Conference: Surfing the latest in optometry

Held in a conference centre just metres away from some of the Beach Boys’ favourite surfing haunts, the 2022 American Academy of Optometry (AAO), as always, offered a wide range of education and research from all areas of eye care practice. In this short feature, I will mention some of the key findings presented in the scientific programme, as selected by the Academy Board and their new president Dr Timothy McMahon (figure 1).

Glaucoma remains one of the leading causes of irreversible blindness across the globe. Even with the advent of selective laser trabeculoplasty (SLT), at present, treatments are typically lifelong while decisions about treatments are based on the monitoring of disease progression. Because of the chronic nature of glaucoma, early and accurate detection and evaluation has major implications for a patient’s functional vision and quality of life.

Dr Jack Pru and colleagues (University of New South Wales) described how current methods of functional assessment, such as threshold fields testing, often take many years before confirming disease progression. Modern threshold fields strategies, such as SITA Fast, have made it possible to undertake multiple visual fields tests at one single visit to a clinic with minimal cost. By adopting this ‘frontloading’ approach, with two fields assessments per visit, Chu has found disease progression is detected three to six visits sooner where disease progression is fast. For more typical, slowly progressing glaucoma, Chu has found that adopting a frontloading approach, with two fields tests every six months, nearly doubles the detection rate (figure 2). Indeed, the current ‘one fields test per visit’ approach misses around 70% of slowly-progressing glaucoma.