Sage Journals: Discover world-class research

Abstract

Purpose: to study patient characteristics and management profile in advanced glaucoma. Method: A retrospective study of 87 case notes of patients registered blind due to glaucoma, and cross-sectional interview of 29 patients. Results: advanced glaucoma at presentation was documented in 43 cases (49%). Insufficient optometry assessment was significantly associated with advanced disease (p = 0.0339). Normal tension glaucoma patients were significantly more likely to present with advanced disease compared to other types of glaucoma (p = 0.0034). Poor compliance with medication was significantly higher in those with hearing loss (p = 0.0168). Patients with advanced field defect at presentation and those with poor compliance had significantly higher social deprivation scores compared to others on the blind register (p < 0.0001). Nine (10%) patients had partial registration before full registration and 29 (33%) patients had late registration. Of the 29 patients interviewed, 20 (69%) did not demonstrate basic knowledge regarding their disease or its management; nor had they received written information on glaucoma or instructions on drop technique. Conclusion: Special care pathways are required in advanced glaucoma taking into account co-existent morbidity, disease education and compliance.

Keywords

advanced glaucoma blindness co-morbidity patient knowledge registration

Get full access to this article

View all access options for this article.

References

Altangerel, U. , Spaeth, G.L. & Rhee, D.J. (2003) `Visual Function, Disability, and Psychological Impact of Glaucoma', Current Opinion in Ophthalmology 14(2): 100—5.

Bamashmus, M.A. , Matlhaga, B. & Dutton, G.N. (2004) `Causes of Blindness and Visual Impairment in the West of Scotland', Eye 18(3): 257—61.

Cackett, P. , Vallance, J. , Cobb, C. , Devlin, H. , Simpson, A. & Sanders, R. (2007) `South-East Scotland Trabeculectomy Survey', Eye 21(1): 45—51.

Chen, P.P. (2003) `Blindness in Patients with Treated Open Angle Glaucoma', Ophthalmology 110(4): 726—33.

Coyle, D. & Drummond, M. (1995) `The Economic Burden of Glaucoma in the U.K. The Need for a Far-sighted Policy', Pharmacoeconomics 7(6): 484—9.

Drummond, S.R. , Drummond, R.S. & Dutton, G.N. (2004) `Visual Acuity and the Ability of the Visually Impaired to Read Medication Instructions', The British Journal of Ophthalmology 88(12): 1541—2.

Folstein, M.F. , Folstein, S.E. & Mchugh, P.R. (1975) `“Mini—mental State”: A Practical Method for Grading the Cognitive State of Patients for the Clinician', Journal of Psychiatric Research 12(3): 189—98.

Fraser, S. , Bunce, C. , Wormald, R. & Brunner, E. (2001) `Deprivation and Late Presentation of Glaucoma: Case-control Study', British Medical Journal 322(7287): 639—43.

Grey, R. H. B , Burns-Cox, C.J. & Hughes, A. (1989) `Blind and Partial Sight Registration in Avon', Br J Ophthalmology 73(2): 88—94.

10.

Henson, D.B. & Thampy, R. (2005) `Preventing Blindness from Glaucoma', British Medical Journal 331(7509): 120—1.

11.

Henson, D.B. , Spencer, A.F. , Harper, R. & Cadman, E.J. (2003) `Community Refinement of Glaucoma Referrals', Eye 17(1): 21—6.

12.

Hillman, J.G. (1994) `Audit of Elderly People's Eye Problems and Non-Attendance at Hospital Eye Service', British Medical Journal 308(6934): 953.

13.

Hinds, A. , Sinclair, A. , Park, J. , Suttie, A. , Paterson, H. & Macdonald, M. (2003) `Impact of an Interdisciplinary Low Vision Service on the Quality of Life of Low Vision Patients', British Journal of Ophthalmology 87(11): pp.1391—1396.

14.

Jay, J. & Murdoch, J. (1993) `The Rate of Visual Field Loss in Untreated Primary Open Angle Glaucoma', British Journal of Ophthalmology 77(3): 176—8.

15.

Kass, M.A. , Gordon, M. & Meltzer, D.W. (1986) `Can Ophthalmologists Correctly Identify Patients Defaulting from Pilocarpine Therapy?', American Journal of Ophthalmology 101(5): 524—30.

16.

Khaw, P.T. & Cordeiro, M.F. (2000) `Towards Better Treatment of Glaucoma', British Medical Journal 320(7250): 1619—20.

17.

King, A.J.W. , Reddy, A. , Thompson, J.R. & Rosenthal, A.R. (2000) `The Rates of Blindness and of Partial Sight Registration in Glaucoma Patients', Eye 14(Pt4): 613—19.

18.

Meads, C. & Hyde, C. (2003) `What is the Cost of Blindness?', The British Journal of Ophthalmology 87(10): 1201—4.

19.

Sanders, R. (2004) International Glaucoma Association Newsletter (Summer Edition), pp. 17—22.

20.

Scottish Executive (2004) Scottish Index of Multiple Deprivation 2004 (SIMD). Online: http://www.scotland.gov.uk/SIMD2004Data [accessed April 2005].

21.

Spry, P.G.D. , Spencer, I.C. & Sparrow, J.M. ET AL. (1999) `The Bristol Shared Care Glaucoma Study: Reliability of Community Optometric and Hospital Eye Service Test Measures ', British Journal of Ophthalmology 83(6): 707—12.

22.

Stroman, G.A. , Stewart, W.C. , Golnik, K.C. , Cure, J.K. & Olinger, R.E. (1995) `Magnetic Resonance Imaging in Patients with Low Tension Glaucoma', Archives of Ophthalmology 113(2): 168—72.

23.

Traverso, C.E. , Walt, J.G. & Kelly, S.P. Et Al. (2005) `Direct Costs of Glaucoma and Severity of the Disease: A Multinational Long Term Study of Resource Utilisation in Europe ', The British Journal of Ophthalmology 89(10): 1245—9.

Patient profile and management in advanced glaucoma

Abstract

Keywords

Get full access to this article

References