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February 2011October 2012 EW GLAUCOMA 63 patients, residents and fellows, and technicians work together to help control the disease. 4. Acknowledge when things are going well. When the disease has not progressed, Dr. Brown will say so. He will also praise patients for consistently taking their medica- tions. The positive reinforcement helps to counteract the negative news that is often part of the glaucoma patient's visits. 5. Set the tone for your staff to stay positive. "It's a self-reinforcing thing," Dr. Brown said. "If you're negative, your staff will be negative. You have to provide the momentum for them." 6. Find ways to give patients a sense of control. Education helps give patients a sense of control, which will lessen depression and anxiety, Dr. Kahook said. He is cur- rently involved in research measur- ing adherence in glaucoma patients who have received more detailed education about their disease. For the methodical engineer type patients, Dr. Rhee gives them "homework," encouraging them to monitor their IOP. Of course, more nervous patients might become too obsessive if they are constantly monitoring IOP fluctuations. 7. Refer patients to mental health professionals when neces- sary. Sometimes a glaucoma diagno- sis will push a patient prone to anxiety over the edge, Dr. Rhee said. "I think the lack of ability to self- monitor adds to anxiety," he said. Although it's a difficult topic to dis- cuss, Dr. Rhee recommends the help of a mental health professional to patients who are severely anxious. "Fifty percent of them are very of- fended, but often a family member involved will agree with the recom- mendation," he said. 8. Encourage patience in pa- tients. Dr. Rhee tells patients to have some patience with themselves and the disease. "I try to impress on them that we have to take this day by day," Dr. Rhee said. EW Editors' note: Dr. Kahook has financial interests with Alcon (Fort Worth, Texas), Allergan (Irvine, Calif.), Merck (Whitehouse Station, N.J.), Bausch + Lomb (Rochester, N.Y.), Glaukos (Laguna Hills, Calif.), Ivantis (Irvine, Calif.), Genentech (San Francisco), Regeneron (Tarrytown, N.Y.), Toll free 1-888-519-5375 www.oculususa.com sales@oculususa.com www.pentacam.com The indispensable tool for anterior segment analysis • Anterior and posterior corneal topography • 3D cataract analysis • Evaluation of corneal optical quality for premium IOLs • Holladay Report for post-refractive IOL calculations • NEW Iris camera and automatic HWTW measurement • NEW Belin/Ambrosio III, improved for Hyperopic eyes • LASIK Screening Join us at the AAO 2012 in Chicago – booth #3814 Shape Ophthalmics (Boulder, Colo.), ShapeTech (San Carlos, Calif.), and Innovative Laser Solutions (Minneapo- lis). The other physicians have no fi- nancial interests related to this article. Contact information Brown: 404-252-1194, reaymary@comast.net Kahook: 720-848-2500, malik.kahook@gmail.com Rhee: 617-573-3670, dougrhee@aol.com Yochim: 650-493-5000, Brian.Yochim@va.gov OCULUS Pentacam® /Pentacam® HR facebook.com/OCULUSusa