Curbside Consultation in Glaucoma 49 Clinical Questions

Dedication Acknowledgments About the Editor About the Associate Editors Contributing Authors Preface Section I General Principles Question 1 How Frequently Does Blindness Develop Among Patients With Primary Open- Angle Glaucoma? With Ocular Hypertension? Philip P. Chen, MD Question 2 Does Reducing Intraocular Pressure Really Prevent the Development and Progression of Glaucoma? Kuldev Singh, MD, MPH Question 3 Are Vascular Factors Involved in the Pathogenesis of Glaucoma? Douglas R. Anderson, MD, FARVO Question 4 What Are the Most Frequent Causes of Glaucoma- Related Medical Malpractice Suits? What Can I Do to Minimize My Risk? E. Randy Craven, MD, FACS Question 5 How Does Glaucoma Af ect Quality of Life? Why Does It Matter? Pradeep Ramulu, MD, PhD, MHS Section II Glaucoma Diagnosis Question 6 How Should I Clinically Examine the Optic Nerve? Felipe A. Medeiros, MD, PhD Question 7 What Imaging Technology Is Best for Diagnosing Glaucoma? For Detecting Progression? Christopher Leung, MD, MSc, BMedSc, MB, ChB Question 8 What Visual Field Tests Should I Use? How Should I Judge Progression? Angelo P. Tanna, MD and Adam C. Breunig, MD Question 9 What Are the Implications of Disc Hemorrhages in Glaucoma Patients or Suspects? Jody R. Piltz- Seymour, MD Question 10 How Should I Follow Patients With Anomalous Optic Discs, Such as Those With Optic Nerve Drusen, Tilted Discs, Myopic Discs, and Discs With Pits? Jane Loman, MD and Joseph Caprioli, MD Question 11 How Frequently Should I Perform Follow- up Examinations, Gonioscopy, Visual Field Testing, and Optic Nerve Evaluation in Patients With Glaucoma? Dana M. Blumberg, MD, MPH; Paul P. Lee, MD, JD; and Reena S. Vaswani, MD Question 12 Should I Measure Central Corneal Thickness in All Patients With Glaucoma? All Glaucoma Suspects? James D. Brandt, MD Question 13 What New Methods Are Available to Mea sure Intraocular Pressure? Are Any Devices Available for Continuous Monitoring of Intraocular Pressure? Arthur J. Sit, MD, SM Question 14 When Is Imaging of the Anterior Segment Useful? Michael Banitt, MD and Anne Ko, MD Question 15 In Which Patients With Glaucoma Should I Perform Neuroimaging, Cardiovascular Evaluation, and/or Laboratory Testing? David S. Greenf eld, MD Question 16 Is Genetic Testing Useful in Screening in Glaucoma? John H. Fingert, MD, PhD Question 17 How Is Cerebrospinal Fluid Pressure Related to Glaucoma? David Fleischman, MD, MS and R. Rand Allingham, MD Question 18 Do Anti– Vascular Endothelial Growth Factor Injections Cause Intraocular Pressure Elevation? John T. Lind, MD, MS and Andrew J. Barkmeier, MD Question 19 What Is the Best Way to Classify Angle Closure Glaucomas? Anna K. Junk, MD Section III General Management Question 20 Which Patients With Ocular Hypertension Should I Treat? Husam Ansari, MD, PhD and Richard K. Parrish II, MDQ uestion 21 How Should I Set a Target Intraocular Pressure? Gregg A. Heatley, MD Question 22 How Should I Begin Treatment for a Patient With Newly Diagnosed Primary Open- Angle Glaucoma? Annisa L. Jamil, MD and Richard P. Mills, MD, MPHQuestion 23 How Should I Manage a Patient Who Is Progressing at Low Levels of Intraocular Pressure? Ta Chen Peter Chang, MD Question 24 Are T ere Special Issues of Which I Should Be Aware Regarding Pigment Dispersion Syndrome or Pigmentary Glaucoma? Celso Tello, MD; Sung Chul Park, MD; and Robert Ritch, MD Question 25 Does Exfoliation Syndrome Increase the Risk of Developing Glaucoma? Are Patients With Exfoliation Glaucoma More Likely to Progress? What Other Issues Do These Patients Have? Robert Ritch, MD Question 26 How Frequent Is Corticosteroid- Induced Glaucoma? How Should I Manage It? Davinder S. Grover, MD, MPH and Alan L. Robin, MD Question 27 What Methods Are Available to Break an Acute Attack of Angle Closure Glaucoma? Darrell WuDunn, MD, PhD Question 28 How Should I Manage Neovascular Glaucoma? Hylton R. Mayer, MD and James C. Tsai, MD, MBA Question 29 How Should I Treat