Trabecular meshwork bypass surgery should be avoided if high episcleral venous pressure is suspected

Tip of the month

Trabecular meshwork bypass surgery should be avoided if high episcleral venous pressure is suspected

The intraocular pressure lowering effect of procedures that attempt to enhance flow of aqueous into Schlemm’s canal by bypassing or cutting the...

November 30, 2020

Haemodialysis can cause an acute rise in intraocular pressure

Tip of the month

Haemodialysis can cause an acute rise in intraocular pressure

Haemodialysis (HD) can reportedly induce a sudden rise in intraocular pressure (IOP) in patients with neovascular (NVG) (1) and pseudo-exfoliative...

October 31, 2020

Glaucoma progression: watch out the fellow, non-progressing eye

Tip of the month

Glaucoma progression: watch out the fellow, non-progressing eye

In clinical practice, the detection of visual field progression in one eye usually leads to management modifications in that eye. Less attention is...

September 30, 2020

Take care not to miss glaucomatous cupping in patients with small discs!

Tip of the month

Take care not to miss glaucomatous cupping in patients with small discs!

The Science behind the Tip The diagnosis of glaucoma can be missed in patients with small optic discs (1). In such patients, relative crowding of...

July 31, 2020

Ask your glaucoma patients about mobility rather than vision

Tip of the month

Ask your glaucoma patients about mobility rather than vision

The Science behind the Tip Self-reported visual disability in glaucoma which correlates with level of visual field loss includes bumping into...

June 30, 2020

Glaucoma patients on topical treatment should be routinely checked for signs of ocular surface disease even if they are asymptomatic

Tip of the month

Glaucoma patients on topical treatment should be routinely checked for signs of ocular surface disease even if they are asymptomatic

The Science behind the Tip The prevalence of ocular surface disease is significantly higher in glaucoma patients (1). While generally accepted that...

May 31, 2020

Late in-the-bag intraocular lens dislocation several years after uncomplicated cataract surgery is relatively common in pseudoexfoliation

Tip of the month

Late in-the-bag intraocular lens dislocation several years after uncomplicated cataract surgery is relatively common in pseudoexfoliation

The Science behind the Tip In pseudoexfoliation syndrome (PSX) and pseudoexfoliative glaucoma (PSG) progressive zonular damage frequently leads to...

March 31, 2020

Consider Brinzolamide to prevent IOP Spikes after Cataract Surgery in Eyes with Glaucoma

Tip of the month

Consider Brinzolamide to prevent IOP Spikes after Cataract Surgery in Eyes with Glaucoma

The Science behind the Tip IOP spikes, i.e. an IOP elevation after surgery compared to baseline, often occur in eyes with glaucoma.2 IOP spikes may...

February 28, 2020

When intraocular pressure lowering does not halt visual field progression in an eye which has classic features of glaucoma (glaucoma cupping, retinal nerve fiber loss and normal visual acuity and colour vision), a diagnosis of compressive optic neuropathy should be considered. While disc pallor is recognised to be a sign of potential ominous disease, it should be appreciated that in the early stages of compressive optic neuropathy, the disc may maintain its normal colour

Tip of the month

When intraocular pressure lowering does not halt visual field progression in an eye which has classic features of glaucoma (glaucoma cupping, retinal nerve fiber loss and normal visual acuity and colour vision), a diagnosis of compressive optic neuropathy should be considered. While disc pallor is recognised to be a sign of potential ominous disease, it should be appreciated that in the early stages of compressive optic neuropathy, the disc may maintain its normal colour

The Science behind the Tip Axonal loss decreases the volume of the disc, and if loss is concentrated in one area without significant gliosis,...

December 31, 2019

While adherence to therapy is undoubtedly important, at least equally important is the patient’s adherence to a prescribed follow up schedule. Therapies can fail over time and missing follow up appointments can be particularly hazardous for fast progressors-practitioners should stress the importance of good follow up

Tip of the month

While adherence to therapy is undoubtedly important, at least equally important is the patient’s adherence to a prescribed follow up schedule. Therapies can fail over time and missing follow up appointments can be particularly hazardous for fast progressors-practitioners should stress the importance of good follow up

The Science behind the Tip Clinical trials have shown us average rates of progression and average ideal IOP readings for populations of patients...

November 30, 2019

Consider using a topical NSAID, or steroid, post SLT laser

Tip of the month

Consider using a topical NSAID, or steroid, post SLT laser

The Science behind the Tip There is widespread variation in post laser treatment regimes. In a recent randomized, double-masked, multi-center...

October 31, 2019

Consider additional 10-2 visual field testing for diagnosing glaucoma, as limiting to 24-2 or 30-2 tests will frequently miss or underestimate paracentral field defects

Tip of the month

Consider additional 10-2 visual field testing for diagnosing glaucoma, as limiting to 24-2 or 30-2 tests will frequently miss or underestimate paracentral field defects

The Science behind the Tip (1,2) It is well-established that damage to macular retinal ganglion cells (RGCs) occurs early in glaucoma (1). Not...

