State of play: Glaucoma

For 30 years, Murray Fingeret, O.D., has delivered care to our nation's veterans, most recently as chief of the optometry section at the Department of Veterans Affairs Medical Center in Queens, New York. But it's his extensive expertise in glaucoma that continues to influence the profession today.

Founder and past president of the Optometric Glaucoma Society, as well as instructor of record for the glaucoma course at SUNY College of Optometry for 17-plus years, Dr. Fingeret is a 2019 inductee into the National Optometry Hall of Fame, administered by Optometry Cares^®—The AOA Foundation .

Is optometry doing enough for glaucoma patients?

Many doctors of optometry are actively involved in the care of glaucoma, starting with the diagnosis and continuing with therapy. In particular, many who graduated within the past decade are comfortable with glaucoma care, in large part, because this was part of their curriculum.

How can optometry do more?

The challenge for a clinician is to stay up to date with new information—which is easier said than done. For example, the Eagle Study, which was published in Lancet several years ago, pointed out that the conventional method to treat angle-closure glaucoma may not be optimal, but this new information takes years to make itself widely known.

How is our understanding of glaucoma evolving?

We are understanding more about a host of issues related to glaucoma, such as genes and how we may be able to influence them; how the optic nerve behaves under pressure; how to modify the trabecular meshwork to improve its outflow, etc. While changes are incremental, over time we see significant changes to our knowledge base.

What new developments should doctors be aware of?

The role of optical coherence tomography (OCT) in supplementing our diagnostic information is important and improves the skill set of each clinician using them. The challenge is to understand what the OCT is telling us and how to incorporate that information into practice. This area will change dramatically with artificial intelligence or "deep learning" on the horizon, which will provide the doctor with clues as to the probability that glaucoma is present or getting worse.

Is glaucoma care motivating?

Most doctors of optometry don't need encouragement as they find glaucoma to be exciting and challenging. As individuals age, many of our patients are developing or have glaucoma so this set of patients, for most, is part of the care we provide day-to-day.