Getting a Handle on IOP
Do you know about this new way to treat high IOP?
BY GLARA YI, O.D., CHRISTOPHER J. QUINN, O.D., F.A.A.O.

The field of glaucoma has changed dramatically over the last few years. Among the exciting changes are new ways to treat and measure intraocular pressure (IOP). We describe a new measurement technology on page 56. Here, we'll introduce one of the newest treatments.

The laser option

Selective laser trabeculoplasty is a new laser application for reducing patients' IOP. It's a Q-switched, frequency doubled (532 nm) Nd:YAG Laser (Lumenis, formerly Coherent, Selecta 7000 Glaucoma Laser System).

The laser permits selective targeting of individual pigmented trabecular meshwork cells without causing structural or coagulative damage to the surrounding trabecular meshwork.

The glaucoma laser trial demonstrated the effectiveness of argon laser trabeculoplasty. In the glaucoma laser trial, 271 patients who had previously untreated primary open-angle glaucoma were randomized to either argon laser trabeculoplasty or medication.

Through 2-year follow up, argon laser trabeculoplasty eyes had lower IOP than medication-treated eyes and fewer laser-treated eyes required two or more medications to maintain IOP control.

At 7 years, in 203 of the original 271 patients, eyes treated with argon laser trabeculoplasty had lower IOP, a better visual field and better optic disc status than eyes in the medication group. Selective laser trabeculoplasty has been shown to be as effective in reducing IOP as argon laser trabeculoplasty and may be more effective than argon laser trabeculoplasty in cases where repeated treatments are required to reduce the IOP.

Mean IOP reduction was 23.5% following selective laser trabeculoplasty.

References available upon request.

Dr. Quinn is center director of Omni Eye Services, a regional optometric co-management center with offices in New Jersey. He's also president of the New Jersey Society of Optometric Physicians.

Dr. Yi is center director of Omni Eye Surgery of New York, an optometric co-management center in New York City. She's a frequent lecturer on topics related to ocular disease and co-management.

Exercise Those Eyes
According to the Glaucoma Foundation, aerobic exercise can lower your intraocular pressure (IOP). Some studies have found that  regular bicycling, brisk walking, jogging and swimming three times a week can reduce IOP by an average of 20%. Advise patients against scuba diving, bungee jumping or certain yoga positions, however; as they can raise IOP. And also make sure that your patients don't chug liquids after exercising -- that can raise IOP, too.