glaucoma blindness

1. Why Do People (Still) Go Blind
From Glaucoma?
Remo Susanna Jr.
Carlos Gustavo De Moraes
George A. Cioffi
and Robert Ritch
Presented by:Krishna Kumar Gupta
University Roll No :1740991427
Bachelor in Optometry
Sankara academy of vision,ludhiana,Punjab
Chitkara University,Punjab,INDIA.

2. GLAUCOMA BASIC AND PREVALENCE:
Glaucoma is a progressive optic neuropathy and is the leading cause
of irreversible blindness worldwide.
Approx. 80M people with glaucoma(2020),60M (2010)
 5.2 million people blind(2020)(15% Of total burden of world
blindness) WHO

3. Three potential reasons why people go blind from
glaucoma:(Grant and Burke;1982)
1. One-third were undiagnosed
2. One-third had not been
treated properly
3. One-third were noncompliant
with therapy
early glaucomatous
cupping
advanced visual field defects
progressive visual field loss
continued to occur even with lowered intraocular
pressure (IOP)

4. Glaucoma Is (Still) Undiagnosed:
Ophthalmologists underestimated glaucoma likelihood in
approximately one in five disc photographs.
 Underestimating the vertical cup-disc ratio and cup shape and
missing retinal nerve fiber layer (RNFL) defects and disc hemorrhage
were the key errors that led to underestimation.
The inability to recognize glaucomatous optic disc and RNFL damage
is one common reason glaucoma is not diagnosed early
Ophthalmologists rely primarily on IOP and visual fields and not on
the appearance of the optic disc.

5. Glaucoma Is (Still) Improperly Treated:
The Severity of Damage Is Underestimated
Definite loss of axons occurred prior to reproducible visual field
defects(Quigley et al)
 Clinically, once there is a visual field defect, there is also a significant loss of
neurons
Insufficient IOP Reduction
Reducing the IOP may not completely prevent disease progression
The idea of ‘‘one-size-fits-all’’ should not be applied to glaucoma treatment
Difficulties in Evaluating the Rate of Progression
 Malik et al. investigated the attitudes of glaucoma specialists to the
frequency of visual field testing in the UK

6. (Still) Lack of Compliance:
 Barriers to adherence, reasons included are forgetfulness other
priorities, lack of information, emotional factors, and did not provide
a reason.
 Side-effect profiles, the cost of therapy, patient education, and the
doctor–patient relationship.

7. REFERENCE:
Susanna Jr R, De Moraes CG, Cioffi GA, Ritch R. Why do
people (still) go blind from glaucoma? Trans Vis Sci Tech. 2015;4(2):
1, http://tvstjournal.org/doi/full/10.1167/tvst.4.2.1, doi:10.1167/
tvst.4.2.1

8. THANK YOU