The Science behind the Tip
The ultimate outcome measure of glaucoma treatment is visual impairment and blindness at the time of death. Based on a systematic review we found the occurrence of end-of-life visual impairment to be considerable in glaucoma patients (1). The reported figures for end-of-life visual impairment are 9%, 9.2% and 15%, for unilateral blindness 11% and 24.1% and for bilateral blindness 0%, 2.7%, 9% and 10.6% (2-6).
Factors associated with end-of-life visual impairment in glaucoma are more advanced baseline visual field loss, higher base-line intraocular pressure, older age and longer duration of disease1. These factors have also been shown to correlate with progression of visual field loss in glaucoma. Older patients that present with advanced glaucomatous damage and high IOP should be considered to be at risk of blindness and treated accordingly.
Contributor: C A Webers, Holland
References
Tip Reviewer: Roger Hitchings
Tip Editors: John Salmon and Gordana Sunaric Mégevand