A new definition of glaucoma is proposed as a condition in which the optic nerve, that connects the eye to the brain, does not tolerate the intraocular pressure. The current "progressive optic neuropathy" definition implies worsening over time, making it difficult to adapt to evidence that not all glaucoma cases must progress. In fact, some can improve over time. This presentation returns to basic principles of biology, embryology and physiology to redefine glaucoma and introduce new concepts of detection, therapy selection and newer models of care, such as officebased stent implantation.

Dr. Shawn Cohen is an Associate Professor of Ophthalmology at McGill University.

Dr. Cohen has no commercial interest in any products mentioned or discussed in this presentation.
Ab externo implantation of a XEN implant (Abbvie) is an offlabel use of this product.

Major References:
1. Shim MS et al, BMB Rep, 2017; 50:6070
2. Majeed M et al, Saudi J Ophthalmol, 2015; 29:197200
3. Moshirfar M et al, Med Hypothesis Discov Innov Ophthalmol, 2018; 7:101111
4. Johnson M & Tanna AP, Ophthalmology, 2018; 125:17411756
5. Ritch R, Can J Ophthal, 2007; 42:425438
6. Weinreb RN et al, Br J Ophthalmol, 2015; 99:738745
7. Yang H et al, IOVS, 2009; 50:58005804
8. Lin MI et al, eLife, 2015; 4:125
9. Zhou X et al, Front Cell Neurosci, 2019; 3:167
10. Hoste AM, Bull Soc Belge Optalmol, 2003; 287:6571
11. Quigley M, Cohen SL, Arch Ophthalmol, 1999; 117:8489
12. Cohen SL et al, Arch Ophthalmol, 2003; 121:3338
13. Damji KF et al, Can J Ophthalmol, 2003; 38:189197
14. Cohen SL et al. Can J Ophthalmol, 2016; 51:445451
15. Cohen SL, Ophthalmic Practice, 2002; 20:100110
16. Cohen SL, Clin & Sur Ophthalmol, 2003; 21:402410
17. Gagné S, Yuen D & Cohen S, J Glaucoma, 2022; 31:675681

• Stock photos created by Dr. Shawn Cohen, reproduced with permission or acquired royalty free from: https://www.dreamstime.com
• Color sketches hand drawn by Dr. Shawn Cohen