Abstract:Background:Vision loss from glaucoma has traditionally been described as loss of “peripheral vision.” In this prospective study, we aimed to improve our clinical understanding of the visual symptoms caused by glaucoma by asking patients specific detailed questions about how they see.Methods:Patients who were clinically diagnosed with various types and stages of glaucoma were included. All had a comprehensive ocular examination, including Octopus visual field testing. Patients were excluded if they had other ocular conditions that affected their vision, including cornea, lens or retina pathologies. Patients responded to an oral questionnaire about their visual symptoms. We investigated the visual symptoms described by patients with glaucoma and correlated the severity of visual field loss with visual symptoms reported.Results:Ninety-nine patients completed the questionnaire. Most patients (76%) were diagnosed with primary open-angle glaucoma. The most common symptoms reported by all patients, including patients with early or moderate glaucoma, were needing more light and blurry vision. Patients with a greater amount of field loss (Octopus mean defect >+9.4 dB) were more likely to report difficulty seeing objects to one or both sides, as if looking through dirty glasses and trouble differentiating boundaries and colors.Conclusions:Vision loss in patients with glaucoma is not as simple as the traditional view of loss of peripheral vision. Needing more light and blurry vision were the most common symptoms reported by patients with glaucoma.

Visante and Cirrus OCT imaging may have limited ability to identify angle closure because of difficulty identifying angle structures. Gonioscopy by well-trained clinicians had remarkably consistent agreement for identifying angle-closure risk.