Risk of visual impairment from glaucoma

Monitoring diagnosed glaucoma patients represents a significant burden on clinical services, with an estimated one million visits annually in the UK alone. Visual field (VF) tests are routinely used for detecting worsening of vision. We modelled VF loss during patient's predicted lifetime by examining more than 400,000 VFs from four regionally different glaucoma clinics/services in England. Levels of VF loss were summarised using the Mean Deviation (MD) index from each test. MD at diagnosis and MD loss during predicted remaining lifetime, using a linear rate of MD deterioration (dB/year) and residual life expectancy tables, were calculated and plotted on motion graphs. Most patients followed in clinics have stable disease. Five percent (95% confidence interval: 4–6%) of patients were predicted to be at risk of statutory blindness in their lifetime [1]. Likelihood of a patient suffering serious visual impairment in their lifetime is linked to level of VF loss at presentation. These findings, from retrospective analysis of ‘big data’ residing in clinics, could help inform planning of follow-up in glaucoma and also illuminate the importance of detecting the disease before it becomes advanced ([1] Saunders et al 2014. IOVS).