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British Journal of Visual Impairment, Vol. 26, No. 1, 7-23 (2008)
DOI: 10.1177/0264619607083835
© 2008 SAGE Publications

Patient profile and management in advanced glaucoma

Elizabeth Jane Wallace

Queen Margaret Hospital, Dunfermline, UK, jwallace3{at}nhs.net

Helen Paterson

Queen Margaret Hospital, Dunfermline, UK

Shirley Miller

Queen Margaret Hospital, Dunfermline, UK

Anne Sinclair

Queen Margaret Hospital, Dunfermline, UK

Roshini Sanders

Queen Margaret Hospital, Dunfermline, UK

Alison Hinds

Chief Scientist Office, Edinburgh, UK

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.

Key Words: advanced glaucoma • blindness • co-morbidity • patient knowledge • registration


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