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Editors Selection IGR 15-4

Quality of Life: Grasping objects

Comment by Pradeep Ramulu on:

22696 The functional consequences of glaucoma for eye-hand coordination, Kotecha A; O'Leary N; Melmoth D et al., Investigative Ophthalmology and Visual Science, 2009; 50: 203-213

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This paper by Kotecha et al. (496) examines how 16 glaucoma subjects reached and grasped objects in comparison to 16 similarly-aged controls without eye disease. The primary findings were that glaucoma subjects were slower to initiate a grasping movement, took longer times to grasp objects, and spent a longer amount of time in the final approach to an object. The authors conclude that glaucoma impairs hand-eye coordination which might be relevant to several routinely-performed tasks. While the control subjects were of similar age to glaucoma subjects, the two groups were not demonstrated to be similar with regards to other characteristics that could also affect reaching and grasping (i.e., physical conditioning, medical comorbidities, or cognitive status). However, several reach and grasp parameters worsened with greater binocular visual field loss suggesting that visual field loss was a major reason for the observed differences. It is difficult to know whether the statistical significance noted between groups is clinically significant. Overall movement duration for the reach and grasp task was roughly one-eight of a second longer in the glaucoma group (967 vs. 833 ms), which is roughly the difference between the 50^th and 25^th percentile of performance in the control group. The authors did find that the glaucoma group had worse scores on a questionnaire designed to measure difficulty with manual dexterity tasks, although group differences were not statistically significant possibly as a result of the small study size. Glaucoma focus groups have not generally identified difficulty with manual dexterity tasks as a major complaint amongst subjects with glaucoma. Further work is necessary to determine whether we've simply not properly asked people about difficulty with tasks involving reaching and grasping, or whether the effect of glaucoma on such tasks is not great enough to significantly impair them.

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