Refined strategies needed to tackle glaucoma burden

 Anja Tuulonen MD, PhD. With the number of patients with glaucoma-related pathologies predicted to increase significantly over the next few years, there is an urgent need for health services to work towards creating high-quality, high-volume and cost-effective glaucoma care for all citizens, according to Anja Tuulonen MD, PhD. “We all know that glaucoma prevalence, as well as other age-related eye diseases, is increasing, while the resources available to us are not. This increase is due not only to longer life expectancy but also because we are diagnosing more patients. We need to step back and see the bigger picture of the healthcare system as a whole,” she told delegates attending Glaucoma Day at the 35th ESCRS Congress in Lisbon. The basic task of glaucoma care is to promote the well-being of patients, said Prof Tuulonen, insisting that practitioners need to be aware that the decisions they make in everyday clinical practice impact, for better or worse, on the quality and cost of healthcare. “We need to make more evidence-based decisions in our glaucoma care. While we like to think that our decisions are evidence-based, it has been estimated that only about 10% to 20% of decisions taken in glaucoma practice are based on high-quality evidence. Furthermore, these items on which we do have high-quality evidence are not often very relevant clinically," she said. Prof Tuulonen noted that there was immense variability in glaucoma care in different countries, and that the trend to diagnosing and treating more patients will not necessarily result in better overall care for patients. “In the United States it has been estimated that half of the demand is created by medical professionals and organisations and not by the needs of the citizens. So we are part of the system and part of the problem because we are increasing the demand by what we are doing in clinical practice,” she said.