Curbside Consultation in Glaucoma, Second Edition contains new questions and brief, practical, evidence-based answers to the most frequently asked questions that are posed during a “curbside consultation” between surgical colleagues.
Dr. Steven J. Gedde and associate editors Dr. Joseph F. Panarelli, Dr. Dale K. Heuer, and Dr. Richard A. Lewis have assembled the top glaucoma consultants from the United States and abroad to offer expert advice, preferences, and opinions on tough clinical questions commonly associated with glaucoma in this updated reference. The unique Q&A format provides quick access to current information related to glaucoma in the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and illustrate surgical pearls.
Some of the questions that are answered inside the Second Edition include:
- What imaging technology is best for diagnosing glaucoma? For detecting progression?
- What new methods are available to measure intraocular pressure? Are any devices available for continuous monitoring of intraocular pressure?
- Do anti-VEGF agents produce intraocular pressure elevation?
- How should I set a target intraocular pressure?
- How should I manage a patient who is progressing at low levels of intraocular pressure?
- Does cataract extraction produce significant and sustained intraocular pressure reduction? When should I perform a combined procedure versus cataract surgery alone?
- What are MIGS? When should I use them?
Curbside Consultation in Glaucoma: 49 Clinical Questions, Second Edition provides information basic enough for residents while also incorporating expert pearls that even high-volume glaucoma specialists will appreciate. General practitioners, residents, fellows, and optometrists alike will benefit from the user-friendly, casual format and the expert advice contained within.
About the Editor
About the Associate Editors
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 Affect 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
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 Measure 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. Greenfield, 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
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, MD
Question 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, MPH
Question 23 How Should I Manage a Patient Who Is Progressing at Low Levels
of Intraocular Pressure?
Ta Chen Peter Chang, MD
Question 24 Are There 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
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?
Bhavna P. Sheth, MD, MBA
Question 33 Is There Still a Role for Miotics in Some Patients? Oral Carbonic
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 Jeffrey 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 Significant 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 Influence Your Choice of Intraocular
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; Jeffrey 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
About the Author
Malik Y. Kahook, MD is Professor of Ophthalmology and Director of Clinical and Translational Research in the Department of Ophthalmology at the University of Colorado. He also directs the glaucoma service and glaucoma fellowship. Dr. Kahook specializes in the medical and surgical treatment of glaucoma and cataracts. He is active within the ophthalmology community, including memberships in the American Academy of Ophthalmology, American Glaucoma Society, American Society of Refractive and Cataract Surgeons, and the Association for Research in Vision and Ophthalmology. Dr. Kahook has authored more than 200 peer-reviewed manuscripts, abstracts, and book chapters, and is editor of 4 textbooks, including Essentials of Glaucoma Surgery (SLACK Incorporated). He is on the editorial board of the American Journal of Ophthalmology and International Glaucoma Review, among others. He was awarded an American Glaucoma Society Clinician-Scientist Fellowship Award for 2007, as well as the American Glaucoma Society Compliance Grant for 2006, and was named New Inventor of the Year for the University of Colorado in 2009 and Inventor of the Year for 2010. Dr. Kahook received the American Academy of Ophthalmology Achievement Award in 2011. He has filed for more than 12 patents, several of which have been licensed by companies for development and commercialization. He currently serves as a consultant to the US Food and Drug Administration’s Ophthalmic Device Division. ? Dr. Kahook completed his residency training at the University of Colorado, Rocky Mountain Lions Eye Institute in Denver, Colorado, where he was named Chief Resident. He then went on to complete his fellowship in glaucoma from the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.
Joel S. Schuman, MD, FACS is the Eye and Ear Foundation Professor and Chairman of Ophthalmology, the Eye and Ear Institute, University of Pittsburgh School of Medicine and Director of the University of Pittsburgh Medical Center (UPMC) Eye Center. He is also Professor of Bioengineering at the Swanson School of Engineering, University of Pittsburgh, and a Founder of the Louis J. Fox Center for Vision Restoration of UPMC and the University of Pittsburgh. He is a member of the McGowan Institute for Regenerative Medicine and the Center for the Neural Basis of Cognition, Carnegie Mellon University and University of Pittsburgh. Dr. Schuman is a native of Roslyn, New York; he graduated from Columbia University (BA, 1980) and Mt. Sinai School of Medicine (MD, 1984). Following his internship at New York’s Beth Israel Medical Center (1985), he completed residency training at Medical College of Virginia (1988) and glaucoma fellowship at Massachusetts Eye & Ear Infirmary (clinical 1989; research 1990), where he was a Heed Fellow. After just over a year on the Harvard faculty, he moved to the New England Medical Center, Tufts University, to co-found the New England Eye Center in 1991, where he was Residency Director and Glaucoma and Cataract Service Chief. In 1998, he became Professor of Ophthalmology, and Vice Chair in 2001.
Dr. Schuman and his colleagues were the first to identify a molecular marker for human glaucoma, as published in Nature Medicine in 2001. He has been continuously funded by the National Eye Institute as a principal investigator since 1995, is principal investigator of a National Institutes of Health (NIH) grant to study novel glaucoma diagnostics, and is co-investigator of NIH grants for research into novel optical diagnostics and short pulse laser surgery and for advanced imaging in glaucoma. He is an inventor of optical coherence tomography (OCT), used world-wide for ocular diagnostics. Dr. Schuman has published more than 250 peer-reviewed scientific journal articles, has authored or edited 8 books, and has contributed more than 50 book chapters.
In 2002, Dr. Schuman received the Alcon Research Institute Award, as well as the New York Academy of Medicine’s Lewis Rudin Glaucoma Prize. In 2003, he received the Senior Achievement Award from the American Academy of Ophthalmology. In 2004, he was elected into the American Society for Clinical Investigation. In 2006, he received the Association for Research in Vision and Ophthalmology (ARVO) Translational Research Award. He was elected to the American Ophthalmological Society in 2008. He received a 2006-2009 American Medical Association Physician’s Recognition Award with Commendation. In 2010, he became a silver Fellow of ARVO. In 2011, Dr. Schuman was the Clinician-Scientist Lecturer of the American Glaucoma Society. In 2012, he received the Carnegie Science Center’s Award in Life Sciences and was a co-recipient of the Champalimaud Award.