and Carole Burns, OD, FCOVD
March 29, 2017
Glaucoma is a medical eyecare area where you may soon see more patients, if you aren’t already, statistics from the National Eye Institute suggest. Currently, more than 3 million people in the U.S. have glaucoma. The National Eye Institute projects this number will reach 4.2 million by 2030, a 58 percent increase.
Glaucoma is a chronic disease that can affect a person at any stage in life. The older we get, the higher the risk is that we will develop glaucoma, but even babies can have glaucoma. Just like any disease, catching it early leads to better outcomes. Medication and/or surgery can help manage the condition, but there is no cure, no magic pill, that makes it go away. What makes it difficult is that glaucoma, in its early stages, is asymptomatic.
Here are some statistics about glaucoma assembled by the Glaucoma Research Foundation:
• “It is estimated that over 3 million Americans have glaucoma, but only half of those know they have it.
• In the U.S., more than 120,000 are blind from glaucoma, accounting for 9-12 percent of all cases of blindness.
• Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.
• After cataracts, glaucoma is the leading cause of blindness among African-Americans.
• Blindness from glaucoma is 6-8 times more common in African-Americans than Caucasians.
• African-Americans are 15 times more likely to be visually impaired from glaucoma than Caucasians.
• The most common form, open-angle glaucoma, accounts for 19 percent of all blindness among African-Americans compared to 6 percent in Caucasians.
• Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics and people who are severely nearsighted.
• Estimates put the total number of suspected cases of glaucoma at over 60 million worldwide.
Since age is a risk factor for glaucoma, that leads us to think about demographics. The Baby Boomers (born between the years of 1946 and 1964) are the second largest population in the U.S. That means the leading edge of the Baby Boomers hit age 65 in the year 2011. The sheer number of Baby Boomers in the population – 74.9 million – will cause the number of patients who develop glaucoma to increase as time moves forward.
Millennials were born between the years of 1978 and 1996. Millennials are the largest population in the U.S. There are 75.4 million Millennials. In the year 2018, the leading edge of the Millennials will hit age 40. As the Millennials age, they will push the numbers of patients with glaucoma even higher.
Let’s take this week to review the glaucoma protocols in the office by addressing these questions:
1) Are you current with your education in the area of glaucoma diagnosis and treatment? Download and read the American Optometric Association document Care of the Patient with Open Angle Glaucoma. Also, take a look at the RANCZO Referral Pathways for Glaucoma Management. How would you change this protocol for your office?
2) Identify the ophthalmologists are you going to work with to co-manage your glaucoma patients. What protocols will you use in your co-management?
3) Do you have the proper instrumentation to detect, diagnose and treat glaucoma? If you need to purchase new instrumentation, first run a return on investment calculation to make sure you have enough glaucoma patients to cover the equipment cost.
4) What staff competencies are necessary to deliver superior care?
5) What monitoring protocols are you using in your practice for glaucoma management?
Once you’ve identified any areas that need attention, address those areas as quickly as possible. Remember that half the people who have glaucoma do not know that they have it. You want to make sure that every patient in your practice who has glaucoma has been identified and is receiving excellent care.
ii. The Eye Diseases Prevalence Research Group, Arch Ophthalmol. 2004; Prevent Blindness America
iii. National Institutes of Health; Quigley and Vitale, Invest Ophthalmol Vis Sci. 1997
iv. The Eye Diseases Prevalence Research Group, Arch Ophthalmol. 2004; Prevent Blindness America
v. Javitt et al, Undertreatment of Glaucoma Among Black Americans. N Eng J Med 1991
vi. The Salisbury Eye Evaluation Study, Arch Ophthalmol 2000
vii. Racial differences in the cause-specific prevalence of blindness in east Baltimore. N Engl J Med. 1991
viii. Quigley and Broman “Number of people with glaucoma worldwide in 2010 and 2020”, 2006