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Glaucoma: Overview01:25

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
07:11

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Published on: May 25, 2020

Patterns of adherence behaviour for patients with glaucoma.

H Cate1, D Bhattacharya, A Clark

  • 1Eye Department, Norfolk and Norwich University Hospital, NHS Foundation Trust, Norwich, UK. heidi.cate@nnuh.nhs.uk

Eye (London, England)
|January 19, 2013
PubMed
Summary

Electronic Adherence Monitors (EAMs) show good adherence to glaucoma medication, but patient self-reports are unreliable. A significant portion of patients exhibit persistent, high adherence to travoprost over two months.

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Area of Science:

  • Ophthalmology
  • Pharmacology

Background:

  • Adherence to long-term glaucoma treatment is challenging for patients and clinicians.
  • Primary open-angle glaucoma requires consistent medication for effective management.

Purpose of the Study:

  • To quantify travoprost non-adherence using Electronic Adherence Monitors (EAMs).
  • To compare adherence data from EAMs with patient self-reports.
  • To evaluate graphical presentation of adherence data in a larger cohort.

Main Methods:

  • A cohort study involving glaucoma patients using travoprost.
  • Prospective adherence data collection using EAMs over two months.
  • Comparison with Morisky Medication Adherence Scale (MMAS) and self-reported missed doses.

Main Results:

  • Median EAM adherence was 88.9%; 36.7% were classified as non-adherent (≥80% threshold).
  • EAM identified significantly more non-adherent patients (36.7%) than MMAS (12.2%).
  • A distinct category of persistent, high adherence (≥97%) was observed in 21% of participants.

Conclusions:

  • EAMs reveal good adherence to glaucoma monotherapy but show poor agreement with self-reported adherence.
  • A subgroup of patients demonstrates exceptionally high and persistent adherence to travoprost.