At the American Academy of Optometry Annual Meeting, Mitch Ibach, OD, of Vance Thompson Vision, presented a session on glaucoma management, covering topics like managing pigment dispersion glaucoma, what to do about low-tension glaucoma with nocturnal IOP spikes, considerations for using new treatments and devices, and more.
Mitch Ibach, OD:
Hey guys, it’s Mitch Ibach with Vance Thompson Vision in Sioux Falls, South Dakota. This past Friday in Anaheim at the American Academy of Optometry meeting, I was privileged to lecture alongside one of my good friends, Dr. Jessica Steen from Nova Southeastern. Jessica and I had a 2-hour lecture titled, “Cases That’ll Make You Think: Advances in Glaucoma Management.” This was a case-based lecture that took many different twists and turns as we went.
Dr. Steen started with talking about some of the landmark glaucoma trials, maybe how we have looked at this data previously, the conclusions that were made, and she shed a new light or a new angle on some of these trials to make sure that we were using them correctly. I then went into a case on managing pigment dispersion glaucoma, looking at the utility of an LPI to change the iris configuration. We talked about SLT in these patients, specifically direct SLT with the Voyager device.
Jess talked a little bit about neuroprotection. How are we using nutraceuticals, specifically nicotinamide and NAD, to try to give our patients a chance who are asking for some of these nutraceutical or neuroprotection options. I think there is still research to be done here, but she presented some of the neuroprotection data as well. I then presented a case on a patient with low-tension glaucoma who was spiking with nocturnal IOP spikes.
We talked about some different medications, how we use them, and then a new device to many of my colleagues, which is called the FSYX OPAP, the ocular pressure adjusting pump. This is a comfortable pair of goggles that patients wear. The goggles are attached to a tubing. The tubing is attached to a vacuum or a pump. Analogous to a CPAP, patients wear this device at night to lower the eye pressure, try to prevent these nocturnal IOP spikes, and treat the eye pressure. It may be one of the optic nerve’s most vulnerable periods. We looked at the Hercules data, which was using the goggles vacuum in 1 eye and not the other. This was the pivotal FDA clinical trial that got OPAP approved in the US.
Then my final case looked at a patient who came in with a visually significant cataract and an eye pressure of 57. This patient, unbeknowingly to the patient, was an angle closure glaucoma. We talked about how we use laser versus clear lens exchange in our practice to ultimately take care of angle closure glaucoma and primary angle closure patients.
Overall, it was a great lecture. We had a full audience. It was very conversational back and forth with Dr. Steen and I.
Hope to see you at the next meeting. Thanks for listening to this interview.
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