Today, more than 3 million Americans are living with glaucoma, and this number is expected to double by 2050.

The only current approved route for treating glaucoma is to lower intraocular pressure (IOP), which can be achieved with eye drops, laser or surgical intervention. Medication eye drops are the most common treatment modality and, over time, patients may need to take multiple types of eye drops to stop progression of a disease that typically has no symptoms initially.

An eye doctor will determine which medications and treatments are best suited for a patient, based on their individual case, medical history and current medication regimen.

New solutions

Recently, there have been numerous advances in the treatment of glaucoma. In 2017, two new drug therapies were approved by the U.S. Food and Drug Administration (FDA). These are the first new classes of glaucoma drops to hit the market in two decades.

The first, Vyzulta™ (latanoprostene bunod ophthalmic solution), developed by Bausch + Lomb, is a dual action, once-per-day eye drop. The second new eye drop, once-daily Rhopressa® (netarsudil ophthalmic solution) from Aerie Pharmaceuticals, Inc., is designed to enhance fluid outflow and reduce the production of fluid in the eye in order to reduce IOP.

“It’s always exciting to have new and effective treatment alternatives available to help patients,” said Andrew Iwach, M.D., the executive director of Glaucoma Center of San Francisco and Chairman of Glaucoma Research Foundation.

“The development and advancement of new surgical options, as well as novel drugs and drug delivery systems, means doctors have more tools to treat glaucoma patients than ever before.”

Minimal invasion

In addition to new drug advances, the continued development of minimally-invasive surgical procedures is providing additional options to lower IOP by enhancing part of the natural drainage pathways of the eye with minimal tissue disruption. Minimally-invasive glaucoma surgery (MIGS) uses microscopic equipment and tiny incisions, offering a safer alternative than conventional glaucoma surgery with the potential benefit of reducing the patient’s dependence on topical glaucoma medication. Current FDA-approved MIGS procedures include the Trabectome (NeoMedix), iStent® (Glaukos Corporation), Cypass® Micro-Stent (Alcon), Kahook Blade (Mew World Medical) for Goniotomy,  and the XEN® Gel Stent (Allergan). The Hydrus™ Microstent (Ivantis) is currently part of an FDA-approved clinical trial with a projected market availability later in 2018.

“The development and advancement of new surgical options,” noted Dr. Iwach, “as well as novel drugs and drug delivery systems, means doctors have more tools to treat glaucoma patients than ever before.” He adds, “The key to these clinical advances is research, and the Glaucoma Research Foundation is dedicated to funding innovative investigations to explore new therapies and ultimately a cure.”