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Reducing the risk

Area director of Northern Europe at Glaukos, Niven Smith (pictured), discusses the need to increase awareness of glaucoma treatment options

20 Jun 2019 by Andrew McClean

What are the current challenges and opportunities in treating glaucoma, and how can these be met to provide better patient care?

The volume of patients is the greatest challenge in the treatment of glaucoma. It is estimated that 500,000 people in the UK are currently diagnosed with glaucoma. With these large numbers comes an enormous pressure on the capacity of the NHS, leading to long waiting times for surgery and follow up visits.

At the moment, the majority of patients are currently using eye drops to treat their glaucoma, but compliance is a major issue. Eye drops need to be used on a daily basis, but many patients find them difficult to administer. If used correctly they can work, but human error, added to side effects such as discomfort, redness and stinging in the eyes, can lead to inaccurate dosage. Many patients are also older, so the issue of forgetting to administer the drops is a factor in ineffective treatment. Studies show that more than 90% of patients are non-adherent to medications and nearly 50% stop taking them before six months.

The key opportunity is the identification of glaucoma at an early stage and allowing the patient to benefit from alternative treatments to eye drops. Establishing effective referral pathways for those diagnosed with mild to moderate glaucoma would ensure they receive the best care possible from early intervention.

“At the moment, the majority of patients are currently using eye drops to treat their glaucoma, but compliance is a major issue”

How is Glaukos providing a solution to glaucoma treatment?

Glaukos is proud to be one of the leading companies in glaucoma research on a global basis, funding research into the field of micro implantable devices, micro drug delivery devices and micro implantable diagnostic devices.

Glaukos has a portfolio of cutting edge products including iStent inject, which is the first ab interno, micro bypass system designed to restore natural physiological outflow through two openings through the trabecular meshwork. Truly ‘micro’ invasive, it is also the world’s smallest medical implant known to be implanted in the human body.

Glaukos’ aim is to leverage the iStent technology platform to build a comprehensive and proprietary portfolio of injectable micro-scale therapies that advance the existing glaucoma standard of care. A large proportion of turnover is dedicated to research and development, and Glaukos prides itself on working in collaboration with some of the leading scientists in the field of glaucoma to discover treatment alternatives for glaucoma patients worldwide.

Glaukos is currently working on iDose – an intraocular implant designed to continuously elute therapeutic levels of a prostaglandin analogue, with the aim of reducing intraocular pressure. It is currently in phase three of clinical trials in the US.

What innovations does Glaukos believe will play a big role in the future of glaucoma treatment options, and what potential do they have for patients?

Trabecular micro-bypass technologies are still relatively new, but they have great potential in the treatment of glaucoma. Over 500,000 iStent and iStent inject have already been implanted globally and the clinical studies have shown that patients experience a reduction in reliance on topical glaucoma medications following the surgery. An international study has shown that 87% of patients who were treated with iStent inject were on one or fewer medications at three years post-op.

“Optometrists are the gate keepers for eye health. They are the first port of call for patients for their eye tests and often the first healthcare professionals to give an initial diagnosis of glaucoma”


There is a need to increase the awareness of these technologies among the optical community. If glaucoma is controlled at an early stage, it can reduce the risk of this sight threatening disease progressing and can help reduce the need for more aggressive surgical options.

Why is it important for optometrists to play a role in glaucoma treatment pathways?

Optometrists are the gatekeepers for eye health. They are the first port of call for patients for their eye tests and often the first healthcare professionals to give an initial diagnosis of glaucoma. Their role in education on glaucoma to patients is also vital. There are also an increasing number of community based glaucoma clinics run by optometrists. These can reduce the burden on hospital units for both treatment before and after surgery.

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