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Editors Selection IGR 15-4
Blindness Due to Glaucoma: Lifetime risk of blindness
Comment by Rupert Bourne on:
54551 Lifetime risk of blindness in open-angle glaucoma, Peters D; Bengtsson B; Heijl A, American Journal of Ophthalmology, 2013; 156: 724-730
Only three studies have assessed lifetime risk of blindness and vision impairment from glaucoma. By retrospectively reviewing charts of 592 glaucoma patients who died within three years of their last glaucoma clinic visit in the North European, predominantly white population of Malmø, Sweden, Peters et al. Reported one out of six glaucoma patients was bilaterally blind at the last visit, while more than 40% were blind in at least one eye. The study was well designed involving two groups of patients, one in which the full glaucoma history was known from time of diagnosis, and another which involved patients referred to the glaucoma service from elsewhere. Careful consideration was given to the representativeness of the glaucoma patient population to the catchment of the hospital glaucoma service by capturing data from both public and private sectors and the sole local rehabilitative service (accessed by only 29% of visually impaired glaucoma patients). Mean duration of diagnosed disease was 11.2 years, which was similar to the duration estimated by Quigley's group (12.8 years) that modeled cross-sectional prevalence data. Mean duration of blindness was three years (range < 1-13), 86% of whom became blind after 80 years of age.
These are important findings, particularly for those involved in advocacy efforts to promote awareness of the burden of glaucomarelated vision impairment. The authors note that the results cannot be generalized to other clinic populations of different ethnicity, however, additional factors such as pseudoexfoliation or more advanced cases at diagnosis may underly the relatively high blindness rates found in this study. In an era where informatics should be improving and where large datasets are becoming available, local knowledge of the likely glaucoma vision loss burden is of great relevance to commissioners and providers of eyecare and this study uses an elegant approach to such an analysis.
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