Eyeworld

52 | EYEWORLD |JULY 2019 G UCOMA stage of glaucoma at diagnosis, fluctuation of IOP during treatment, presence of exfoliation syndrome, and poor patient compliance. 5 Risk factors for glaucoma-related blind- ness were documented by various studies and include: noncompliance with the treatment regimen, late presentation (the major cause of blindness in 29–41% of patients registered as blind from glaucoma), greater severity of disease at the time of diagnosis despite begin- ning treatment, and a general lack of knowledge about glaucoma, Dr. Januleviciene said. "The main reason why people are becom- ing blind has to do with our aging and expand- ing population, which is understandable, but noncompliance and a lack of knowledge is not acceptable. The fact that patients wait until they lose the vision in one eye before they come for a check-up of the other eye can also be explained by the patients' lack of knowledge to some extent," Dr. Januleviciene said. Although we fear blindness and associate glaucoma with blindness, relatively few indi- viduals understand what glaucoma is, the risk factors, how it is detected, and how it can be treated. An investigation carried out in Germa- ny including 2,742 glaucoma patients revealed that 75% had a passive knowledge of the term but only 8% could correctly identify a basic glaucoma definition. The investigators found that general knowledge among patients was poor. 6 to decrease the blinding effects of glaucoma. While the blinding rate can reach 30% in parts of the developing world, some data suggest it to be 1.3% in the white population of the U.S. A European blinding rate is harder to assess, as according to Dr. Januleviciene, each coun- try's varying economic development plays a determining role. One study observed twice the incidence of blindness in eastern and central Europe compared to western Europe. 3 "The current world blindness rate of 8.66% is expected to be lower by the year 2020, estimated at 8.43%. Central and eastern Eu- rope, however, will likely still see an increase in the blindness rate, with only western Europe expected to see a decrease. With all of our technology and so many educated doctors, we should not be seeing increasing blindness from glaucoma in Europe," Dr. Januleviciene said. Several studies documented the preva- lence and risk of blindness from glaucoma. A retrospective chart review from 2006–2010 in Malmö, Sweden found that out of 592 persons with glaucoma, 42.2% had at least one blind eye and 16.4% were bilaterally blind. The median time with glaucoma diagnosis was 12 years, the median age when developing bilateral blindness was 86 years, and the median duration of bilat- eral blindness was 2 years. 4 Another retrospec- tive evaluation of 106 patients between 1991 and 2002 found that the risk of going blind from glaucoma in both eyes was 6%. Blindness from glaucoma was associated with advanced continued from page 50 References 1. Tham YC, et al. Global preva- lence of glaucoma and projec- tions of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90. 2. Quigley HA, Broman AT. Number of people with glaucoma worldwide in 2010 and in 2020. Br J Opthalmol. 2006;90:262–7. 3. Bourne RRA, et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections. Br J Ophthalmol. 2018;102:575–585. 4. Peters D, et al. Lifetime risk of blindness in open-angle glaucoma. Am J Ophthalmol. 2013;156:724–30. 5. Forsman E, et al. Lifetime visual disability in open-angle glaucoma and ocular hypertension. J Glau- coma. 2007;16:313–9. 6. Pfeiffer N, et al. Knowledge about glaucoma in the unselected population: A German survey. J Glaucoma. 2002;11:458–63. Financial interests Januleviciene: None ASCRS | ASOA COMBINED OPHTHALMIC SYMPOSIUM AUG. 23–25, 2019 | AUSTIN, TEXAS REGISTER AND BOOK YOUR HOTEL COS.ASCRS.ORG PRESENTED BY ASCRS | ASOA & ASORN

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