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Abstract #19239 Published in IGR 3-1
The choice of glaucoma
Van Buskirk EMOphthalmology 2001; 108: 641-642
In this interesting editorial, the author discusses the attraction of glaucoma as a subspecialty. The new critique on glaucoma seems to be that its care does not pay. Furthermore, the glaucoma specialist may fare poorly with an indefinable clinical problem, chronic patients, and no true surgical niche. The low profitability of glaucoma comes as no surprise. The author sees glaucoma primarily as an academic endeavor and talks about academic passion. The glaucoma specialist's clinical expertise lies less in what he can do than in what he decides to do and how he does it. Other subspecialties, such as vitreoretinal surgery, are more service-oriented. There is a lack of clear distinction about what the glaucoma specialist can do and what the comprehensive ophthalmologist can do. On the one hand, the author sees the real acknowledged value of a good glaucoma specialist and, on the other, there are the specialists who complain about lack of support, low reimbursement, and the complexity of postoperative care. Glaucoma, he states, is simply not big money. That comes from other activities such as cataract and refractive surgery. He continues by praising the attraction of glaucoma care, the challenges of clinical and laboratory research, etc. The advantages and disadvantages of glaucoma care have been recognized. A balance has to be found between professional priorities and the attractions of the open market. The author states that glaucoma is a wonderful disease with the rewards of being able to attack the complex clinical problems and to carry out exciting research. The practicing glaucomatologist needs to demonstrate better results, diagnosis, and preservation of vision. The aficionados, the glaucomatophils, appreciate, welcome, and even relish, the joys and challenges of glaucoma. We should encourage those with a true interest in glaucoma to enter its field and love it. On the other hand, those who like a quick fix and primarily seek financial success should be discouraged.