Section 5 – Glaucoma and its impact on patient function

1. Standard measures for assessing glaucoma include measures of optic nerve structure and function including cup/disc ratios, thickness of the retinal nerve fiber layer and ganglion cell layer, white on white visual fields, blue on yellow visual fields, and intraocular pressure. While these measures provide an assessment of the eye, they are surrogates for how the patient is functioning. Both PROs and functional tests provide important information in addition to standard tests on the impact of glaucoma on the patient.
2. It was previously believed that only advanced glaucoma damage has an impact on the patient ability to function. However, more recent cross-sectional clinic-based and population-based studies have demonstrated that early glaucomatous visual field loss has an impact on the patients’ ability to function as assessed by patient reported outcome measures and functional tests.
3. Future studies are needed to explore the relationship between PROs and functional measures and glaucoma progression.
4.  Numerous instruments and tests have been used for assessing PROs and functional measures in research settings. However, there is no consensus on a single PRO or functional measure (or set of PROs or functional measures) for clinical practice. There is a need to create simpler PROs and functional tests which can easily be reproduced in a wide variety of settings.

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