ASCRS News: Annual Meeting Preview
July 2021
by Ellen Stodola
Editorial Co-Director
Richard Lewis, MD, will give this year’s Binkhorst Lecture during the Opening General Session at the ASCRS Annual Meeting. His lecture is titled “We Can Prevent Blindness in Glaucoma—Why Don’t We?”
The lecture will include an overview of “how we got here, where we are” and will dive deeper into “where we’re going to be and how we’re going to stop people from going blind,” Dr. Lewis said.
He was motivated to highlight this topic as it’s something that hasn’t been resolved. “There’s definitely an unmet need that we’re not treating,” Dr. Lewis said. “We’ve made so many inroads in other specialties, yet here we are in glaucoma, and we’re just scratching the surface of why people are going blind.”
While he noted that there have been some steps forward, Dr. Lewis said there are still many improvements needed to address the problem of glaucoma-related blindness.
He noted that a survey done by the Mayo Clinic in 2000 found that 13% of patients still go blind from glaucoma, despite all the treatment options. This number would be unacceptable in other ophthalmic specialties, and Dr. Lewis thinks this number should be much less. “The first time I heard a similar talk in 1982, I was a resident, and the percentage of patients who went blind shocked me,” he said. The number has dropped a bit. “We’ve gotten a little better with early diagnosis, risk factors, and better treatment, but it’s not nearly at the level of so many other common diseases, like cataract and even macular degeneration.”
We’ve made so many inroads in other specialties, yet here we are in glaucoma, and we’re just scratching the surface of why people are going blind.
Richard Lewis, MD
In glaucoma, there’s a group of people who go blind with high pressure, Dr. Lewis said, but there is also a substantial number of patients who go blind with low pressure. “We’re not good at treating the low-pressure people,” he said. “At least with high pressure, we have drops, laser, and surgery. It’s the low pressures that can potentially fall through the cracks, and it’s unfortunate.”
The reality, Dr. Lewis said, is there are a lot of people who need help with this because it’s complex. “It’s not always a pressure phenomenon,” he said. “You may be doing everything to lower IOP but haven’t done enough to maintain vision.”
The good news on this front, Dr. Lewis said, is there are new options in the pipeline, including new therapies in trials. Dr. Lewis said this is one of the exciting parts of this topic, discussing new approaches.
While a lot of content at the ASCRS Annual Meeting focuses on cataract and refractive surgery, Dr. Lewis said he sees the separation between the subspecialties as less now, particularly with the increased use of MIGS. Ike Ahmed, MD, was the first glaucoma specialist to give the Binkhorst Lecture in 2014 on MIGS, and Dr. Lewis, who is proud to be the second glaucomatologist to present, said this shows how all the subspecialties overlap now and how glaucoma is important in cataract and refractive surgery. “The ASCRS Annual Meeting has opened itself up to include more glaucoma in the curriculum, and I think it is an exciting time,” he said.
About the physician
Richard Lewis, MD
Founder
Sacramento Eye Consultants and Capital City Surgery Center
Sacramento, California
Contact
Lewis: rlewis@saceye.com
