Risk factors for late presentation in chronic glaucoma.

Area of Science:

• Ophthalmology
• Public Health

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Late presentation to eye services contributes to advanced glaucomatous visual field loss.
• Identifying risk factors for late presentation is crucial for timely intervention.

Purpose of the Study:

• To determine risk factors associated with advanced glaucomatous visual field loss at the initial visit to hospital eye services.
• To identify patient subgroups at higher risk for late diagnosis and treatment.

Main Methods:

• A hospital-based, case-control study was conducted.
• Patients newly diagnosed with glaucoma at three UK ophthalmic departments were included.
• Exclusion criteria included prior ocular hypertension or documented glaucoma suspicion.

Main Results:

• Independent risk factors for advanced visual field loss included occupational group, initial intraocular pressure (IOP), family history of glaucoma, referral method, and time since last optometrist visit.
• Higher occupational status was associated with a lower likelihood of late presentation.
• Increased IOP, family history of glaucoma, referral by non-optometrists, and longer intervals since the last optometrist visit were significantly associated with advanced field loss.

Conclusions:

• Specific patient subgroups are at increased risk of presenting with advanced, irreversible visual field loss.
• These findings highlight the need for targeted screening and public awareness initiatives for glaucoma.
• Understanding these risk factors can help optimize referral pathways and improve patient outcomes.