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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

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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.
Drugs such as carbonic anhydrase inhibitors, α2- and...
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Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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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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Glaucoma: Overview01:25

Glaucoma: Overview

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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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Related Experiment Video

Updated: Sep 13, 2025

Ultrasound Cyclo Plasty in Eyes with Glaucoma
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Selective Laser Trabeculoplasty and the Evolving Glaucoma Paradigm.

Tony Realini1, Gus Gazzard2

  • 1Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia.

Ophthalmology. Glaucoma
|July 27, 2025
PubMed
Summary

Glaucoma treatment may shift from eye drops to primary selective laser trabeculoplasty (SLT). This change could improve patient adherence and long-term outcomes by reducing the need for daily self-medication.

Keywords:
COASTGlaucomaLiGHTSelective laser trabeculoplasty

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Area of Science:

  • Ophthalmology
  • Glaucoma Management
  • Medical Therapeutics

Background:

  • The traditional glaucoma management approach relies heavily on topical medications.
  • Patient adherence to topical glaucoma medications is often suboptimal, impacting treatment efficacy.
  • Complex factors contribute to poor medication adherence in glaucoma patients.

Purpose of the Study:

  • To re-evaluate the long-standing topical medications-first approach in glaucoma management.
  • To explore novel therapeutic options that can bypass topical medications.
  • To advocate for a paradigm shift towards primary selective laser trabeculoplasty (SLT).

Main Methods:

  • Review of the strengths and limitations of topical medical therapy for glaucoma.
  • Analysis of new and emerging data supporting alternative treatment strategies.
  • Discussion of patient communication regarding selective laser trabeculoplasty (SLT).

Main Results:

  • Topical medications, while safe and effective, suffer from poor patient adherence.
  • Novel therapies like sustained-release platforms, SLT, and minimally invasive glaucoma surgery offer alternatives to topical treatments.
  • Moving away from topical therapy has the potential to improve long-term glaucoma outcomes due to enhanced adherence.

Conclusions:

  • A paradigm shift to primary selective laser trabeculoplasty (SLT) is appropriate for most glaucoma patients.
  • Primary SLT offers a viable alternative to topical therapy, potentially overcoming adherence challenges.
  • Integrating primary SLT into clinical practice can lead to better long-term glaucoma management and patient outcomes.