Three Real-World Scenarios in Which a Minimally Invasive Approach Prevailed

In these cases, MIGS was a safer, effective alternative to traditional incisional surgery.

Arkadiy Yadgarov, MD

Glaucoma Today

KEY TAKEAWAYS MIGS is not a replacement fortraditional glaucoma surgery, but it has become an essential componentof modern glaucoma care. MIGS can be used to safely and effectively lower IOP, reduce the medication burden, and delay—or even avoid—the need for more invasive incisionalprocedures. Minimally invasive procedures can also preserve future surgical options and allow earlier, more tailored intervention across arange of disease stages. During the past decade, MIGS has evolved into an essential component of the modern glaucoma treatment algorithm. Although trabeculectomy and tube shunt surgery remain indispensable options for managing advanced and refractory disease, MIGS can offer a safer, effective, and strategically sound alternative in numerous real-world situations. This article highlights three case scenarios in which MIGS meaningfully lowered the patient’s IOP, reduced their medication burden, and preserved their future surgical options. SCENARIO NO. 1 A 68-year-old White man presented with an IOP of 39 mm Hg OD. An examination revealed pseudophakia, pseudoexfoliative material in the pupillary margin, and dense (3+ to 4+) trabecular meshwork pigmentation on gonioscopy. OCT demonstrated glaucomatous retinal nerve fiber layer thinning, whereas the visual field was full on standard automated perimetry.

The Hidden Burden of DED: A Biopsychosocial Perspective

Managing this condition may benefit from the inclusion of a mental health element.

Hardeep Kataria, OD, FAAO

Modern Optometry

Dry eye disease (DED) is increasingly recognized as a biopsychosocial condition—one that extends far beyond ocular surface discomfort. DED affects patients’ mental health, time, finances, and overall quality of life. This article reviews the physiological and psychological burdens of DED, drawing from the literature to highlight the need for a more integrated, multidisciplinary approach to care. EFFECT ON QUALITY OF LIFE DED significantly impairs quality of life, workplace productivity, and emotional well-being, particularly in individuals who have more severe symptoms.1 Notably, the effect is greater on women than men.2 Patients frequently face difficulties accessing appropriate care, understanding the chronicity of their condition, and finding effective treatment. A key challenge lies in information access; up to 50% of patients report that their eye care provider is not their primary source of information on treating their DED, with 29% relying on online and social media sources.3 This can lead to misinformation, wasted time, and unnecessary financial burden—ultimately affecting patient outcomes and clinical workflow. ECONOMIC AND TIME BURDENS DED can be time-consuming and expensive to manage. One in four patients reports spending 1 hour each day on treatment—not including the time spent researching and sourcing products.3 Patients may spend up to $1,300 annually on artificial tears alone, which is generally considered a first line of treatment for most optometrists.3 The average cost to manage a patient with DED in the United States was estimated to be $13,302 in 2011—a figure that has likely increased in 2025 due to inflation and the growing cost of specialized therapies.4 More severe disease correlates with higher health care use, multiple visits, and increased out-of-pocket spending. Lack of effective monotherapies, low compliance, and fragmented care models also contribute to reduced workplace productivity. THE BIDIRECTIONAL LINK BETWEEN DRY EYE AND MENTAL HEALTH The relationship between DED, depression, and anxiety is bidirectional. Inflammatory processes, ocular discomfort, and side effects of systemic medication all play a role.

Outlook Wins Appeal for Wet AMD Drug Candidate Lytenava

Eyetube

Outlook Therapeutics takes a major step forward in its plan to gain approval for wet AMD drug Lytenava; the first commercial FLIGHT procedures using the ViaLuxe Laser System are performed in Europe; and Oculus introduces a new AI-assisted tool designed to help clinicians evaluate MGD using meibography images. Learn more about your ad choices. Visit megaphone.fm/adchoices