Is the light shining brighter for glaucoma patients?

For World Glaucoma Week, Dr João Barbosa Breda on hope for the future of glaucoma patients… Dr Breda is part of Allergan Foundation’s International Glaucoma Panel.

There are many things in the near future that might improve the quality of life of glaucoma patients. First of all, there have been very good results with new artificial intelligence algorithms for glaucoma diagnosis. As we know, in certain populations over 50% of the patients are still undiagnosed. These tools might allow a faster route for those who still don’t know they have the disease. This will probably have a higher likelihood of saving sight when applied in developing countries, especially in populations with a higher likelihood of having glaucoma.

A couple of years ago I joined a voluntary mission in São Tomé and Príncipe, an island nation off the coast of Africa with 200.000 inhabitants. One of the most prevalent diseases we saw there was glaucoma, especially open-angle glaucoma, and in many cases at an already advanced stage. Despite low literacy levels, people were aware of the disease running in the family, which sometimes gave symptoms at an early age. In these cases, having an early diagnosis is key, since there is almost no support for people with visual disability. These novel automatic tools might help us in such scenarios in order to allocate more (scarce) resources to those who need them the most. A note should be made about health education, which was perhaps even more relevant. I realized this when a young patient promptly returned to renew the timolol prescription, having squeezed a whole bottle in merely 2 days.

Moving on from software novelty, there are also other sources of “light” in the future. Due to recent high-scientific level publications, laser trabeculoplasty has resurfaced and is now a front-line treatment for many physicians. This will certainly improve many patients‘ quality of life, by reducing the burden of drops and their many side effects. It is definitely not easy to tell a patient that the laser had no effect; but for the ones that it is successful, it is easy to see the benefit.

Finally, in the near future we will have new drug classes available to our patients. This will expand our drop armamentarium, allowing more flexibility when planning a treatment plan.

In summary, these are simply some points that I believe might make the future of glaucoma patients (and ophthalmologists) brighter.

Image on top: Team of the Project Saúde para Todos Mission June 2016; mission organisers top right Luis Dias Pereira and bottom right Anabela Raposo