We all want to know what the future looks like. If we knew what would happen tomorrow, imagine the power we’d have in changing what we do today. However, as computer scientist Alan Kay once said, “The best way to predict the future is to invent it.”
When starting out in glaucoma, I saw the space as an area that was ripe for innovation. The explosion of glaucoma drops and combinations was exciting, but even at that time I felt this was a Band-Aid solution that relied too heavily on patient compliance, adversely affected quality of life, and did not address the disease pathology. Today, many more are making efforts to find alternative solutions to glaucoma.
Part of this recent progress in the space has entailed changing the way we think about glaucoma and being more interventional in its management by offering treatments such as selective laser trabeculoplasty, MIGS, sustained drug delivery, and other novel approaches earlier in the disease process. Moving from a passive to an active approach to disease management is a paradigm shift that does not occur in every specialty. Glaucoma is turning on its head, but we must continue working to affect such cultural change on a large scale.
How can we encourage others to question long-held beliefs and alter how they think about treating glaucoma? How do we help people to stop passively watching patients progress and instead motivate them to embrace the challenge to think and act differently than before?
Firstly, we need to have the technology, the evidence, and the confidence of which patient is best served by what approach. I’m excited about better diagnostics, personalized approaches to medicine, and improved active monitoring in glaucoma.
But, in truth, the greatest challenge in affecting change is not technology but people—ourselves. Change isn’t comfortable. Despite all advances, there can still be tremendous indifference, resistance, and desire to maintain the status quo. As we embark on a new year, I encourage all of us to get comfortable being uncomfortable, to accept the challenge to think differently, and to recognize that our mindsets and practices are inventing the future today.
