Philosopher Thomas Kuhn maintained that scientific research and thought are defined by paradigms. According to Kuhn, scientists typically accept an existing paradigm and then try to extend its scope over time. Eventually, however, their efforts may expose the paradigm's inadequacies or contradict it entirely. An accumulation of these difficulties triggers a crisis, which, in turn, sparks an intellectual revolution, or a paradigm shift. This is a model of change that we may be experiencing in glaucoma.
From issues with treatment noncompliance to the complex, chronic nature of the disease itself, glaucoma has long presented challenges to those who strive to manage it and those who live with it. These challenges have, in turn, served as an impetus for innovation and have contributed to the formation of a new school of thought: interventional glaucoma (IG).
The IG paradigm is founded on the objective to approach glaucoma in a proactive—not reactive—way and to intervene in a disease-centric and patient-centric manner. The IG specialist considers not only the disease's impact on a patient's quality of life but the treatment's impact as well. Although MIGS was developed with this in mind, IG does not refer solely to one type of intervention.
Those who can view glaucoma from the patient's perspective and factor quality of life into their treatment decision-making will be able to prioritize an IG mindset. As innovation continues and this patient-centric outlook grows, we can all approach glaucoma in a way that addresses safety, efficacy, and quality of life. The path is long and there is much to accomplish, but the desire to truly improve the lives of our patients with glaucoma is the driving force we need to push this movement forward.