Explaining Treatment Options Can Help Patients Understand Proactive Measures for Glaucoma: Christine Funke, MD

Christine Funke, MD, glaucoma specialist at Barnet Dulaney Perkins Eye Center in Phoenix, Arizona, emphasized the importance of speaking to patients to determine which method of treatment to use when proactively addressing glaucoma.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

How can doctors inform patients about proactive measures for glaucoma?

I think step 1 is just talking to patients about these options. It's a big barrier, I think, for some people to overcome. When I talk to other physicians about using minimally invasive [glaucoma surgery], there's a lot of discussion about [how] patients really don't want to do that. Or even laser therapy, which we know has superiority to drop therapy as first-line treatment. I mean, we have beautiful, documented, evidence-based medicine telling us that, and yet still the majority of patients aren't getting that as first line therapy. There's a barrier there. And I think a lot of it is just a fear of not being successful with treatment; I think [it] is hard for people to swallow. As cataract surgeons as well, because most people who do glaucoma also do cataract surgery. There's a lot of gratification with cataract surgery. People are instantly better. Glaucoma doesn't work that way, and I think when we do surgeries, even if we are 70% successful, 80% successful, we are not 100% successful. Having discussions with patients sometimes can be frightening because we can't offer 100% success with what we're planning on doing. But you have to keep remembering that this is still ultimately going to be what's best for patients' care, because you're still taking a lot of that burden off of them and giving them other options.

I think talking and having a good discussion, but also that discussion needs to be based [on] why you think these options are superior for them. If you believe that and we have evidence-based medicine to support that, which we do, then I think that it's an easy discussion to have. And honestly, the majority of patients, when I speak with them, they hop right on board. I think of just this week, I had a lovely patient who's been controlled on a single drop for years. No complaints, came in just for a pressure check, [and] I said, “Hey, listen, I just want to tell you about this laser option I have. I think that it's something that could benefit you.” I told her why, and I told her a little bit about the evidence around it. And she was like, “I am on board. I've hated this drop for years.” And she's super thrilled. But again, you just have to get over the, “I can get in and out and not have this discussion” or I can sit down, because I believe in this therapy, it's what I would do for myself, it's what I would do for my family, and give that moment to have the discussion.

And then there's also the idea, too, of having other educational material out there and available. People are waiting in our offices. Having videos available, brochures available, having your techs talk to your patients about that before you even walk in the room so that they're educated. And your tech may say, "Hey, they're interested in, say, an eye dose. They want to try and get off of a medication." Or "Hey, this patient's been sitting on this medicine, but their eyes look a little red, and I talk to them about it, and this might be something that would benefit them." That helps, too, because that also breaks down that burden of the office pressure of seeing a lot of patients. Then, of course, all of your referring [doctors] as well. You want to really educate everyone, not only yourself, about what's available, but everybody who's around you, because medicine is not like a singular solo sport. It is a team sport, and we all really need to understand, have a common goal, and then be able to talk about that goal and why it's important. I think education for everyone around us, as well as the patients, will also help move this needle forward of discussing interventional glaucoma, which is what what we're talking about here, or IG, which is using procedural methods to try and get patients' disease under better control.