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Abstract #18933 Published in IGR 3-1
Delivering a diagnosis of glaucoma: are we considering the patient or only his eyes?
Anders HActa Ophthalmologica Scandinavica 2001; 79: 107
In an excellent editorial, the author comments on delivering a diagnosis of glaucoma. He states that labelling the patient as having glaucoma is not merely a technical mater, but also a verdict that may substantially affect the quality of life of a glaucoma patient. The editorial is based on two articles by Odberg et al. Even though many of the patients in that study had ocular hypertension, even though most of them reported good vision, and even though their relationship with their treating ophthalmologists was reported to be good, the mere diagnosis of disease caused much anxiety and depression. Even patients who did not have visual field defects had a fear of becoming blind. In this respect, the author discusses the aspect of pre-perimetric glaucoma and our attempts to diagnose glaucoma in an earlier and earlier stage. This may not be so welcome in the light of quality of life. Many of the visual function techniques or the imaging techniques that we use come with a considerable amount of false positive classifications. As glaucoma is a slowly progressive disease and the risk of blindness is indeed quite small, we may as well ask ourselves what is more important: the earliest diagnosis of glaucoma or the quality of life of the patient. The author correctly states that overly stressing the importance of risk factors and of pre-perimetric glaucoma will do our patients no good. We should refrain of giving a diagnosis of glaucoma before we are absolutely certain. We should stress that glaucoma usually has a good prognosis. In short, we should not forget the psychological needs of our patients.
Prof. A. Heijl, Department of Ophthalmology, Malmo University Hospital, S-205 02 Malmo, Sweden
Classification:
1.4 Quality of life (Part of: 1 General aspects)
