Glaucoma is the most common optic neuropathy. The only clinically proven treatment is to reduce IOP by using medical, laser, and surgical therapies. Treatment is typically selected depending on the level of IOP, stage of the disease, pace of progression, and current and past treatment history. Glaucoma management with drops can be problematic, mainly because they can be difficult for patients to instill properly and because of the related side effects.

In treating glaucoma, the typical route is often to prescribe medications.
If topical drops fail to achieve a reduction in intraocular pressure (IOP), then the alternative is to try laser trabeculoplasty, and finally surgery.

From 2019 to 2020, I co-chaired the European Glaucoma Society (EGS) Guidelines Committee with Carlo Traverso. The 5th Edition of the EGS guidelines was published in October 2020, after a superb team effort among a large number of colleagues (1). We aimed to promote evidence-based clinical practice and, to that end, followed GRADE methodology, including identification of key questions, critical evaluation of published literature, and formulation of recommendations.

Download the EGS Guidelines on the European Glaucoma Society website.

To compare visual field outcomes of ocular hypertensive and glaucoma patients treated first with medical therapy with those treated first with selective laser trabeculoplasty (SLT).