Glaucoma Management

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.