Employ Follow-Up Questions

When performing a detailed glaucoma consultation, dig further to better achieve a complete patient history: “In cases in which patients do not know exactly what eye conditions their family members may have … follow up with, ‘does anyone in your family have an eye condition that they take eye drops for?’ Further, for patients who are unsure of the type of glaucoma the family member has, I listen for descriptors, such as ‘normal pressure’ or ‘pigment,’ as they can provide defining clues.” – Jessilin Quint, OD, FAAO, “The Glaucoma Consultation: From Soup to Nuts."

Ensure Patients Understand the Information You Provide

In this three-step article on getting patients to comply with their prescribed anti-glaucoma medications, patient education is critical and can be facilitated by encouraging the patient to ask questions, both during and after the visit: “I encourage the patient to write any questions they may forget to ask prior to our next appointment, so we can go over each one at the next patient visit.” – Justin Holt, OD, “Acquire Medication Adherence."

Use Fresnel Prism Spectacles

When providing refractive correction options for glaucoma patients who have VF loss, one option is Fresnel prism spectacles: “Fresnel prisms can help expand the peripheral field in patients who have VF loss. With the incorporation of horizontal peripheral prisms, patients can expand the field above and below the horizontal meridian, still leaving a vertical gap in the central area for direct, binocular vision for activities like driving. Oblique designs allow for tilting of the bases of both prism segments in the direction of the hemianopia and expanding fields for up to 15°.” – Kriti Bhagat, OD, FAAO, “Suggest Refractive Correction Options."

Shoot for Evening Dosing

In this “Contact Lens” column, which provides action steps on helping glaucoma patients to achieve successful lens wear, one such step is to prescribe anti-glaucoma drops for evenings: “Evening dosing with a single medication after contact lens removal is ideal, as the interaction and effect on drug absorption, adsorption, and release when medication is instilled during lens wear is complex: Factors include contact lens polymer and surface characteristics, the molecular size and charge of the active drug ingredients, and the presence and type of preservative.” – Susan A. Resnick, OD, FAAO, FSLS, “Manage Glaucoma Patients.” 

Turn to the Basics

In this “Dry Eye” column on treating glaucoma without exacerbating dry eye disease, one tip is to turn to the basic dry eye disease treatments if a patient starts showing signs of ocular dryness, but has stable glaucoma while using a preservative-containing IOP-lowering medication: “[These include] warm compresses, omega-3 and omega-6 fatty acids, lid hygiene, and preservative-free artificial tears. If no improvement is noted in the patient’s symptoms or clinical appearance, then we can continue to move up the treatment ladder, using prescription medications, in-office treatments, and more.” – Cecelia Koetting, OD, FAAO, “Defy Glaucoma-Related Dry Eye.”