Are We Overtreating Glaucoma?

by John R Martinelli MD OD FAAO

Oct 20, 2024

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Maybe we shouldn't be so defensive...

Are we sometimes guilty of being overzealous in pursuing glaucoma treatment and management? This question needs to be addressed when understanding certain risks of overtreatment in our glaucoma patients. And it was a topic of conversation at this years American Glaucoma Society meeting.

Recent studies show aggressive intraocular pressure (IOP) reduction may not always yield proportional benefits, particularly in cases of early or low-tension glaucoma.

Overtreatment can lead to a cascade of issues, including ocular surface toxicity, as well as potential cataract progression and even paradoxical IOP spikes in some surgical interventions. Moreover, the psychological burden and fear factor put on individuals subjected to overmanagement and unnecessary treatment cannot be overlooked.

We must always critically evaluate our treatment approach, considering not just the potential for vision preservation, but also the quality of life implications for our patients. The challenge lies in truly understanding the pathophyiologic basis of all the glaucoma's and striking a balance between undertreatment and overtreatment, then tailoring our approach to individual risk profiles, progression rate, or potential progression.

-JRM

Go to the conversation in AAO's Eyenet Magazine:

GO TO ARTICLE

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