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Predictability of glaucomatous progression uncertain
KOLOA, Hawaii — The progression of glaucoma remains unpredictable, Kuldev Singh, MD, MPH, said at Hawaiian Eye 2017, where he gave a presentation on the “big picture” of glaucoma care in the U.S.
“In the United States, only about 25% to 50% of patients with glaucoma know they have the disease,” Singh said. Only 15% to 20% of individuals with glaucoma are receiving the appropriate care.
Kuldev Singh
“But there’s great variability in the natural history of the disease and only a small percentage of patients with glaucoma are destined to go blind or lose functional vision,” he said.
One misconception regarding glaucoma care is that disease progression is predictable, Singh said.
Citing personal experience with a study of a group of young Asian men whose examination findings would point to a natural progression to glaucomatous disease — peripapillary atrophy, tilted nerves, dense field defects, pressures in the 12 mm Hg to 15 mm Hg range — Singh said that after a decade of follow-up, the men did not show the expected progression. Rather, their damage was related to strain on the optic nerve from myopia early in life.
“Disease decreased over time,” he said. “This has been shown in the Korean and Chinese populations over and over again in recent years,” Singh said. – by Patricia Nale, ELS
Reference:
Singh K. Glaucoma care in the United States: The big picture. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.
Disclosure: Singh reports he is a consultant for Aerie, Alcon, Allergan, ForSight Vision 5, Glaukos, InnFocus, Ivantis, Ocular Therapeutix, Shire and Transcend Medical.