed eye drops, avoiding strenuous activities, and attending follow-up appointments with your doctor. It’s important to communicate any concerns or changes in your vision to your doctor promptly. By following these guidelines, you can help maximize the benefits of the surgery and protect your vision in the long term.

Suitable For

Patients who are typically recommended glaucoma surgery are those who have not responded well to medication, have advanced glaucoma that is causing significant vision loss, or who are unable to tolerate the side effects of medication. Additionally, patients who have cataracts and glaucoma may benefit from MIGS surgery, as it can address both conditions simultaneously.

Overall, glaucoma surgery is recommended for patients who need a more effective treatment to lower their IOP and prevent further vision loss. It is important for patients to discuss their options with their eye care provider to determine the best course of treatment for their individual needs.

Timeline

Timeline of a patient’s experience before and after glaucoma surgery:

Before surgery:

  1. Patient is diagnosed with glaucoma and prescribed medication to lower eye pressure.
  2. Patient may struggle with adhering to their medication regimen, leading to worsening of their condition.
  3. Patient’s eye pressure continues to rise, putting them at risk for vision loss.

After surgery:

  1. Patient undergoes minimally invasive glaucoma surgery (MIGS) either alone or in combination with cataract surgery.
  2. Surgery is successful in lowering the patient’s eye pressure.
  3. Patient experiences improved vision and reduced reliance on glaucoma medication.
  4. Patient’s risk of vision loss decreases, leading to a better quality of life.

Overall, the timeline of a patient’s experience before and after glaucoma surgery involves a transition from struggling with medication adherence and worsening vision to achieving better eye pressure control, improved vision, and reduced risk of blindness.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What type of glaucoma surgery do you recommend for my specific case?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period after glaucoma surgery?
  4. Will I still need to use glaucoma medication after the surgery?
  5. How likely is it that the surgery will be successful in reducing my eye pressure?
  6. Are there any lifestyle changes or precautions I need to take before or after the surgery?
  7. How often will I need to follow up with my doctor after the surgery?
  8. Are there any alternative treatment options to consider before opting for surgery?
  9. What is the success rate of minimally invasive glaucoma surgery compared to traditional glaucoma surgeries?
  10. How will the surgery impact my vision and overall eye health in the long term?

Reference

Authors: Fingeret M, Dickerson JE Jr. Journal: Optom Vis Sci. 2018 Feb;95(2):155-162. doi: 10.1097/OPX.0000000000001173. PMID: 29370021