Nineteenth century ophthalmology, characterized by significant gains in diagnostic techniques, provided the basis for great advancements in treatment during the 20th century.
Drug therapy at the turn of the century was empiric, palliative, and often toxic. The development of ocular pharmacology during the 20th century provided the basis for a rational therapeutic approach to ocular disease. Foremost among the therapeutic developments were
antibiotics, due to their potential to cure conditions that frequently resulted in
blindness. Second, other therapeutic classes provided
palliative therapy for
chronic diseases, and thus decreased morbidity. For example, drugs specifically targeting many different aspects of
glaucoma have had remarkable success controlling intraocular pressure and forestalling development of
blindness. In addition, other new approaches provided
palliative therapy for nonblinding conditions and effective adjuncts to
surgical procedures. Antiallergy and anti-inflammatory drugs greatly increased patient comfort and facilitated treatment of allergic and inflammatory reactions.
Local anesthetics and
analgesia reduced patient discomfort during surgery. Other adjunct drugs improved surgical outcomes by reducing
inflammation and infectious complications. The 21st century will undoubtedly provide novel approaches to address many of today's therapeutic dilemmas.
Photodynamic therapy,
growth factors, antisense technology, and genetic-based
therapies all show great promise. Many of the conditions that are only treated palliatively today will be curable in the next century using many of these pharmacological advances.