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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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Shared Decision Making in Ophthalmology: A Scoping Review.

Michael Bouaziz1, Tiffany Cheng1, Aurelia Minuti2

  • 1From the Department of Ophthalmology and Visual Sciences (M.B., T.C., K.D., A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

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Summary

Shared decision making (SDM) in ophthalmology shows promise for patient care but faces implementation barriers. Further research is needed to overcome these challenges and develop more decision aids for eye conditions.

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Area of Science:

  • Ophthalmology
  • Health Services Research
  • Patient-Centered Care

Background:

  • Shared decision making (SDM) is linked to better patient satisfaction and outcomes in medicine and surgery.
  • Its specific role and implementation within ophthalmology remain underexplored.

Purpose of the Study:

  • To conduct a scoping review exploring the characteristics, implementation, and outcomes of SDM in ophthalmology.
  • To identify current trends and gaps in the literature regarding SDM in eye care.

Main Methods:

  • A comprehensive literature search was performed across major databases (PubMed, Embase, Web of Science, Cochrane).
  • 1602 studies were screened, with 57 full-text articles reviewed for relevance to ophthalmology and SDM.
  • 19 eligible studies were qualitatively coded for predefined themes, including patient outcomes and implementation strategies.

Main Results:

  • All 19 studies highlighted the value of SDM in ophthalmology; two reported improved patient outcomes.
  • Cataracts and glaucoma were the most frequently studied conditions.
  • Common implementation barriers included limited patient knowledge, communication issues, and time constraints.

Conclusions:

  • SDM is a valuable patient-centered approach for ophthalmology, but significant implementation barriers exist.
  • Further research is required to address these barriers and develop patient decision aids for a wider range of ophthalmic diseases.