Treatment of patients with glaucoma requires careful word choice, upbeat attitude

CHICAGO — A clinician's attitude can play an important role in the management of glaucoma, according to a presenter here. Interacting with glaucoma patients requires a degree of optimism and encouragement, and physicians should learn to emphasize the positive aspects of treatment, he said.

"The thing you don't want to do is turn your doubt and fear over to the patient," Reay H. Brown, MD, said here at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting. "Your words are a critical part of the exam and the therapy."

Dr. Brown said the physician's first priority should be to "enjoy" treating glaucoma. Acknowledging that this is an unconventional word choice, he said if physicians learn to emphasize the positive aspects of treatment, such as the availability of effective medications and advanced surgical options, they can better focus on how the care they provide is not only successful, but also life altering for patients.

While glaucoma is an incurable disease, focusing on the negative aspects during conversations with patients can frighten them unnecessarily, Dr. Brown said. Physicians should also avoid being too specific, he said. For example, stating what the target IOP is could cause undue emotional stress for the patient when they do not achieve that goal.

He recommended that physicians avoid absolute statements, such as: "Nothing is working;" "I've tried everything. I don't know what else to do;" or "I give up."

Treatment options are abundant and varied, and therefore physicians should not abandon treatment just because one approach might not be working, Dr. Brown noted.