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Current management of glaucoma

Kenneth Schwartz1, Donald Budenz

  • 1The Georgetown University Hospital/Washington Hospital Center Washington, DC, USA. twsamuelson@mneye.com

Current Opinion in Ophthalmology
|March 17, 2004
PubMed
Abstract

Insights

Glaucoma treatment goals are evolving with new evidence from clinical trials. Prostaglandin analogs are now the preferred initial medical therapy for managing intraocular pressure.

Area of Science:

  • Ophthalmology
  • Glaucoma Management
  • Ocular Hypertension

Background:

  • Recent clinical trials have refined understanding of glaucoma therapy goals.
  • Advances in medical, laser, and surgical treatments have expanded therapeutic options.

Purpose of the Study:

  • To review current concepts in glaucoma therapy goals.
  • To examine the interventional sequence and management options for glaucoma.
  • To incorporate findings from recent clinical trials into therapeutic strategies.

Main Methods:

  • Review of current literature and recent clinical trials.
  • Analysis of evidence regarding treatment goals and sequences.
  • Evaluation of pharmacological, laser, and surgical interventions.

Main Results:

  • Prostaglandin analogs are replacing beta-blockers as first-line medical therapy.
  • Laser trabeculoplasty shows comparable efficacy to initial medical therapy.
  • Trabeculectomy with antifibrotic agents remains a key surgical option, with implants for refractory cases.

Conclusions:

  • Medical therapy, particularly prostaglandin analogs, remains central to intraocular pressure control.
  • Laser trabeculoplasty is effective, though often reserved for treatment-resistant cases.
  • Surgical interventions like trabeculectomy and glaucoma drainage implants are indicated for advanced or refractory glaucoma.

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