Bill Harvey: Laser love
Author: Bill Harvey
Loads of big stories this week from the eye world.
Perhaps the most significant was the report published in the latest Lancet which hit the national papers last Sunday – coincidentally also World Glaucoma Day. The findings of a three-year study by a team based at Moorfields suggests selective laser trabeculoplasty (more widely known simply as SLT) should replace the use of eye drops in the management of glaucoma. They predict that, not only is SLT safer and more effective than eye drops, but moving to a one-hit surgical intervention is likely to save the NHS around £1.5 million a year. As we saw recently (Optician 01.03.19) the use of drugs carries significant risk of adverse effects. Add to this the problems of compliance with drug acquisition and a daily regime of drop use by the patient, often for decades, and the attraction of a single surgical procedure is clear. Might the public one day think of glaucoma treatment in the way they currently understand cataract treatment?
NICE announced it was to recommend lowering the threshold for prescribing blood pressure lowering drugs. The thinking is that, by intervening at the very earliest stages of raised blood pressure, long term disease will be significantly reduced. We all see middle-aged patients regularly and might play a role in reminding our patients to have regular pressure checks.
The links between diet and diabetic retinopathy are coming thick and fast. For example, a large study of Australians in this month’s BJO suggested some foods, namely cheese and wholemeal bread, may be protective. A study in the JAMA of Taiwanese diabetics found retinopathy risk much reduced when statins were taken. These are all small steps to form a bigger picture highlighting the massive role lifestyle changes will have in tackling the diabetes epidemic.