When determining a therapeutic approach to a patient with glaucoma, the life expectancy of the patient needs to be considered

The Science behind the Tip

Patients who present with early glaucoma who have a short life expectancy are unlikely to go blind from glaucoma in their lifetime, irrespective of the therapeutic approach to their care (1, 2).

In a recent study, two thirds of patients with newly diagnosed glaucoma were dead within 20 years of diagnosis, with a median survival time of 16 years. The mean age of death was 84 years, mainly of vascular causes (2).

A tool has been developed that helps to predict visual impairment from glaucoma within the expected life expectancy of the patient, and is based on age, existing damage and rate of progression (3).

Contributor: John F Salmon MD - Oxford Eye Hospital - UK

References

1. Kwon YH, Kim CS, Zimmerman MB et al. Rate of visual field loss and long-term visual outcome in primary open-angle glaucoma. Am J Ophthalmol 2001; 132: 47-56

2. King C, Sherwin JC, Ratnarajan G, Salmon JF. Twenty year outcomes in patients with newly diagnosed glaucoma: mortality and visual function. Br J Ophthalmol doi : 10. 1136/2017 – 311 595.

3. Wesselink C, Stoutenbeeck R, Jansorius NM. Incorporating life expectancy in glaucoma care. Eye 2011; 25: 1575-80.

Tip Reviewer: Roger Hitchings
Tip Editor: John Salmon