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    Glaucoma experiences transformative growth as a subspecialty

    Renaissance features innovative diagnostic and therapeutic tools to improve disease management

    By Vanessa Caceres, Reviewed by Kuldev Singh, MD, MPH

    Glaucoma is experiencing a renaissance with promise in a greater number of therapies, exciting research, and the brightest talent being attracted to the profession, according to Kuldev Singh, MD, MPH.

    Dr. Singh made an analogy to the European Renaissance—a period of intellectual enlightenment from the 14th century to the 17th century—to glaucoma’s current renaissance. Before the European Renaissance, the Middle Ages represented a bleak period in history when wars, famine, and the lack of progress by those with power hindered the advancement of the arts and sciences.

    Dr. Singh is professor of ophthalmology and director, Glaucoma Service, Stanford University School of Medicine, Palo Alto, CA.

    As was the case with literature, art, and physics, the renaissance in ophthalmology arrived for different subspecialties at different times. The introduction of innovations, such as intraocular lenses and phacoemulsification, initially were met with skepticism, but ultimately prevailed due to the conviction of the innovators.

    While Dr. Singh acknowledged the advances in perimetry and imaging as critical to the “Glaucoma Renaissance,” he focused on glaucoma therapeutics. The introduction of new pharmacologic agents, the evolution of cataract surgery as a glaucoma procedure, refinements in trabeculectomy, and the introduction of adjunctive antimetabolite drugs contributed to improved patient care. These advances were followed a few years later by the breakthrough innovation of micro-invasive glaucoma surgery (MIGS), according to Dr. Singh.


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