The paradigm shift toward proactive glaucoma management
Termed interventional glaucoma (IG), proactive glaucoma management is a patient-centric approach that features earlier intervention with lasers, minimally invasive procedures, and procedural pharmaceuticals to help slow disease progression, preserve vision, and reduce the burden of daily medication, without compromising quality of life for patients.1,2
Benefits of a proactive approach to glaucoma management
- More continuous 24-hour intraocular pressure (IOP) control
- Improved compliance
- Delayed visual field progression
- Decreased medication burden
- Revitalization of the natural outflow pathway
- Less reliance on topical medications
- Reduced need for more invasive procedures
Focus on proactive treatment options for glaucoma patients
- Laser procedures: Includes selective laser trabeculoplasty (SLT), micropulse laser trabeculoplasty (MLT), and direct SLT (DSLT); typically implemented early in the disease course due to their safety, repeatability, and ability to delay or reduce reliance on topical medications.
- Minimally invasive glaucoma surgery (MIGS): Comprises tissue-sparing MIGS (trabecular micro-bypass, canaloplasty) and non-tissue-sparing MIGS (goniotomy, trabeculotomy).
- Procedural pharmaceuticals: Sustained-release intracameral implants such as iDose TR (travoprost intracameral implant 75mcg), and DURYSTA (bimatoprost intracameral implant 10mcg); used as standalone or adjunctive options to provide consistent IOP control without daily adherence challenges.
For more detailed information on when to implement these options into your treatment plan, refer to the “Interventional Glaucoma Consensus Treatment Protocol,” published in Expert Review of Ophthalmology.
Tips for adopting interventional glaucoma in your practice
- Act earlier in diagnosing, monitoring for progression, and intervening1
- Base decisions upon both new and existing evidence1
- Move beyond rigid, “one-size-fits-all” treatment algorithms and adopt a more individualized approach—one that accounts for the patient's specific disease characteristics, lifestyle, and personal preferences1,3
- Acknowledge the limitations of topical drop therapy—including side effects, adherence challenges, and medication burden—and proactively explore alternative treatments when appropriate to optimize both outcomes and quality of life3
- Maintain a comprehensive understanding of all available therapeutic options and engage in transparent, patient-centered discussions to determine the most appropriate course of treatment for each patient3
Get your patients involved
- Performing light aerobic activity (walking, biking, swimming)
- Consuming a healthy diet
- Engaging in mental/emotional health practices that help reduce stress (gentle yoga, breathing exercises, meditation)
- Having an open discussion with patients about proactive treatment options
- Encouraging patients to monitor their eye health
- Providing lifestyle tips for how they can safely stay active with glaucoma
- Referring them to educational materials and resources for additional background information on the disease and treatment options