Medical Therapy for Glaucoma: Current Unmet Needs in PAPS for Glaucoma Management

Topical prostaglandin (FP agonists) is the first-choice medication for eye drops and is recognized for its strong IOP-lowering effects. However, in some cases, it poses a problem by causing Prostaglandin-Associated Periorbitopathy (PAPS), represented by the sunken appearance of the upper eyelids. PAPS can have a significant negative impact on medical examinations, including IOP measurements, and surgical outcomes. During this session, I would like to discuss the frequency and issues associated with PAPS, as well as potential solutions currently under consideration.

There are several instances when PAPS becomes a problem. In the initial stages, there are the distinctive side effects and concomitant effects on compliance and self-confidence. In the longer term, glaucoma management may be affected by inaccuracies in IOP measurement. Finally, the effect of the Deep Upper Eyelid Sulcus on the results of trabeculectomy surgery and difficulties in needling with anti-fibrotics seems to plague the surgeons who deal with these PAPS eyes. The attendees will be offered way to circumvent these issues.