CRU 2025: Interventional glaucoma as a proactive approach to glaucoma management

Deborah Ristvedt, DO, from Vance Thompson Vision discusses the significant evolution of glaucoma treatment over the past decade. The presentation focuses on moving beyond traditional eye drop treatments to more proactive and patient-friendly interventional approaches. The key shift in glaucoma care is transitioning from a reactive to a preventative model. Ristvedt emphasizes that drops are no longer the only or best solution, highlighting several misconceptions in current glaucoma treatment. While medications can be effective, patient compliance and side effects remain significant challenges. Modern glaucoma management now includes multiple innovative techniques, including selective laser trabeculoplasty (SLT) for consistent 24/7 pressure control, procedural pharmaceuticals that directly target eye pressure, minimally invasive glaucoma surgeries (MIGS) focusing on the trabecular meshwork, and novel devices addressing aqueous fluid production and flow.

The ultimate goals are comprehensive 24/7 pressure control and preventing vision loss. Ristvedt notes that currently, 13% of patients still risk losing vision in one eye, making early intervention crucial. A critical aspect of improved glaucoma care is patient education and early detection. Ristvedt stresses the importance of collaboration between ophthalmology and optometry to help patients understand glaucoma and overcome fears about treatment. Emerging technologies like ocular perfusion goggles for treating normal tension glaucoma represent exciting advancements. The focus is on individualizing care, reducing patient burden, and intervening earlier in the disease progression. The future of glaucoma treatment looks promising, with an increasing number of techniques and devices that allow more personalized, less invasive, and more effective management strategies. By educating patients and implementing these advanced treatments, healthcare professionals can help patients maintain long-term vision and quality of life.