ODs should take a measured approach to glaucoma management that considers the big picture, treat the disease carefully, assess all known risk factors, interpret results carefully, and more than anything else, use clinical evidence as a guide.
ODs need to understand a range of conditions to make the correct glaucoma assessment. For example, traumatic glaucoma is not as common as secondary glaucomas and features two peak incidences:
– Within one year of the initial trauma
– More than 10 years after the initial trauma
Glaucoma is complex with a myriad of risk factors, though some are less known than others.
Research suggests that obstructive sleep apnea is a risk factor r glaucoma. One study showed that 47.6 percent of patients with primary open-angle glaucoma had sleep-disordered breathing.1
Perhaps surprisingly, research on erectile dysfunction shows a link to open-angle glaucoma.2
These lesser-known risk factors underscore the need for ODs to take extensive case histories from patients during their initial evaluation before making glaucoma care decisions.
1. Onen SH, Mouriaux F, Berramdane L, Dascotte JC, Kulik JF, Rouland JF. High prevalence of sleep-disordered breathing in patients with primary open-angle glaucoma. Acta Ophthalmol Scand. 2000 Dec;78(6):638-41.
2. Chung SD, Hu CC, Ho JD, Keller JJ, Wang TJ, Lin HC. Open-angle glaucoma and the risk of erectile dysfunction: a
population-based case-control study. Ophthalmology. 2012 Feb;119(2):289-93.
3. Sihota R, Gupta S, Angmo D. Evaluation of macular ganglion cell analysis compared to retinal nerve fiber layer thickness for
pre-perimetric glaucoma diagnosis. Indian J Ophthalmol. 2018 Apr;66(4):491-493.
4. Xu XY, Lai KB, Xiao H, Lin YQ, Guo XX, Liu X. Comparisons of ganglion cell-inner plexiform layer loss patterns and its diagnostic performance between normal tension glaucoma and primary open angle glaucoma: a detailed, severity-based study. Int J Ophthalmol. 2020 Jan 18;13(1):71-78.