Holistic Approach to Glaucoma

Hi! My name is David Richardson. I’m an eye surgeon that specializes in cataract and glaucoma surgery.

The first video here is going to be on what I would call a holistic approach to glaucoma. Now, by holistic I don’t mean woowoo. I’m very much based in the scientific method when it comes to my recommendations for treating glaucoma. But I would say there’s a lot of misconceptions out there about glaucoma, both among patients and doctors. So by holistic, I really mean an overall approach– one that goes beyond just intraocular pressure. So shall we get driving?

So the first thing I’d like to talk about is the idea of pressure and glaucoma. Many people, including doctors, focus pretty much just on the pressure. The interesting thing is that the definition of glaucoma— if you look at certain references doesn’t even have intraocular pressure in it. And that’s because glaucoma is really a progressive optic neuropathy. That means they damage the optic nerve. It gets worse over time. Now it is pressure sensitive but pressure itself is only one of the components of glaucoma and we’re discovering that a major component is actually blood supply to the optic nerve.

There may be other issues as well such as types of mechanisms in the cellular level that result in destruction of the cells, oxidative damage…things like that. So when patients come to me for glaucoma treatment, I very much want to focus on not just the pressure but on these other very important things. And in particular point out how my patients can, themselves, address the many issues that are involved in glaucoma besides just pressure.