January is Glaucoma Awareness Month, designated by the National Eye Institute, the American Academy of Ophthalmology and Prevent Blindness. It’s no surprise that these organizations want to start the new year with awareness of this sight threatening disease. According to the Bright Focus Foundation, glaucoma is the leading cause of irreversible blindness in the U.S. and the world. They reported that in 2020, about 80 million people had glaucoma worldwide, and this number is expected to increase to over 111 million by 2040.
Glaucoma is a group of eye diseases that can cause vision loss and blindness by damaging the optic nerve. It’s important to note that increased intraocular pressure (IOP) is a risk factor for glaucoma, but not glaucoma itself. Vision loss from glaucoma usually begins in the periphery and can progress to blindness without treatment. Intervention to reduce intraocular pressure includes daily eye drops, eye surgery or laser treatment. While eye drops are the most common treatment, many people struggle with administering drops regularly, cost and access to professional care. Especially in low-income areas, patients may forgo the drops allowing glaucoma to progress.
According to a recent study published in The Lancet Global Health, Africa has the highest prevalence of the condition and highest prevalence of blindness due to glaucoma. Rates in Sub-Saharan Africa are predicted to nearly double by 2040. Researchers from the London School of Hygiene & Tropical Medicine wanted to find a more convenient cost-effective way to treat glaucoma. In Tanzania, they treated 100 patients with drops and 101 patients with Selective Laser Trabeculoplasty (SLT). With SLT, laser energy is applied to the trabecular meshwork, the drainage tissue in the eye. This starts a chemical and biological change in the tissue that results in better drainage of fluid through the drain and out of the eye. This eventually results in lowering of IOP. The effect will generally last between one to five years, eliminating the risk of erratic use of daily drops. In the Tanzania study, after one year, SLT was nearly twice as effective as drops in controlling IOP.
But what about the cost? Researchers estimated that considering the cost of the equipment and maintenance, one SLT procedure would cost $12.49 in total, while annual therapy with eye drops cost around $16.32 per eye in Tanzania. More research is needed, but a more convenient, cost-effective treatment for this potentially blinding disease will improve the lives of underserved communities worldwide.
• Linda Conlin
Pro to Pro Managing Editor