September 30, 2019

When performing a laser peripheral iridotomy (LPI) for primary angle closure the position of the iridotomy in relation to the eyelid should always be considered

Tip of the month

When performing a laser peripheral iridotomy (LPI) for primary angle closure the position of the iridotomy in relation to the eyelid should always be considered

The Science behind the Tip (1,2,3) The incidence of reported dysphotopsias after an LPI varies from 2% to 11% with linear dysphotopsia and...

July 31, 2019

Avoid the use of monocular prostaglandin analogue medication

Tip of the month

Avoid the use of monocular prostaglandin analogue medication

The Science behind the Tip Where glaucoma predominantly affects one eye, monocular therapy may be used. Prostaglandin analogues are widely used as...

July 31, 2019

A glaucoma patient who progresses despite presumed good adherence might be using inadequate or insufficient technique when applying the anti-glaucomatous eye drops

Tip of the month

A glaucoma patient who progresses despite presumed good adherence might be using inadequate or insufficient technique when applying the anti-glaucomatous eye drops

The Science behind the Tip It is well known that if poor technique is used when a drop is applied to the eye it does not reach its target. This can...

June 30, 2019

Selective Laser Trabeculoplasty (SLT) can be considered as the first treatment for newly diagnosed patients with ocular hypertension and mild to moderate primary open angle glaucoma

Tip of the month

Selective Laser Trabeculoplasty (SLT) can be considered as the first treatment for newly diagnosed patients with ocular hypertension and mild to moderate primary open angle glaucoma

The Science behind the Tip The LiGHT trial compared two treatment pathways for treatment naïve ocular hypertension and mild to moderate glaucoma....

May 31, 2019

Ocular coherence tomography (OCT) should be used cautiously in the context of uveitic glaucoma

Tip of the month

Ocular coherence tomography (OCT) should be used cautiously in the context of uveitic glaucoma

The Science behind the Tip Patients with uveitis have a heightened risk of developing secondary glaucoma. Ocular Coherence Tomography (OCT) imaging...

March 31, 2019

Depression may follow a diagnosis of chronic glaucoma, but depressive symptoms are less likely to be present one year later

Tip of the month

Depression may follow a diagnosis of chronic glaucoma, but depressive symptoms are less likely to be present one year later

The Science behind the Tip It is common for a newly-diagnosed patient with glaucoma to experience symptoms of depression (1,2). Patients who are...

March 01, 2019

Early bleb revision usually results in successful resolution of hypotony maculopathy after trabeculectomy with mitomycin C

Tip of the month

Early bleb revision usually results in successful resolution of hypotony maculopathy after trabeculectomy with mitomycin C

The Science behind the Tip Hypotony maculopathy is characterized by painless loss of vision usually more than three months after glaucoma...

January 31, 2019

Children using topical corticosteroids for the treatment of allergic conjunctivitis must have their intraocular pressure regularly checked

Tip of the month

Children using topical corticosteroids for the treatment of allergic conjunctivitis must have their intraocular pressure regularly checked

The Science behind the Tip 30-40% of the population respond to topical steroids by increasing their IOP (1). A steroid response is commonly found...

December 31, 2018

The results of trabeculectomy with mitomycin C are significantly improved in children with glaucoma secondary to juvenile idiopathic arthritis if they are on immune-modulatory treatment

Tip of the month

The results of trabeculectomy with mitomycin C are significantly improved in children with glaucoma secondary to juvenile idiopathic arthritis if they are on immune-modulatory treatment

The Science behind the Tip Juvenile idiopathic arthritis (JIA) is the most common systemic disease associated with childhood anterior uveitis....

November 30, 2018

Microperimetry may be a more sensitive method of detecting a small glaucomatous defect close to fixation, than standard automated perimetry and OCT analysis of the retinal nerve fibre layer (RNFL)

Tip of the month

Microperimetry may be a more sensitive method of detecting a small glaucomatous defect close to fixation, than standard automated perimetry and OCT analysis of the retinal nerve fibre layer (RNFL)

The Science behind the Tip Microperimetry is a form of fundus-tracking perimetry that can detect reduced retinal sensitivity close to fixation more...

October 31, 2018

A glaucoma drainage device may be more effective than trabeculectomy in lowering IOP after keratoplasty, but is more likely to result in graft failure

Tip of the month

A glaucoma drainage device may be more effective than trabeculectomy in lowering IOP after keratoplasty, but is more likely to result in graft failure

The Science behind the Tip A well-controlled intraocular pressure (IOP) after penetrating keratoplasty (PK) is essential for graft survival and to...

September 30, 2018

When determining a therapeutic approach to a patient with glaucoma, the life expectancy of the patient needs to be considered

Tip of the month

When determining a therapeutic approach to a patient with glaucoma, the life expectancy of the patient needs to be considered

The Science behind the Tip Patients who present with early glaucoma who have a short life expectancy are unlikely to go blind from glaucoma in...

June 30, 2018

The insertion of a punctal plug improves ocular comfort and results in a modest reduction of IOP in patients with glaucoma who are using topical medication

Tip of the month

The insertion of a punctal plug improves ocular comfort and results in a modest reduction of IOP in patients with glaucoma who are using topical medication

The Science behind the Tip Patients with ocular hypertension and chronic glaucoma have a higher prevalence of ocular surface disease (OSD) than...

May 31, 2018