Primary open-angle glaucoma: everyone's business

Primary open-angle glaucoma (POAG) is sometimes called the ‘thief of sight’. There is no pain or discomfort, and vision loss is so gradual that people often do not notice it. POAG cannot be cured: it requires ongoing treatment for the remainder of a patient’s life. Blindness from POAG also cannot be reversed, but it can be prevented if the disease is diagnosed early and treated. Effectively addressing POAG therefore requires the careful involvement of many different people, including health workers, the patient, non-clinical staff, and health planners. As eye care practitioners, we must do more than merely diagnose and treat people with POAG; we must gain the trust of patients and show them that we are there to help. It is important to understand the fears people have about surgery, which is often the most certain way to preserve the sight of people with POAG. Many people dread the words ‘surgery’ or ‘operation’ but will also struggle to afford eye drops or come to the eye clinic for follow-up visits (see the case study on page 71). Unless we address their fears and misconceptions, they will certainly lose their sight. Patients themselves, and their carers, are extremely important in the successful management of glaucoma, whether by surgery or medical treatment. They must come to the clinic for surgery and follow-up and instil any eye medication needed. Patients also can help to prevent blindness from POAG in their loved ones by encouraging their first-degree relatives (parents, siblings, and children) to come for an eye examination. It can be very helpful to find out what the community knows and thinks about POAG (page 44). This knowledge enables us to provide appropriate information to patients and their families and ensures that we are effective in raising the public’s awareness of the condition (page 46). For patients on medical treatment, time is needed to explain the crucial role patients or their carers have to play, as well as all the practicalities (pages 77 –79):