Avoidable sight loss from glaucoma: is it unavoidable?
- 1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK
- 2Research and Development Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Correspondence to Miss Wendy A Franks, Glaucoma Service Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK;
Contributors WAF: study conception, data interpretation, manuscript critique. CB: study design, data analysis and interpretation, manuscript critique. SF: Data collection, manuscript critique. AK: data analysis and interpretation, manuscript writing and critique.
- Accepted 9 March 2012
- Published Online First 4 April 2012
Aims To review the characteristics of patients attending a tertiary ophthalmic referral centre certified as sight impaired (SI) or severely sight impaired (SSI) from glaucoma.
Methods One hundred consecutive patients certified SI/SSI from the Glaucoma Service at Moorfields Eye Hospital, London, from January 2007 were identified from the England and Wales certification of visual impairment database. Clinical and demographic data were collected from hospital case records.
Results The median (IQR) age of patients at presentation was 66.3 (55.6 to 75.3) years; median (IQR) interval to certification was 62.2 (22.5 to 129.3) months. Fifty-seven patients presented with bilateral SSI (median (IQR) age 70.4 (59.0 to 76.9) years); interval to certification was 35.4 (5.6 to 78.1) months. Seventeen patients presented with a bilateral SI (median (IQR) age 62.1 (58.7 to 68.4) years; median (IQR) interval to certification: 137.4 (64.4 to 190.4) months). Twenty-eight patients showed disease progression while under National Health Service hospital eye service care, five of whom had no certifiable visual impairment in either eye at presentation. This was attributed to inadequate intraocular pressure control; five of these patients (18%) were deemed poorly compliant to topical hypotensive medication.
Conclusions Over 80% patients on the certification of visual impairment register from Moorfields Eye Hospital with glaucoma as the primary cause had a significant visual disability at presentation, with almost two-thirds of patients presenting bilaterally ‘blind’. There appear to be delays to certification. Despite being under the hospital eye service, a number of glaucoma patients still progress to certifiable visual impairment.
Funding Dr Kotecha receives a proportion of her funding from the Department of Health's National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology at Moorﬁelds Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology.
Competing interests None declared.
Ethics approval Institutional research review board approval for retrospective review of hospital charts.
Provenance and peer review Not commissioned; externally peer reviewed.