“It’s an exciting time in glaucoma right now” has been heard often in glaucoma symposia and conferences during the last several years. I first remember hearing it years ago when I was applying to fellowship due to the dawn of minimally invasive glaucoma surgery (MIGS) at that time. Since then, innovations in MIGS have continued at a rapid pace and have been a key contributor leading to these continued “exciting times” in glaucoma.

Along with MIGS, we have seen the promise of innovative ways to monitor glaucoma with remote testing, diagnose glaucoma with artificial intelligence and treat glaucoma with sustained release medications. These developments not only keep the field exciting, but they also allow us to provide better care for our patients and provide avenues of hope for an otherwise progressive disease.

HOT TOPICS COVERED

In this issue of Ophthalmology Management, we are focusing on these hot topics in glaucoma. I asked several rising stars in the field of ophthalmology to contribute to this issue in an effort to understand these innovative technologies and how they will affect doctors and patients.

Dr. Brian Shafer discusses sustained-release drugs and the hesitancy some ophthalmologists may feel in the face of this new technology.

We also realize that as technology changes, so does the reimbursement landscape. Dr. Alisha Kumar discusses MIGS in light of the new reimbursement changes.

Also, Dr. Monisha Vora discusses trends among young glaucoma surgeons, including sustained-release options and telemedicine.

I feel that all ophthalmologist could use a primer on how glaucoma is involved in other disease states, such as uveitis, and how to differentiate from other optic neuropathies found in neuro-ophthalmology. Dr. Purnima Patel writes a beautiful review of how glaucoma is managed in uveitis, and Dr. Kim Gokoffski delineates some of the newer topics in neuro-ophthalmology.

One of the most important changes in the future of glaucoma will be how we detect the disease and how we measure and monitor IOP. At some point, we will slowly move past the traditional approach of obtaining an IOP “snapshot in time” in the office and instead rely on remote monitoring methods. Dr. Jeffrey SooHoo sheds some light on the importance of home tonometry.

Lastly, we are on the dawn of implementing artificial intelligence. While I believe we are a long way from replacing the human factor, there is no doubt that AI will play a role in our future. Sarah Zhou and Dr. Benjamin Xu from USC Roski Eye Institute define the role of algorithms in artificial intelligence and how it can play a role in telemedicine and diagnosing risk factors for glaucoma.

My hope is that this discussion of the current hot topics in glaucoma will help move us forward in an “exciting” and innovative way. OM

Sahar Bedrood, MD, PhD, is a glaucoma and cataract specialist at Advanced Vision Care in Los Angeles. She received her undergraduate degree in biochemistry at UCLA and completed a combined MD/PhD program at the Keck School of Medicine of USC. She finished her residency in ophthalmology at the Doheny/USC Roski Eye Institute in Los Angeles, then completed her fellowship in glaucoma as a Society of Heed fellow at the Wilmer Eye Institute at Johns Hopkins University in Baltimore. She became an assistant professor at the USC Roski Eye Institute, where she continues to have an adjunct affiliation teaching residents.