Eyeworld CME Supplements

EW_AUG 2016 Supported by Aerie Pharmaceuticals, Alcon Laboratories, Allergan, and Bausch + Lomb

This is a supplement to EyeWorld Magazine that doctors can take a test after reading and receive CME credits for.

Issue link: http://cmesupplements.eyeworld.org/i/706806

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Page 1 of 7

Advanced glaucoma treatment: Diagnostics, pharmaceuticals, and surgical options 2 by Richard Lewis, MD Addressing patient adherence: Impact on the overall progression of glaucoma Members think 31% of pa- tients receiving 1 topical medica- tion are not compliant and 38% of those receiving more than 1 medication are not compliant. Twenty-four percent of respondents perform microinva- sive glaucoma surgery (MIGS), and 25% plan to offer this within 12 months (Figure 2). Therefore, nearly 50% of respondents are using MIGS or plan to within 12 months, which is an impressive adoption rate. Respondents indicated that 8% of their cataract patients are MIGS candidates. If 3.5 million cataract surgeries are performed in the U.S. each year and 8% are MIGS candidates, this translates into 280,000 cataract plus MIGS procedures per year. This supplement will high- light advancements in glauco- ma management. Our panel of experts will discuss the impact of patient compliance on overall disease progression, as well as the safety and efficacy of new and current therapies and the use of MIGS techniques for long-term glaucoma treatment. Dr. Brown practices with Atlan- ta Ophthalmology Associates in Atlanta. He can be contacted at reaymary@comcast.net. medications are more efficacious and tolerable than generics. Beta blockers were the preferred therapy to add to a prostaglandin analog (54%), followed by an alpha agonist, laser trabeculoplasty, topical carbonic anhydrase inhibitor, and combination aqueous suppressant (Figure 1). ophthalmologists develop more effective treatment strategies for these patients, a team of noted experts will share their insights and recommendations in this supplement. The survey reported that 75% of members prescribe a pros- taglandin analog as a first-line therapy, and 54% think brand continued from page 1 Advanced diagnostics are improving glaucoma management, but non- compliance may alter outcomes N ew diagnostic, pharma- cologic, and surgical developments continue to enhance glaucoma management. To obtain optimum treatment outcomes, however, ophthalmologists need to use them well and enhance patient compliance. Case report A 56-year-old man referred for glaucoma with progressive field loss complained of recurrent hy- peremia with his medications. His highest intraocular pressure (IOP) was 21 mm Hg. He had a long history of reference to cupping and borderline IOP. He had no history of steroid use, ocular trau- ma, diabetes, or hypertension. His vision was 20/20 in both eyes, his IOPs were 20 and 21 mm Hg, and his cornea was slightly thin. He had hyperemia in his conjunctiva but otherwise a normal anterior segment. He also had cupping. Images from our non-mydri- atic camera showed an inferior Practice pearl: Showing patients images of their optic disc (as compared to normals) is a great motivator to enhance understanding of the disease and compliance. –Richard Lewis, MD " The non-mydriatic camera has been a huge boost to our practice, providing an image within 30 to 60 seconds. " –Richard Lewis, MD continued on page 3 Figure 2. The survey asked: "Which of the following best describes your use of/interest in MIGS?"

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