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What's Important in the Management of your Glaucoma?

As a glaucoma patient for nearly 20 years, a practitioner of internal medicine, and a glaucoma clinical researcher, I would like to share my knowledge and experience with the hope that it can improve your life with glaucoma.

I know glaucoma can be devastating, but with appropriate management progression can be slowed and the adverse effects minimized. I know from my practice as an internist, like other conditions, assessment of outcomes for glaucoma treatment is more than what is measured by intraocular pressure, contrast sensitivity, visual fields, and visual acuity. These measures constitute the standard of care for glaucoma and are essential in the successful management of this condition. They also tend to be the focus of your concerns and those of your eye doctor.

However, there are other measures that provide important information about the status of your glaucoma, and add considerably to the objective information obtained by your doctor. Simply stated they constitute "how does glaucoma affect your life?"

Do you have trouble seeing at night, have you had a fall recently, or are other activities limited due to your vision? Your doctor can use available standardized quality-of-life surveys to assess more comprehensively how glaucoma is affecting your life. As we do in internal medicine, your eye doctor can use this information to modify treatment - such as referral to a low vision specialist.

Often, help may be obtained from social workers or occupational therapists. Occupational therapists can help patients with improving lighting in the home, recommending adaptive equipment and training how to use it, etc. Organizations such as Lighthouse International (lighthouse.org) and American Foundation for the Blind (afb.org) provide excellent resources for patients coping with vision loss.

In summary, the "numbers" that can benefit you in the management of glaucoma are those objective measures made by an eye doctor - and the subjective information that translates how those findings relate to how you function in everyday life. Sharing and discussing your condition in this context will improve communication and help your eye doctor provide better treatment.
Article by William C. Steinmann, MD, MSc and L. Jay Katz, MD.


William C. Steinmann, MD, MSc is Emeritus Professor of Medicine at University of Missouri Health Sciences Center. As Director of Glaucoma Research at Wills Eye Hospital, he participated in the evaluation of screening, diagnostic and treatment practices for glaucoma. As a glaucoma patient he has benefited greatly from the medicines, surgeries and available resources such as referral to a low vision specialist.


L. Jay Katz, MD is Director of the Glaucoma Service at the Wills Eye Institute and Professor of Ophthalmology at Thomas Jefferson University in Philadelphia. Dr. Katz graduated medical school and completed his residency program at Yale University School of Medicine, and his glaucoma fellowship at the Wills Eye Hospital. Dr. Katz has published numerous peer-reviewed articles and authored three books on ophthalmology surgery.

Last reviewed on October 29, 2017

This article appeared in the September 2014 issue of Gleams.


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