Elevated Intraocular Pressure (With or Without Glaucoma Damage) Associated With Uveitis? David L. Cute, DO and Francisco Fantes, MD Question 30 How Should Children With Congenital Glaucoma Be Followed? Wendy W. Huang, MD Section IV Medical Therapy Question 31 Are Any New Medications in Development? Are Any Neuroprotective Agents Currently Available for Treating Glaucoma? Sarah R. Wellik, MD Question 32 Which Glaucoma Medications Can Be Safely Used During Pregnancy? In Childhood? Bhavna P. Sheth, MD, MBA Question 33 Is T ere Still a Role for Miotics in Some Patients? Oral Carbonic Anhydrase Inhibitors? Richard K. Lee, MD, PhD Question 34 How Can I Improve Patient Adherence? Silvia Orengo- Nania, MD Section V Laser and Incisional Glaucoma Surgery Question 35 Is Selective Laser Trabeculoplasty a Repeatable Procedure? When Should I Use It? Brian A. Francis, MD, MS Question 36 When Should I Perform a Prophylactic Laser Iridotomy? Martin Wand, MD Question 37 When Is Laser Iridoplasty Used? Alon Skaat, MD and Jefrey M. Liebmann, MD Question 38 When Should I Perform Incisional Glaucoma Surgery? Which Procedure Should I Choose? Joseph F. Panarelli, MD Question 39 Are Anti– Vascular Endothelial Growth Factor Agents Useful Adjuncts to Glaucoma Filtering Surgery? Rashmi G. Mathew, FRCOphth and Keith Barton, MD, FRCP, FRCS Question 40 What Are Surgical Pearls for Performing Trabeculectomy? Ronald L. Fellman, MD and Davinder S. Grover, MD, MPH Question 41 What Are Pearls for the Postoperative Management of Trabeculectomy and Its Associated Complications? Ahmad A. Aref, MD Question 42 What Are Surgical Pearls for Performing Aqueous Shunt Implantation? Steven J. Gedde, MD Question 43 What Are Pearls for Postoperative Management of Aqueous Shunt Implantation and Its Associated Complications? Joseph F. Panarelli, MD and Paul A. Sidoti, MD Question 44 Which Aqueous Shunt Should I Use? Donald L. Budenz, MD, MPH Question 45 Does Cataract Extraction Produce a Signifcant and Sustained Intraocular Pressure Reduction? When Should I Perform a Combined Procedure vs Cataract Extraction Alone? Igor Estrovich, MD and Steven L. Mansberger, MD, MPH Question 46 Is Cataract Surgery a Useful Treatment for Angle Closure Glaucoma? Dennis Lam, MD, FRCOphth; Vineet Ratra, DNB, FRCS(Ed); and Enne Liang, PhD Question 47 Does the Presence of Glaucoma Infuence Your Choice of Intraocular Lens Implant? Joshua C. Teichman, MD, MPH, FRCSC and Iqbal Ike K. Ahmed, MD, FRCSC Question 48 In Which Glaucoma Patients Should I Consider Cyclodestruction? Malik Y. Kahook, MD; Jefrey R. SooHoo, MD; and Leonard K. Seibold, MD Question 49 What Are MIGS? When Should I Use Them? Hady Saheb, MD and Dima Kalache, MD, CM Financial Disclosures Index

Biography

Steven J. Gedde, MD is Professor of Ophthalmology and Vice Chairman of Education at the Bascom Palmer Eye Institute. He received his medical degree from Vanderbilt University School of Medicine. Dr Gedde completed his residency training in ophthalmology at Wills Eye Hospital, where he also served as Chief Resident. His clinical glaucoma fellowship was done at the Bascom Palmer Eye Institute.

Dr. Gedde has lectured nationally and internationally. He has authored or coauthored more than 250 articles, book chapters, and abstracts. He serves on the Editorial Boards for Ophthalmology, Journal of Academic Ophthalmology, EyeNet, Ocular Surgery News, Ophthalmology Management, and EyeWorld. Dr. Gedde has been listed among Best Doctors in America since 2005, and he received the American Academy of Ophthalmology Achievement Award in 2006 and Se­nior Achievement Award in 2012. He has served as the Residency Program Director at the Bascom Palmer Eye Institute since 1999, and he was selected as the Excellence in Health Care Educator of the Year in 2009. Dr. Gedde is also a study chairman for the Tube Versus Trabeculectomy (TVT) Study and Primary Tube Versus Trabeculectomy (PTVT) Study, multicenter randomized clinical trials comparing tube shunt surgery with trabeculectomy.