Ask your glaucoma patients about mobility rather than vision

The Science behind the Tip

Self-reported visual disability in glaucoma which correlates with level of visual field loss includes bumping into things, difficulty with stairs, tripping and problems with outdoor mobility tasks (1,2,3,4). However, the question ‘Do you ever notice that parts of your field of vision are missing’ has no relationship with the level of binocular visual field loss (2).

An example of why this knowledge is important for doctors, patients and policymakers is given by the International Glaucoma Society in its ‘Driving and Glaucoma’ information leaflet (5): ‘The gradual onset and adaption to the loss of vision means there is no awareness of these blind areas but there are potential serious consequences when driving.‘

Contributor: Ananth Viswanathan, Moorfields Eye Hospital, London

References

1. Mills RP, Drance SM. Esterman disability rating in severe glaucoma. Ophthalmology. 1986 Mar;93(3):371-8.
2. Viswanathan AC, McNaught AI, Poinoosawmy D, Fontana L, Crabb DP, Fitzke FW, Hitchings RA. Severity and stability of glaucoma: patient perception compared with objective measurement. Arch Ophthalmol. 1999 Apr;117(4):450-4.
3. Noe G, Ferraro J, Lamoureux E, Rait J, Keeffe JE. Associations between glaucomatous visual field loss and participation in activities of daily living. Clin Exp Ophthalmol. 2003 Dec;31(6):482-6.
4. Nelson P, Aspinall P, Papasouliotis O, Worton B, O'Brien C. Quality of life in glaucoma and its relationship with visual function. J Glaucoma. 2003 Apr;12(2):139-50.
5. https://www.glaucoma-association.com/media/wysiwyg/Leaflet_PDF_Files/DAG_2017.pdf

Tip Reviewer: Roger Hitchings
Tip Editors: Frances Meier-Gibbons, Humma Shahid, Karl Mercieca, Francisco Goni