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In this edition of Advances in Eyecare we hear from four experts about their fields of research as applicable to optometric practice:

  • Dr Deacon Harle and Paddy Gunn discuss the use of selective laser trabeculoplasty as an alternative to topical drug management of glaucoma and ocular hypertension. They clarify what it is, how it is done and who can do it.
  • Dr Shelby Temple describes the latest technique for macular pigment assessment and the implications for its use in community practice eye health screening.
  • Dr Keyur Patel explains the use of intense pulsed light (IPL) treatment for persistent and chronic lid margin disease.

Last published: April 2020

    ◄Learning objectivesUnit 2 - New approaches to macular pigment screening (~16 mins)►

    Unit 1 - Selective laser trabeculoplasty for optometrists (~27 mins)

    Unit 1 - Selective laser trabeculoplasty for optometrists (~27 mins)

    Paddy Gunn and Dr Deacon Harle

    The lowering of intraocular pressure (IOP) is the mainstay treatment for primary open angle-glaucoma and slows down further progression of the disease. Many patients present with raised IOP but without optic nerve damage and this is termed ocular hypertension. Many ocular hypertensives convert to glaucoma, and so lowering their IOP helps reduce the risk of the disease establishing. Recently published LiGHT study suggests that the use of a laser treatment, selective laser trabeculoplasty (SLT), may replace the need for on-going use of IOP-lowering drops. In this interview, we speak to Dr Deacon Harle and Patrick Gunn to find out more about the SLT technique, and what it means for optometrists.

    • References

    • Cantor L, Katz L, Cheng J, et al. (2008) Economic evaluation of medication, laser trabeculoplasty and filtering surgeries in treating patients with glaucoma in the US. Curr Med Res Opin  24(10), pp 2905-2918

      Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. (2018) Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. A multicentre randomised controlled trial: design and methodology. Br J Ophthalmol 102(5), pp 593–598

    • Harvey B (2019) Selective laser trabeculoplasty. Optician (3), pp 25-31

      Hutnick C et al. (2019) Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360 degree Selective Laser Trabeculoplasty – A Randomized, Single-Blind, Equivalence Clinical Trial. Ophthalmology 126, pp 223-232

      Jha B, Bhartiya S, Sharma R et al. (2012) Selective Laser. Trabeculoplasty: An Overview. Journal of Current Glaucoma Practice 6(2), 79-90

      Nguyen D, Khan A, Hickley N (2015) Glaucoma – part 4: surgical management. Optician, 0.07

      Samples JR et al. (2011) Laser Trabeculoplasty for Open-Angle Glaucoma: A Report by the American Academy of Ophthalmology. Ophthalmology  118, pp 2296–2302

      Wong M et al. (2015) Systematic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Survey of Ophthalmology 60, 36-50

    ◄Learning objectivesUnit 2 - New approaches to macular pigment screening (~16 mins)►