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Are we wasting precious resources of our healthcare budgets?
In the recent past glaucoma care has experienced a revolution led by new technologies and treatments. As Knox et al describe in this issue of the BJO (p 162), new glaucoma medications have caused profound changes in glaucoma treatment in Ireland. It is highly likely that these trends are occurring throughout the Western world.1–,4 We would like to comment on several of the findings reported in their compelling and solid analysis.
There is an overall increase in the number of prescriptions for glaucoma that is not justified by an increased prevalence of the disease
Among several possible explanations, it would seem that physicians may be (a) trying to reach lower intraocular pressure (IOP) in existing glaucoma subjects, and/or (b) recommending treatment to patients who would not be treated in previous years (for example, patients with ocular hypertension, OHT). Considering the available scientific evidence, maximising IOP lowering in patients with advanced glaucoma should not be contested. However, we should question the benefit of treating patients with OHT or pre-perimetric glaucoma (that is, incipient optic nerve damage with normal visual field) and challenge this trend. From the health provider point of view, this is a …