Education Committee Highlights WGC-2021 | part 7.2

5 things to improve your care of glaucoma patients

How to improve glaucoma care? This session, coordinated by Prof. Chota Matsumoto presents many concepts that should be adopted to provide better assistance to our glaucoma patients.

Practical tips for improving care
When considering glaucoma, what are the barriers to care? Prof. Mona Kaleem starts by listing several issues to be addressed: understanding the disease, communication, relationship with care providers, physical barriers, co-morbidities, time/convenience, financial constraints, and the need of personal support systems.

She continues by teaching us the ALIVE concept: to be Accessible, Listen, Involve, consider Vision resources and Economics. Each item is discussed in detail, and you should not miss this presentation!

Low vision care for the glaucoma patient
In this presentation, Prof. Ashley Deemer lists the functional domains affected by glaucoma: reading, mobility and transportation, visual information, visual motor and activities on daily living and driving. She explains that reading is the most common chief complaint among low visual patients.

Then, strategies for reading rehabilitation are presented. Regarding mobility, Prof. Deemer emphasizes that this is the primary complaint among patients with glaucoma. Visual information is related to subjective clarity during distance viewing (reading signals, navigate in unfamiliar territory and recognize faces).

Next, she explains the concept of visual motor and activities on daily living. Driving complaints must also be considered. Strategies for all these functional domains are presented and discussed.

When is my patient safe to drive (or not)?
Considering that driving license requirements are mainly based in visual acuity, even advanced glaucoma patients can retain a driver’s license. In this presentation, Prof. Shiho Kunimatsu-Sanuki starts with the following question: are visual field defects associated with increased risk of motor vehicle collisions (MVCs)? Surprisingly, there are inconsistent data in the literature.

This may be explained by the fact that, in many studies, patients only present mild visual field defects. However, a relationship between advanced glaucoma patients and MVCs, using driving simulators, have been demonstrated. She emphasizes that, based on driving simulators, inferior visual field defects make patients unable to notice vehicles that appear from the left or right sides. Also, mild visual field defects can make drivers unable to notice traffic lights.

After presenting some clinical examples, she concludes that a driving assessment clinic equipped with driving simulators may be useful to check driving abilities and enhance patients’ understanding of what driving situations are risky for them.

Supporting glaucoma patients through support networks
Why should we consider supporting glaucoma patients with support networks? Prof. Simon Skalicky translates his next slides into one line: “Because burdens are easier shared”, he says. As soon as the diagnosis of glaucoma is made, many questions may arise. What about the future? Am I going to be blind? What about costs? My ability to work? What are the implications to my family? In this scenario, support networks may play an important role.

Sources of information may be informative websites, newsletters, contact for questions outside of clinic, ability to participate in research, social network groups and even drive screening (population or at-risk groups).

As an example, Prof. Skalicky presents his data on Glaucoma Australia, a group founded in 1988, now with 30,000 members on database. Social media, websites, chatgroups, newsletters, public forums, Facebook live are widely used, with proven benefits in anxiety and glaucoma knowledge. He also emphasizes the importance of awareness campaigns and concludes his lecture by presenting some tips to better support glaucomatous patients.

Watch the presentations