Glaucoma: the patient's perspective.

Abstract

#### Clinical Question What are the concerns of patients with glaucoma and how can they be addressed in general practice? Glaucoma is the leading cause of irreversible blindness worldwide, affecting more than 70 million people, with half unaware they are affected.1–3 As glaucoma cannot be cured, patients require lifelong monitoring and treatment. The aim of this article is to provide an update on glaucoma from the patient’s perspective by addressing some commonly raised questions. Glaucoma is an optic neuropathy characterised by loss of retinal ganglion cells and accompanying loss of visual field (Figure 1). Although raised intraocular pressure (IOP) is the major risk factor, some patients develop glaucoma with normal IOP (≤21 mmHg), whereas others have high IOP but do not have glaucoma (ocular hypertension). As glaucoma can be asymptomatic until later stages, for most patients diagnosis follows the unexpected discovery of an abnormality on routine testing at a high-street optometrist. It is therefore important to encourage regular eye examinations.3 Figure 1. Optic disc photograph and visual field showing advanced glaucoma in the left eye. Glaucoma can be divided into open or closed angle, the angle referring to the opening between the iris and cornea, the location of the trabecular meshwork. Both open and angle closure glaucoma can be divided into primary and secondary subtypes. Primary open angle glaucoma (POAG) is the most common type in the UK, affecting 2% of those aged >40 and 10% of those >75 years. Risk factors include age, short sight, family history, African–Caribbean ancestry, and diabetes. Glaucoma …