Glaucoma
March 2021

by Nathan Radcliffe, MD
Glaucoma Editor

For many years, the field of glaucoma has advanced parallel to the development of novel pharmacotherapeutics. The release of latanoprost had such a profound effect on the field that laser trabeculoplasty rates in the U.S. dropped for 5 years after latanoprost was approved, recovering only years later with the adoption of selective laser trabeculoplasty. I often feel fortunate when I compare glaucoma management to the management of hypertension where treatment is comprised of only medicinal therapy. With six classes of IOP-lowering therapies currently available, the field has matured pharmacologically, and although topical therapy remains critical, in some ways glaucoma management is moving in a new direction.

Like the pharmacological movement before it, the field’s new movement is being led by technological advances in surgical instrumentation, surgical stent development, laser therapy, and drug delivery. In this issue, you will read about many aspects of glaucoma’s new direction. This movement is based on a recognition that ideal glaucoma therapies would be physician delivered, as well as safe and effective. Our understanding of the harmful role of non-compliance and the poor ocular surface tolerability of eye drops has driven us to seek these novel approaches.

In this section, we will hear about the early experience with Durysta (bimatoprost implant, Allergan) and how other sustained therapies can benefit the glaucoma patient following cataract surgery. We also reflect on our world amid the COVID-19 pandemic and learn about how glaucoma care can be streamlined to keep everyone safe.

I invite you to learn about glaucoma’s future and celebrate you for keeping an open mind as we discuss ideas that challenge our former paradigms. The good news is that the patient’s quality of life remains front and center.