Welcome to Med Op-Ed, where we highlight recently published editorials. In this installment: the clinical ramifications of longer pollen seasons; what’s under the surface of missed appointments; and advances in artificial intelligence (AI) and genetics that may soon transform glaucoma care.

Climate Change Fuels Allergy Seasons

Climate change may significantly worsen allergic rhinitis and chronic rhinosinusitis through extended pollen seasons, increased production of aeroallergens, and elevated levels of air pollution, creating a need for enhanced clinical awareness and preventive strategies, wrote Duncan A. Meiklejohn, MD, and colleagues in JAMA.

The Context

• The pollen allergy season in North America has lengthened by more than a week over the past 30 years, with pollen levels rising 21% during this period, and researchers predict further increases by 2100.
• Particulate matter with a diameter of < 2.5 mm (PM2.5) is linked to increased risk for chronic rhinosinusitis, with one study finding each microgram per cubic meter rise associated with a 10% increase in outpatient visits related to the condition.
• High PM2.5 exposure also is tied to nasal polyps.

In Their Own Words

“Climate change affects sinonasal health directly by increasing aeroallergens and indirectly by changing weather patterns that result in drought-related dust, increased concentrations and stasis of air pollutants, worsening of wildfires, and heat-induced increases in ground-level ozone.”

Read it: Climate Change, Allergic Rhinitis, and Sinusitis

Missed Appointments May Signal Deeper Issues

Responding negatively to patients who miss appointments is likely to further discourage attendance as their absence may indicate deeper challenges. Addressing nonattendance can be a vital, yet often overlooked, aspect of patient care, wrote Adam Polnay, MBChB, and Adam Burley, DClinPsych, in BMJ.

The Context

• Displaying posters that tally “Did Not Attends” can shame patients, potentially discouraging those already uncertain or mistrustful of services.
• Repeatedly missed appointments may signal fear, shame, a sense the service is unsuitable, concerns about power imbalance, or limited resources, they wrote.
• Research indicates patients who frequently miss appointments often have greater health needs and may have socioeconomic disadvantages or adverse childhood experiences.

In Their Own Words

“Rather than framing a patient’s absence as wasted time, we should recognize it as clinically relevant and respond outwardly in ways that keep the door open to care.”

Read it: Attending to Patients Who Do Not Attend — Missed Appointments Deserve Clinical Attention

Advances Poised to Transform Glaucoma Care 

Systems of classifying glaucoma require major revisions to address the complex, heterogeneous nature of this slowly progressive cause of blindness. Advances in genetics and AI promise more personalized diagnosis within the decade, according to Paul J Foster, PhD, FRCS(Ed), and colleagues writing in the American Journal of Ophthalmology.

The Context

• A recent study by Vianna and colleagues found current classification systems struggle with cases graded as “uncertain” by experts, the very patients for whom diagnostic tools are most needed.
• Emerging polygenic risk scores and whole-genome sequencing offer realistic prospects for molecular-informed diagnosis.
• AI has shown remarkable capabilities in analyzing retinal images, including 97% accuracy in determining sex from retinal photographs, suggesting potential for detecting previously hidden glaucomatous features.

In Their Own Words

“Glaucoma remains a scourge on visual health globally. It is the commonest cause of medically and surgically irreversible blindness and impacts the economic productivity and quality of life of those afflicted, their families, and wider communities.”

Read it: Glaucoma — Are We Getting the Wrong Answers, or Asking the Wrong Questions?

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.