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Purpose: The past few years have been difficult in the lives of most glaucoma patients in view of the COVID?19 pandemic. Our aim was to find out patients’ perspective and disruption of their quality of life during the COVID?19 pandemic by conducting a telephone survey among glaucoma patients. Methods: This was a cross?sectional study involving the glaucoma patients of a tertiary eye care hospital in India. Patients who had completed at least five years of follow?up before 2020 were randomized by a random number generator. A validated (forward–backward translation and completed pilot analysis) set of 14 questionnaires was administered to the patients, the latter of whom were telephonically interviewed by one of the investigators in February 2022. The entire data was audio?recorded. Statistical Package for the Social Sciences (SPSS) version 26 was used. Results: Out of 1141 patients with >5 years of follow?up, 103 were selected by randomization. A large group of 46 patients (44.6%) admitted to glaucoma affecting their daily activities. Only 12 (11.6%) admitted to being irregular with their drops. Thirty?four (33%) patients felt that their glaucoma was deteriorating and 31 (30.1%) had fear of blindness. Ninety?five patients (92.7%) felt that they were safe under the care of the treating doctor. There were 46 (44.6%) out of 103 patients who did not turn up for follow?up for six months or more. Lockdown (36.2%) and travel?expenses (27.6%) were the two most common reasons for the loss to follow?up visits. Conclusion: Nearly half of the long?term glaucoma patients were lost to follow?up during the COVID?19 pandemic. Glaucoma affecting daily lives and fear of losing vision turned out to be significant observations in the telephone survey. This fear seemed to be ameliorated by the majority still feeling safe by being in touch with their doctor for continued care even during the COVID?19 pandemic.
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Purpose: To compare the glaucoma assessment skills among general ophthalmologists in their referral patients over 5 years. Methods: This was a retrospective auditing of the electronic medical record database. Details of consecutive new glaucoma patients seen in the glaucoma services of a tertiary eye care institute in 2013 and 2018 were collected. Details of each patient included the clinical presentation, baseline intra?ocular pressure (IOP), type and severity of glaucoma, referral details, gonioscopy, HVF (Humphrey visual field) data, and the number of medications. Statistical tests used were the Chi?square test and T test using SPSS version 22. Results: Of 28,886 medical records screened, 211 and 568 new glaucoma patients were retrieved in 2013 and 2018, respectively. The patients presenting in 2018 were younger (58.1 ± 15.4 years) at presentation than in 2013 (65.6 ± 15.2 years), P < 0.01, and also had higher baseline IOP (IOP ?40 mm Hg was found in 9.5% in 2018 versus 2.4% in 2013; P < 0.01). The percentage of eyes with presenting visual acuity worse than 20/400 or 20/600 was higher in the patients presenting in 2018 (22.2% vs. 15.1%; P = 0.03). Although primary glaucoma predominated in both periods, the number of eyes referred to as disc suspects showed an increase in 2018 (4.7% to 14.4%; P < 0.01). Among 195 and 517 referrals in 2013 and 2018, respectively, the documentation of clinical findings were dismally poor in both the groups in terms of absent gonioscopy (99% vs. 98.2%, P = 0.4), absent disc details (89.6% vs. 91%, P = 0.5), or absent visual field analysis (79.1% vs. 74.8%, P = 0.2). However, the missing IOP values were significantly better in the latter year (77.3% vs. 57.2%; P < 0.01). Conclusion: The increase in the number of new glaucoma patients and referrals did not show a corresponding improvement in documentation of findings except for IOP recording among general ophthalmologists. Hence, we need to re?emphasize the training of general ophthalmologists on basic glaucoma evaluation to improve their referral ability