Dr Leon Herndon Explains the Role of Age in Primary Open-Angle Glaucoma

As patients live longer, ophthalmologists need to revisit the notion that older patients may not need as aggressive treatment for glaucoma as younger patients, said Leon Herndon Jr, MD, a glaucoma specialist, ophthalmologist, and professor of ophthalmology at the Duke University Eye Center.

Transcript

Can you introduce yourself and explain your work?

My name is Leon Herndon, professor of ophthalmology at the Duke University Eye Center, where I'm the chief of the glaucoma division. My passion really deals with taking care of glaucoma patients and teaching the next generation of glaucoma specialists.

How can a patient's age impact the diagnosis and treatment of primary open-angle glaucoma?

Well, we know that the incidence of glaucoma increases as patients get older, and the population is getting older. We know that if you look at life table analysis, a 90-year-old patient has another 4 to 5 years to live. It really would be nice to know how long each patient will live, but we just don't have that ability to predict that. But from a lot of work out of the Duke Glaucoma Registry, we know that older patients tend to lose nerve fiber layer at a greater rate than younger patients. So, the classic teaching has been that the older the patient is, that we're not quite as aggressive with management of their glaucoma as we might be with a younger patient, who has many more years to live. But we need to revisit that. These older patients will live longer, and they may continue to lose vision if we don't pay attention to their intraocular pressures.