Keynote lecture focuses on heavy impact of late diagnosis of glaucoma

Issue: July/August 2013

COPENHAGEN, Denmark — Late diagnosis of glaucoma is a widespread issue, leading to poorer prognosis, lower quality of life and higher expenses, according to the keynote lecturer here.

"When diagnosed, the majority are still unaware of their condition. Undiagnosed patients were 90% in the Indian Aravind Eye Study, 60% in the Blue Mountains Eye Study and 55% in the Rotterdam Eye Study," Roger Hitchings, MD, said at the meeting of the European Society of Ophthalmology.

Roger Hitchings

Late presentation is primarily correlated to socioeconomic status, but the "age effect," ie, the underestimation of symptoms because they are perceived as a part of growing old, also plays a significant role.

The economic burden of delayed diagnosis is significant. Hitchings showed that late stages of the disease increase the direct and indirect costs to more than double the costs of the early stages.

Bilateral field loss has the biggest impact on life quality, affecting activities such as reading, daily tasks, mobility and driving.

"Bilateral field loss has been shown to lead to a threefold increase in falls over 12 months compared to healthy matching-age subjects and to a sixfold increase in motor accidents over 5 years," Hitchings said.

"The loss of peripheral vision and brain compensation prevent patients from identifying hazards," he said. "They cannot see much of what’s coming along and may be totally unaware that there are problems."

Decreases in social status and life expectancy are unavoidable consequences of glaucoma-related blindness, Hitchings said.

"When patients become blind, especially in the developing world, they can’t work. Their life expectancy drops down one-third that of a matched peer. Fifty percent of the blind report a loss of social standing and decision-making authority," he said.

Disclosure: No products or companies are mentioned that would require financial disclosure.