Because optometrists are the primary eyecare providers, it’s essential they be aware of their vital roles in the care of patients who have cataracts or glaucoma. This was the overall message of Paul C. Ajamian, OD’s lecture, “Cutting Edge Cataract and Glaucoma Care” at the 2025 Optometric Management Symposium. 

“Cataract and glaucoma management should be a large part of each and every optometric practice, “said Dr. Ajamian. “We worked long and hard to gain the privileges associated with managing these diseases…”

Cataract Role

When it comes to outstanding outcomes with cataract surgery, Dr. Ajamian stressed the optometrist assess the patient using corneal topography to rule out ocular surface disease, meibomian gland dysfunction, and anything else, such as Salzmann’s nodular degeneration or basement membrane dystrophies, that may cause regular or irregular astigmatism.

Further, he noted that lifestyle complaints of the patient, along with best-corrected visual acuities, refraction, slit lamp and dilated fundus exam findings should be included in the referral letter to the surgeon. After all, doing so increases the likelihood of postoperative success.

Finally, Dr. Ajamian said the OD should be knowledgeable of all the premium intraocular lens options, so they can educate the patient to prepare them for their referral visit. 

Interventional Glaucoma

Regarding patients who have glaucoma, Dr. Ajamian urged attendees to move away from automatically prescribing drops first and piling one drop on top of another and, instead, consider referring the patient early on in the disease process for selective laser trabeculoplasty or a minimally invasive glaucoma surgery. His reasoning: In many patients, the “drops-first” approach can set the patient up for failure due to compliance and adherence issues, while these surgical interventions can preserve outflow tissue and prevent disease progression without being a major burden to the individual.

Collaboration Is Key 

Finally, Dr. Ajamian pointed out that both cataract and glaucoma patient success is also contingent on building partnerships with tech-forward surgeons, visiting their ambulatory surgical centers, and understanding the patient’s experience, firsthand. OM