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Glaucoma Management

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The American Optometric Association (AOA) Guidelines classify glaucoma as a group of eye disorders that lead to damage of the optic nerve with a defect in the retinal nerve fiber layer resulting in visual field loss. Glaucoma is a chronic, progressive disorder and if not diagnosed early and treated appropriately, it can lead to an irreversible decline in eyesight.

Glaucoma is a leading cause of blindness in the US. The most common type of glaucoma, open-angle glaucoma, affects approximately 3 million individuals in the US. The prevalence is estimated to reach 7 million by 2050, due to the increased prevalence of glaucoma in older adults and the growth of the elderly population in the US.

Many classes of medications are used in the management of glaucoma, including prostaglandin analogs, beta-adrenergic blockers, alpha2-adrenergic agonists, carbonic anhydrase inhibitors, and cholinergic agents. Prostaglandin analogs or beta blockers are usually considered first-line therapy, although prostaglandin analogs are increasingly preferred.3 Factors that should be taken into account when deciding what agent(s) to initiate include efficacy, side effects, cost, and dosing frequency. There are a number of barriers to adherence with glaucoma medication.4 Healthcare professionals should be aware of these barriers and assess for their presence frequently.

Important aspects of patient education include reviewing potential medication complications, counseling on proper administration technique, and coping strategies for medication management with vision loss.


Publication Date: 05/20/2016
Expiration Date: 05/20/2019
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Jamie Rickards Cronquist, PharmD, BCPS, MBA s an Assistant Professor and Clinical Geriatric Pharmacist at Notre Dame of Maryland University, School of Pharmacy, Baltimore, Maryland.

Disclosure Statement

Dr. Cronquist reports no financial relationship with the manufacturer(s) or provider(s) of any commercial interest(s) or service(s) that appears in this issue.

Guest Editorial Advisor

Expert Editorial Advisor: Edward M DeSimone, RPh, PhD, FAPhA

Target Audience

This accredited program is targeted to advanced practice/registered nurse .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Discuss the risk factors and pathophysiology of glaucoma.
    2. List the medication classes and individual agents available for glaucoma management. Discuss the mechanism of action and efficacy of each class.
    3. List the side effects, cautions, and contraindications for the most commonly used glaucoma medications.
    4. Educate patients on the proper administration and scheduling of medication eye drops, as well as the importance of adherence. Recognize potential barriers to adherence and provide possible solutions.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-16-005-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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