Eyeworld

WINTER 2026 | EYEWORLD | 79 G Relevant disclosures Giovingo: Iridex, PLU Ophthalmic Smith: AbbVie, Alcon, Avisi Technologies, Bausch + Lomb, Glaukos, iSTAR Medical, New World Medical, Nova Eye Medical, Ocular Therapeutix, Olleyes, Sanoculis, Théa Pharma Contact Giovingo: mgiovingo@cookcountyhhs.org Smith: tsmith@glaucomaassociates.com pay. I just see them," Dr. Smith said, acknowl- edging, however, that cost may be a big concern for patients. Treatment options The question of whether to use drops or proceed to surgery, and if affordability and compliance comes into play, is one that applies globally, Dr. Smith said. She noted the LiGHT Trial, which is help- ing to change the outlook and landscape of the treatment for glaucoma. "We're tending to do SLT earlier," she said, adding that this is not just because of the results of that study but also in terms of cost-effectiveness. In places where resources are an issue, as well as the need for compliance and where people are not able to afford their medicine, a laser is paramount. Dr. Smith said that one of her "pet projects" is to campaign for better access to lasers around the world. "Now that we know lasers are in the forefront of what we do first, I can imagine how that would change things if there was the ability to use lasers to treat glaucoma early on." It would change the paradigm of treatment both in the U.S. and outside the U.S., she said. "If you give someone a bottle of timolol, which is $4 here, some people will stretch that for 3 months," she continued. "This could be an issue with adherence and/or affordability, and for that reason, there are certain things that are changing in the way we care for patients." Dr. Smith also discussed newer treatment options. She's excited about the potential for sustained release treatments, like iDose TR and Durysta, for patients in general. "iDose TR may not be for every patient, but it has been shown to work well in clinical trials and follow-up studies," she said. This could help maintain intraocular pressure for an extended period of time without the patient having to deal with topical medication. She uses Durysta in the U.S. and said it's a good option to keep patients top- ical medication-free for the short term. She also mentioned that for every iDose TR implanted, Glaukos will donate one for charity. Dr. Smith encouraged those who are inter- ested to get involved with humanitarian work. "You can be a part of the process at any point," she said, including anywhere from being part of different campaigns to being on the ground in another country. "The important thing is to be able to make a change when and where possible for the international ophthalmology community and patients in need." Glaucoma wet lab at the Eye Foundation Hospital in Ikeja, Lagos, Nigeria Source: Oluwatosin Smith, MD

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