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Invited Commentary
December 13, 2018

Preliminary Steps to Address Glaucoma Medication Adherence: Beginning to Tackle the Elephant in the Room

Author Affiliations
  • 1W. K. Kellogg Eye Center, University of Michigan, Ann Arbor
  • 2Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2019;137(3):246-247. doi:10.1001/jamaophthalmol.2018.6074

The study by Varadaraj et al1 in this issue of JAMA Ophthalmology addresses a very important topic in glaucoma management: glaucoma medication adherence. Glaucoma treatment is effective in halting vision loss. In 2002, the Early Manifest Glaucoma Trial found a 50% reduction in risk of glaucomatous progression over 6 years among patients treated with glaucoma medication and trabeculoplasty compared with a control group. In 2014, the UK Glaucoma Treatment Study2 found that those who started taking a prostaglandin analogue had a 44% reduced risk of visual field loss compared with those taking a placebo in just 2 years. Glaucoma medications are effective in stopping glaucomatous vision loss, but only if people take them. When people do not take their medications, their outcomes will be similar to what was seen in the arms not receiving treatment of these clinical trials, where glaucomatous progression was seen in 25% of participants in only 2 years.2