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Back to Index Glaucoma Topics & Trends Advances in the diagnosis and treatment of glaucoma are taking place with enormous rapidity. A recent Medline search under the keyword “glaucoma” found 132 peer-reviewed papers on the subject published in the current month alone. Not surprisingly, even ophthalmologists with a subspecialty interest in glaucoma find it challenging to stay abreast of the literature. The diagnosis and treatment of glaucoma, however, is not solely the province of subspecialists. Rather, glaucoma diagnosis and management is typically the province of comprehensive and general ophthalmologists. For these individuals, keeping up with the current volume of primary research would be a Herculean task. To meet the needs of the many ophthalmologists who diagnose and treat but who do not subspecialize in glaucoma, Glaucoma Topics & Trends offers both expert consensus and a summary and review of major findings from the glaucoma literature. Articles not only describe major findings but put them into an intellectual context that will facilitate their clinical application. Educational Design Within each issue are four articles, each of which treats some aspect of the theme in a specific way: The “Special Feature” is a major review that outlines the expert consensus on the topic area, bringing together research findings and the judgment of highly regarded clinical scientists An “Update” examines research directions and the latest findings in the theme area A section called “Clinical Focus” relates research to clinical practice The last section, “In Practice,” describes a related technique or procedure in sufficient detail to allow its immediate adoption in the clinic. Glaucoma Topics and Trends has been produced as an independent Continuing Medical Education enduring material since 2006, sponsored by Allergan. Faculty: Clive Migdal, MD, FRCS, FRCOphth; George A. Cioffi, MD; Ivan Goldberg MB, FRANZCO, FRACS Can We Screen for Glaucoma 2008, Issue 12 Learning Objectives • List the arguments for and against population screening for glaucoma. • Discuss the importance of disease definition in creating glaucoma screening criteria. • List the major areas of cost and describe the resources necessary to set up a glaucoma screening program. • State three barriers to determining the cost-effectiveness of glaucoma screening. Take Exam . The Challenge of Childhood Glaucoma 2008, Issue 11 Learning Objectives • List the steps of an informative examination of the pediatric glaucoma patient. • Discuss the role of the several known genetic mutations in the etiology of congenital and developmental childhood glaucoma. • Create a protocol for monitoring intraocular pressure (IOP) during the long-term follow up of pediatric glaucoma patients. • Describe the interaction of medical and nonmedical caregivers in the ongoing treatment of pediatric glaucoma patients and their families. ** Education credits for all exams prior to Issue 12 are now expired. **   RCTS: Keys to Evidence-Based Management 2008, Issue 10 Learning Objectives • Name randomized clinical trials that confirm that lowering intraocular pressure in early glaucoma slows progression of the disease. • List three benefits and two limitations of using a risk calculator in deciding whether to treat patients with ocular hypertension. • Discuss the limitations of applying data from RCTs to individual patients. • List three factors that come into play when setting a target intraocular pressure.     RCTS: Keys to Evidence-Based Management 2008, Issue 9 Learning Objectives • Name randomized clinical trials that confirm that lowering intraocular pressure in early glaucoma slows progression of the disease. • List three benefits and two limitations of using a risk calculator in deciding whether to treat patients with ocular hypertension. • Discuss the limitations of applying data from RCTs to individual patients. • List three factors that come into play when setting a target intraocular pressure.   Optimizing Medical Therapy 2007, Issue 8 Learning Objectives • Define “adherence” and “persistence” and list the known risk factors for, and barriers to, compliance with medication regimens and follow-up visits. • List four potential drug delivery technologies that are being considered for use in glaucoma pharmacotherapy. • Discuss the way in which economic evaluation can be used to make rational decisions with respect to resource allocation in glaucoma. • List the conditions under which use of a fixed dose combination is appropriate   Glaucoma Surgery 2007, Issue 7 Learning Objectives • Discuss the principal surgical procedures available to control intraocular pressure in glaucoma. • Discuss the advantages and risks of using antimetabolites in glaucoma filtration surgery. • Discuss the most common complications of glaucoma filtration surgery and list the standard methods of dealing with them. • Discuss techniques for controlling inflammation and intraocular pressure in the weeks following trabeculectomy.     Neuroprotection 2007, Issue 6 Learning Objectives • Describe the different objectives of IOP-lowering and neuroprotection as strategies for the treatment of glaucoma. • State the basis for thinking that a therapeutic vaccine might be able to stimulate a protective autoimmune response that could, potentially, affect disease progression in glaucoma. • State the criteria for accepting a drug as neuroprotective. • List three types of non-IOP lowering strategies for treating glaucoma.     Angle Closure 2007, Issue 5 Learning Objectives • Discuss the causes, diagnosis, treatment, and prophylaxis of primary angle closure glaucoma. • State the prevalence of primary open angle glaucoma in different ethnic groups and describe the quality of the available prevalence data. • Discuss the role of gonioscopy in the diagnosis of angle closure. • List the steps in performing a laser iridotomy.     Pseudoexfoliation 2006, Issue 4 Learning Objectives • Discuss the prevalence exfoliative syndrome and its associations with other disease states. • Compare exfoliative glaucoma to primary open angle glaucoma in terms of progression, severity, prognosis, medical management, and treatment response. • Discuss the worldwide prevalence of exfoliative syndrome. • Discuss the importance of IOP fluctuationand the importance of 24-hour IOP control in exfoliative glaucoma. • List the potential complications of performing cataract surgery on eyes with exfoliation syndrome and state ways of managing those complications pre-, intra-, and postoperatively.     Diagnosis 2006, Issue 3 Learning Objectives • Discuss the importance for glaucoma diagnosis of structural changes to the optic disc and retinal nerve fiber layer • List four structural changes to the optic disc and retinal nerve fiber layer associated with glaucoma progression • State the issues that make the correlation of structural changes with functional loss difficult in glaucoma • Explain why SITA testing is faster than full threshold perimetry • List five key aspects of the optic nerve/retinal nerve fiber layer examination • Describe the process of detecting glaucoma progression using standard software programs that evaluate the results of automated perimetry     Medical Management 2006, Issue 2 Learning Objectives • Discuss the agents available for lowering intraocular pressure (IOP) in glaucoma. • List the drug classes used to lower IOP. • Name the pathways by which aqueous humor can flow out of the anterior chamber. • State three ways to improve patient compliance with topical glaucoma medication regimens. • Describe a technique for topical drop application in patients who are unable to sit up.     Intraocular Pressure 2006, Issue 1 Learning Objectives • Discuss the anatomical and physiologic factors that produce increases or decreases in intraocular pressure (IOP). • Describe the primary mechanisms by which IOP produces the optic nerve head damage characteristic of glaucoma. • Discuss the importance of central corneal thickness to glaucoma diagnosis and treatment. • List the steps in calibrating a Goldmann tonometer.