Eyeworld

SPRING 2025

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/1533348

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94 | EYEWORLD | SPRING 2025 G UCOMA by Manjool Shah, MD Glaucoma Editor T he field of glauco- ma management stands at an exciting crossroads, fueled by rapid technological advancements and a deeper understanding of the disease's complexities. As clinicians strive to provide the best possible care for patients, staying abreast of innovations while remaining grounded in the fundamental prin- ciples of glaucoma management is crucial. In this issue, we focus on topics both new and old, including the integration of telemedicine, the careful consideration of steroid-induced glauco- ma, and the nuanced management of pseudo- exfoliation glaucoma. All these topics exemplify the multifaceted challenges and opportunities that shape daily practice. With the upcoming ASCRS Annual Meeting serving as a platform to reflect on past achievements and chart future directions, embracing a holistic approach that combines cutting-edge tools with time-tested strategies is more important than ever. This approach will allow glaucoma specialists to nav- igate the evolving landscape of glaucoma care and optimize outcomes. Telemedicine offers promising avenues for expanding access and improving efficiency in glaucoma care. Grayson Armstrong, MD, MPH, and April Maa, MD, share their unique perspec- tives on this emerging field. Telehealth infra- structures have demonstrated their value, par- ticularly in reaching underserved populations and saving patients travel time. The integration of AI and support technologies holds the poten- tial to further enhance screening and diagnosis for conditions like diabetic retinopathy and glaucoma. According to our contributors, virtual reality and augmented reality may further en- hance the space, and the dramatic growth of AI modalities will inevitably augment our ability to care for patients, potentially providing decision support while improving the ability to offer truly personalized medicine to each of our patients. Malik Kahook, MD, Rebecca Chen, MD, and Robert Noecker, MD, discuss a personal favorite condition of mine, steroid-induced glaucoma. This Friday afternoon special remains a prevalent concern in ophthalmic practice. As Drs. Kahook, Chen, and Noecker noted, potent topical agents and intravitreal steroids carry a significant risk of elevating IOP, and while discontinuation can often resolve the insult, patients and physicians alike may find them- selves between a rock and a hard place where steroids need to be continued to manage other chronic eye diseases. Fortunately, laser and even MIGS-based solutions offer promise to allow us to have our cake and eat it, too. Pseudoexfoliation glaucoma presents unique management and surgical consider- ations. Kevin Halenda, MD, and Michael Krause, MD, PhD, offer several important surgical pearls when managing pseudoexfoliation cataracts, but the most important point is to identify pseu- doexfoliation with careful slit lamp examina- tion. The advent of MIGS procedures has had a huge impact on the management of this difficult disease, but the authors note the importance of traditional glaucoma surgeries as well in more recalcitrant cases. In an era of rapid advancement, it seems clear that every day may represent another leap forward. The insights shared by our contribu- tors serve as a reminder of the importance of continuous learning and adaptation, and there is no place better to feel the energy of lifelong learning like the ASCRS Annual Meeting. I personally can't wait for us to come together in Los Angeles, as the Annual Meeting inevitably provides an opportunity to share knowledge and build upon past successes. This is how our vibrant glaucoma community can collectively advance the field. A commitment to staying informed, embracing innovation, and remain- ing patient-centered will ultimately shape the future of glaucoma management and ensure a brighter world for our patients. A commitment to staying informed, embracing innovation, and remaining patient-centered In an era of rapid advancement, it seems clear that every day may represent another leap forward.

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