Dr Leon Herndon on Tailoring Glaucoma Care for Older Patients

The search for safer surgical options for our older patients remains an unment need in glaucoma care, said Leon Herndon Jr, MD, a glaucoma specialist, ophthalmologist, and professor of ophthalmology at the Duke University Eye Center.

Transcript

What are the next steps for understanding and implementing the best medical and surgical practices or managment patterns for older patients with glaucome?

I think the next step is ongoing research to find safer alternatives, and in many cases safer surgical alternatives than traditional surgeries such as trabeculectomy and glaucoma drainage device procedures, which are rife with more complications. There's a whole class of surgeries called MIGS, minimally invasive glaucoma surgeries, that are directed in lowering patients' eye pressure, with fewer complications. There are lots of different MIGS options, but there's still not one out there that can lower the patient's pressure as low as a standard trabeculectomy can. So I think the search for safer surgical options for our elderly patients is an area that has this unmet need for our practices.

Do you have any closing thoughts you'd like to share?

Based on some of the work out of Duke, when you look at an older population glaucoma patient vs a younger population, we find that older patients may lose nerve fiber layer at a quicker rate than their younger counterparts. So we may need to rethink our process of being less aggressive in an older patient and really pay attention to how their visual fields are progressing in a nerve fiber layer analysis and present what're the surgical options that patients need to have that.