The future of canine glaucoma therapy

Glaucoma, whether primary or secondary, is the main cause of blindness in dogs. The uncontrollable increase intraocular pressure and the extreme pain associated with this condition, generally justifies enucleation.

This free-access viewpoint article sums up recommendations from recent ACVO diplomates’ meetings to improve the management of canine glaucoma. Understanding the disease’s mechanism, knowing how early to treat, optimizing the IOP-lowering medical treatment and establishing novel surgical options and therapies are all important to improve overall management of glaucoma.

Surgery is currently the preferred treatment as dogs respond differently to the available drugs, most of which were designed for human treatment.  Common surgical approaches include the placement of drainage implants to shunt aqueous humor to equatorial bleb-promoting reservoirs and/or cyclodestructive techniques to reduce aqueous humor production. Studies are evaluating these approaches to glaucoma, including the use of micropulse laser in transscleral cyclophotocoagulation in dogs.  Minimally invasive surgeries (with or without nanoengineered implants) may well become more common.

New medical treatments are also in development while advances in technology, such as smart phone apps or home tonometry, may also help us to monitor the condition.

Komáromy A et al. The future of canine glaucoma therapy. Veterinary Ophthalmology. May 2019; https://doi.org/10.1111/vop.12678