Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject : Understanding Clinical Usage Pattern of Triple Drug Combination (Brimonidine + Brinzolamide + Timolol) in Primary Open Angle Glaucoma: A cross sectional survey

Globally, an estimated 80 million people have glaucoma, and this number is projected to increase to 111.8 million by 2040. Glaucoma is the second leading cause of irreversible blindness worldwide, with approximately 3 million people currently blind due to the condition. Asia accounts for the largest number of glaucoma cases, despite having a lower prevalence rate.

Early identification and treatment are key to prevent blindness due to Glaucoma. Patients typically present with one or more symptoms from among the following: blurry vision, diplopia, halos around light, sensitivity to glare, affected color vision and increased need to change glasses frequently.

Clinical evaluation of glaucoma involves assessing a patient's history, performing a comprehensive eye exam, and potentially using imaging techniques to evaluate the optic nerve and other eye structures. The goal is to diagnose the type of glaucoma, determine its severity, and assess disease progression.

Primary Open Angle Glaucoma (POAG) is a chronic, progressive ocular disease characterized by the gradual loss of optic nerve fibres, leading to visual field defects and potentially irreversible blindness if left untreated.i. Glaucoma treatment focuses on lowering intraocular pressure (IOP) to prevent further optic nerve damage and vision loss. Common treatments include eye drops, laser therapy, and surgery. Eye drops are the first line of defense, and laser procedures like selective laser trabeculoplasty (SLT) or laser iridotomy may be used.

Patients’ adherence to prescribed medical therapy remains one of the great unmeasurable challenges of glaucoma care. Although even a single medication may present a dosing regimen that challenges patients, clinicians accept that increasing the complexity and burden of treatment cannot possibly help adherence rates. Fixed combinations are highly effective and reduce complexity.

Recently, a new triple drug combination (Brimonidine + Brinzolamide + Timolol) has been launched, offering a potentially more effective treatment option for patients with POAG.iiThe introduction of this triple drug combination aims to simplify the treatment regimen for patients, improve adherence, and enhance the overall effectiveness of glaucoma management.

This survey seeks to gather insights from ophthalmologists on the clinical usage patterns, effectiveness, tolerability, and patient profiles associated with this new medication. Understanding these factors will help in optimizing treatment strategies and improving patient outcomes.

We invite you to participate in this data collection activity. All you need to do is to report on a standard form your experience in management of Glaucoma, in the normal course of your practice. If you agree to participate, you will need to fill data collection forms (which we call DCF).

In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.