Managing Glaucoma in an Evolving Clinical Landscape
Coy Steel, Andy Renschler MD, Brian Stagg MD MS and Barbara M Wirostko MD*
ABSTRACT
Glaucoma continues to affect patients at a rate overwhelming to current care models, a problem particularly evident in rural and underserved communities. This necessitates reevaluation of the current glaucoma management approach and opens the door for the development of collaborative care frameworks that leverage the complementary skills of optometrists and ophthalmologists. As our understanding of glaucoma continues to evolve, ongoing research consistently identifies new risk factors, mechanisms, and therapeutic targets. Emerging technologies, including home tonometry, wearable perimetry devices, and polygenic risk score, have the potential to reshape glaucoma screening, monitoring and treatment. Similarly, systemic conditions like obstructive sleep apnea and hypertension, as well as medications including glucagon-like peptide-1 receptor agonists, calcium channel blockers, nicotinamide, and pyruvate, warrant consideration in glaucoma. New insight into glaucoma pathophysiology combined with access to novel screening, monitoring, and treatment modalities, positions eyecare providers to deliver more comprehensive, patient-centered care. By combining new discoveries and technology with interprofessional collaboration, we are positioned to transform glaucoma care from a traditionally reactive approach toward a more proactive, preventive model.
