ABSTRACT.Purpose: To evaluate the feelings and experiences of patients living with glaucoma. Methods: A questionnaire was delivered to patients willing to take part, at a regular visit to their ophthalmologist, for filling in anonymously at home. A total of 589 questionnaires were returned. Results: More than 80% reported negative emotions on learning that they had glaucoma, one-third were afraid of going blind. Half the patients had no visual problem at all, 14% complained of poor or very poor vision. This proportion increased with age. One-fourth of the patients on topical medication experienced adverse effects of moderate or high degree. About half the patients being treated with laser or surgery felt their situation had improved afterwards. Nine-tenths of the individuals were satisfied with the information and care given, although their knowledge about glaucoma was rather incomplete. One-fifth missed information, mainly on causes, treatment and prognosis of the disease. The younger patients were more anxious and inquiring, reported more side effects and were less satisfied than the older patients. The women were in general more dissatisfied than the men. Conclusion: Giving a patient a diagnosis of glaucoma influences his quality of life negatively. Only half of our patients experienced any visual difficulties, whereas one-fourth reported adverse reactions due to the therapy. Most of the patients were very satisfied with the information and care given. Ophthalmologists in private practice are quite central in the management and care of the glaucoma patients in a medical setting like ours.

ABSTRACT.Purpose: To elucidate the relationship between the visual difficulties reported by patients treated for glaucoma and their objective functional damage, and to evaluate the reliability of the patient responses. Methods: Questionnaires concerning quality of life filled in at home by 589 patients treated for chronic open angle glaucoma were correlated to corresponding questionnaires returned from their ophthalmologists. Results: Few of our patients had a visual field damage judged to be of functional significance. There was a weak to moderate association between both visual field defects and decreased visual acuity and self-reported visual difficulties. A high proportion of the patients had normal binocular visual field and a stable disease, raising the suspicion that some of them were treated for ocular hypertension. The agreement between the responses from the patients and the ophthalmologists concerning the topical treatment was good, regarding treatment duration and other diseases of the patients the agreement was moderate. Conclusion:The association between subjective visual disability and presence of visual field defects was weak to moderate in our patients treated for glaucoma, and this association was further weakened by adjusting for visual acuity. Some patients might be treated unnecessarily, and a favourable prognosis might be given to most of them. The reliability of the patients in general was good.Key words: glaucoma -quality of life -visual field defect -visual acuity -questionnaire -reliability.

Results: The probability of treatment success (no medication required) was for chronic open angle glaucoma 77% after 2 years, 67% after 5 years and 67% after 8 years. Corresponding numbers for pseudoexfoliation glaucoma were 80%, 54% and 36%. Prelaser IOP higher than 31 mmHg, pretreatment visual field defect and sparse pigmentation of the trabecular meshwork were independent predictors of failure. Conclusion: Primary argon laser trabeculoplasty gives a long-lasting and favourable effect in chronic open angle glaucoma where 2/3 of the eyes still managed without additional medication for 8 years. The success in pseudoexfoliation glaucoma was even higher the first 3 years, and kept above 50% for 5 years. This makes laser a valuable option as first choice of therapy in glaucoma.Key words: open angle glaucoma -pseudoexfoliation glaucoma -argon laser trabeculoplastyprimary treatment -long-term results -quality of life.

79 eyes in 71 patients with advanced glaucomatous damage (loss of at least half the visual field) have been followed for 5-18 years. At the first visit 42 eyes had an intraocular pressure of 40 mmHg or higher. During the followup the visual field defect was stable in 23 eyes (29%) and progressed in 56 eyes (71%). Deterioration of the field was not dependent on the initial degree of defect. Central vision was lost in 27 eyes, and 16 eyes became amaurotic. The visual field was unchanged in 36% of the operated eyes, as against 20% of the medically treated eyes. In no case was central vision lost as as consequence of surgery. Obviously, the prognosis was better in eyes with intraocular pressures below 15 mmHg during the follow-up (58% stable visual fields) than in the eyes with pressures higher than 15 mmHg (15% stable fields). Most of the eyes with pressures below 15 mmHg had been operated.