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Symptoms reported by patients with varying stages of glaucoma: Review of 401 cases

      Abstract

      Objective

      To elucidate the symptoms that patients with glaucoma voluntarily report and to determine the correlation between the symptoms and the stage of glaucoma.

      Design

      Retrospective case series.

      Participants

      A total of 401 patients who presented to the Glaucoma Service from January 2012 through November 2013.

      Methods

      The Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the medical records of patients who visited the Glaucoma Service from January 2012 through November 2013. We recorded any symptom written in the charts at the last eligible visit of each patient. The patients were classified by different stages according to the mean deviation of the Octopus visual field.

      Results

      We analyzed 401 patients, who were graded with mild (n = 170), moderate (n = 106), or severe (n = 125) visual-field loss. The majority of patients did not report any symptoms (56.0%); 24.2% reported ocular surface disease (OSD) symptoms; and 25.8% reported visual complaints. The presence of symptoms positively correlated with the severity of glaucoma (p = 0.01) and the number of surgeries (p = 0.02). Burning/smarting/stinging and blurry vision showed a positive correlation with the severity of glaucoma (p < 0.05). Older patients (> 69 years) showed a significant increase in OSD symptoms (p = 0.001).

      Conclusions

      About one-fourth of the patients with glaucoma reported visual complaints, and another fourth reported OSD symptoms, both of which correlated with glaucoma severity. The high prevalence of OSD symptoms suggests that patients should be specifically questioned about these symptoms and treated as indicated. This information is of value particularly in the new era of nonpreserved glaucoma medications.

      Résumé

      Objet

      Élucidation des symptômes du glaucome que les patients signalent volontairement et détermination de la corrélation entre les symptômes et l’étape du glaucome.

      Nature

      Séries rétrospectives de cas.

      Participants

      401 patients qui s’étaient présentés au Service du glaucome de janvier 2012 à novembre 2013.

      Méthodes

      Le Centre Wills Eye de recherche oculaire en glaucome a revu rétrospectivement les dossiers médicaux de patients qui avaient visité le Service du Glaucome entre janvier 2012 et novembre 2013. Nous avons relevé tout symptôme inscrit dans les dossiers dans la dernière visite éligible de chaque patient. Les sujets furent classifiés selon diverses étapes selon la moyenne de déviation du champ visuel Octopus.

      Résultats

      Nous avons analysé 401 patients, dont la perte visuelle a été classée légère (N=170), modérée (N=106) ou grave (N=125). La majorité des patients n’avait pas signalé de symptôme (56,0 %), 24,2 % avaient signalé des symptômes de maladie de la surface oculaire (MSO) et 25,8 % avaient exprimé des plaintes visuelles. La présence de symptômes était en corrélation avec la gravité du glaucome (p = 0,01) et le nombre de chirurgies (p = 0,02). Les brûlements/picotements/piquements et la vision trouble montraient une corrélation positive avec la gravité du glaucome (p < 0,05). Les patients plus âgés (>69 ans) présentèrent une hausse significative des symptômes de MSO (p = 0,001).

      Conclusion

      Environ le quart des patients atteints du glaucome a signalé des plaintes visuelles et un autre quart a fait état de symptômes de MSO, les deux groupes étant reliés à la gravité du glaucome. La forte prévalence des symptômes de MSO suggère que les patients devraient être interrogés particulièrement sur ces symptômes et traités tel qu’indiqué. Cette information est particulièrement valable dans la nouvelle ère de médication du glaucome sans agent de conservation.
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