Foreword Volume 2 of our serial publication continues our desire to address glaucoma with a combination of science and speculation. As science expands, the emphasis is on data, interpretation, and dogma. We disagree; open minds open new approaches. Using methodologies that are primarily molecular and genetic, we seek to refine the causes of glaucoma as well as how it is best treated, especially incorporating thoughts and hypotheses about new methods of treatment. Glaucoma is a complex disease, and genetics proves that a variety of proteins are culpable at one level. At another level, however, there are likely final common pathways and numerous feedback loops which have defied explanations to date. The search for answers goes on in basic science researcher’s laboratories and clinical ophthalmologist’s offices and operating rooms. We are all well-served by understanding that glaucoma is a neurodegenerative disease. Current attempts to solve the disease have focused on two strategic arenas: the trabecular meshwork function and its impact on intraocular pressure as a major risk factor for the disease; and the optic nerve dysfunction leading to visual loss. Genetic mutations have yielded puzzling clues to the cause, but without resolution. For example, mutations in myocilin and optineurin genes are closely connected to the phenotype, but how do they cause the disease? In the next two years, priority areas of research are signaling pathway discoveries, biomarker panels, epigenetic factors, and continued genomic studies to yield answers to the common final pathways of the disease. The final pathways are complex and redundant, such that the overlap of bio-informatics will be challenging. Current promising leads suggest the innate immune system holds important clues to both trabecular meshwork and optic nerve pathophysiology. When the primary open-angle glaucoma disease pathways are unraveled, drug discoveries and new treatment modalities will be available for better regulation of intraocular pressure and neuroprotection for the optic nerve. This volume discusses the glaucoma pipeline from several perspectives as well as future candidate classes. As always, the authors herein are urged to speculate on how the cure of glaucomatous optic nerve damage will yield to new treatments. John R. Samples Clinical Professor, Elson S. Floyd College of Medicine, Washington State University School of Medicine www.glaucomaconcepts.com Paul A. Knepper Associate Professor of Ophthalmology, Feinberg School of Medicine, Northwestern University Medical School Research Scientist, University of Illinois at Chicago

This first volume of the New Concepts in Glaucoma series was conceived as a platform to express new ideas and approaches to understanding and solving primary open-angle glaucoma. The authors have attempted to expand levels of knowledge, present new ideas and challenge existing theories. Although the authors have painted a broad picture, the central theme of the book is to ask the right questions and seek the answers for patients with primary open-angle glaucoma.

Successful interventional glaucoma remains a sought-after goal for the glaucoma clinician for many reasons. Medical costs, compliance, and adherence remain major barriers for the treatment of our patients. A truly definitive treatment for glaucoma is most likely to be largely surgical, as it is doubtful that patients will continue to use glaucoma drugs in the future for anything other than transient lowering of intraocular pressure. In the coming era, it seems probable that neuroprotection and neurorestoration will be combined with MIGS to lower pressure. The different types of MIGS are increasing in proportion to their efficacy. To date, there are no fewer than 12 choices available to glaucoma specialists. Choice of procedure depends on the underlying anatomy as well as the patient’s individual characteristics. Truthfully, the number of available surgeries depends upon their taxonomy. Most are based on the outflow system and the canal, as illustrated in this book.

The Science of Glaucoma Management: From Translational Research to Next-Generation Clinical Practice bridges the gap between laboratory research and clinicians by bringing the latest promising research directly from researchers to clinicians long before they translate into clinical advances, and often before they are presented at conferences. Organized as a series of clinically relevant topics written by world-leading experts, this book summarizes the current state of laboratory and translational research and draws on the potential implications for day-to-day clinical practice. It offers new insights and mind-opening statements through contributions from some of the most respected glaucoma research groups. The book allows glaucoma specialists to explore novel ways to refine and rethink their practice based on the latest discoveries in basic sciences and breakthrough technologies, and to gain a better understanding on how their specialty is evolving and how research may shape tomorrow's practice. - Presents a detailed report on the latest translational research and breakthroughs that may transform glaucoma practice - Overviews the specialty from a scientific and clinical point-of-view - Written by world-renowned clinicians and researchers in the field of glaucoma - Includes insights, opinions and recommendations from some of the most prominent scientists and ophthalmologists - Covers hot topics and the latest technologies in glaucoma, such as minimally invasive glaucoma surgery, telemedicine, gene therapy, neuroprotection and artificial intelligence

As the population of the Americas grows older and increasingly urban, impairments and disabilities - already important problems - are likely to become more prevalent, especially among the most improverished groups. However, the field of rehabilitation medicine currently receives insufficient emphasis in the education and training of health personnel in the Region. This publication responds to the need of health professionals for an update on knowledge of the clinical practice of physical medicine and rehabilitation. It summarizes in one volume the best of current practice, focusing on the significant advances that have come to light in the last 10 years and describing techniques and equipment in adequate detail so that the clinician can apply them in practice.