Activity Description and Purpose

Medical therapy has been the mainstay of first-line glaucoma treatment for more than 150 years. Recent advances, including selective laser trabeculoplasty (SLT), sustained-release drug delivery platforms, and minimally invasive glaucoma surgeries, have expanded the treatment options. New data from the LiGHT (Laser in Glaucoma and Ocular Hypertension) study and others support the role of SLT as preferred first-line therapy over medications. COAST (Clarifying the Optimal Application of SLT Therapy) is an ongoing multicenter clinical trial supported by the National Institutes of Health/National Eye Institute to evaluate the role of annual low-energy SLT as primary therapy for glaucoma. This educational activity will briefly review the historical context that shaped the medications-first treatment paradigm, discuss limitations of medical therapy and emerging data supporting an SLT-first approach to glaucoma care, and present a novel interventional paradigm for the management of glaucoma in 2023 and beyond.