Distinguishing Glaucoma, Cataract, and Glaucoma Suspect Based on Visual Symptoms

Area of Science:

• Ophthalmology
• Medical Diagnostics
• Patient Reported Outcomes

Background:

• Glaucoma, glaucoma suspect, and cataract patients often present with distinct visual symptoms.
• Differentiating these conditions based on symptoms can provide valuable diagnostic information.
• Symptom assessment is crucial for managing patients with overlapping ocular conditions.

Purpose of the Study:

• To compare the specific visual symptoms experienced by patients diagnosed with glaucoma, cataract, or identified as glaucoma suspects.
• To identify key visual symptoms that effectively distinguish between these three groups.

Main Methods:

• A questionnaire assessing 28 visual symptoms was administered to 257 patients (79 glaucoma, 84 cataract, 94 glaucoma suspect).
• Statistical analyses, including univariate and multivariable logistic regression, were employed to identify differentiating symptoms.
• Patient-reported symptom frequency and severity were analyzed to determine diagnostic value.

Main Results:

• Glaucoma patients were more likely than glaucoma suspects to report poor peripheral vision, better vision in one eye, and light sensitivity.
• Cataract patients reported increased light sensitivity and worsening vision compared to glaucoma suspects.
• Glaucoma patients reported more poor peripheral vision and missing patches but less worsening vision than cataract patients.

Conclusions:

• Patient-reported visual symptoms offer a moderate degree of diagnostic capability for distinguishing between glaucoma, cataract, and glaucoma suspect states.
• Incorporating symptom-based questioning can serve as a valuable supplementary diagnostic tool.
• This approach can inform clinical decision-making, particularly for complex cases like glaucoma patients considering cataract surgery.