Monocular drug trials for glaucoma therapy in the community setting

Abstract

The clinical management of glaucoma would be far simpler if all patients responded equally well to therapy with IOP-lowering medication. Unfortunately, this is not the case. Consider that timolol offers median IOP reduction of approximately 5-6 mmHg. This does not mean that every patient will manifest a 5-6 mmHg IOP reduction. Rather, it means that half of the patients will enjoy an IOP reduction exceeding this median amount, while the other half will have a lesser IOP reduction. There is currently no way of identifying a priori how patients will respond to their medication; we are limited to a trial and error approach, a so-called n-of-one trial. © 2010 Springer-Verlag New York.