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| Division of Occupational Therapy - OT Connect Glaucoma
“Glaucoma is a condition where the optic nerve is subject to damage--usually, but not always, because of excessively high intraocular pressure (pressure within the eye--also called IOP). If untreated, the optic nerve damage results in progressive, permanent vision loss, starting with unnoticeable blind spots at the edges of the field of vision, progressing to tunnel vision, and then to blindness” (Lica, 2000). Common Symptoms/Course of disease Because this disease sometimes begins without symptoms regular checkups are needed to catch it before it progresses. Chronic Open-Angle Glaucoma:
Acute Closed-Angle Glaucoma:
Congenital Glaucoma:
Low tension or normal tension glaucoma:
Pigmentary Glaucoma:
Age of Onset: Can occur at any age but is more likely to occur as you age. After the age of 40, you should be tested every two to four years; after 65, you should be tested every one to two years (What, 1999). Sex Bias: Glaucoma is not linked to sex. It is more likely to occur if the parents or siblings also have the disease (Weston, 2000). Cultural Biases: Glaucoma is four times more prevalent in African Americans (LoBuono, 2000). It is the second leading cause of blindness in the U.S. (What, 1999). Current Medical Treatment:
"Sight lost due to glaucoma cannot be restored.” (Lica, 2000). Occupational Therapy Involvement Low vision can lead to problems associated with the activities of daily living (ADL’s). Occupational therapists (OT’s) can help to promote independence in clients with low vision/Glaucoma. An OT will test a client’s functions to see how the disease is affecting the client’s life. This testing may include visual acuity testing, contrast sensitivity assessment, the effect of glare, color appreciation, visual field assessment, and ADL’s. The client’s environment (such as home/work) may also be evaluated to see if any modifications can be made to promote independence. The OT should provide the client with information about Glaucoma and its progress. The therapist will also help the client to modify their environment and activities to help the client function (Smith, 2001). Reference
How OT Makes a Difference: Evidence-Based Practice Due to the fact that low vision treatment by Occupational Therapists is such a new field, evidenced based articles were difficult to find on treating glaucoma. I did find the following article that focuses on low vision rehabilitation. These ideas can be utilized in treating patients with glaucoma also. McCabe, P., Nason, F., Demers, T.P., Friedman, D., & Seddon, J.M. (December, 2002). Evaluating the effectiveness of a vision rehabilitation intervention using an objective and subjective measure of functional performance. Ophthalmic Epidemiology, 7(4), 259-7. This study looks at 97 patients to see if occupational therapy, optometry and social work services utilized in rehabilitation for vision deficits is beneficial in improving a patient’s functional performance. The study found that the majority of the patients had both subjective and objective improvements in function following rehabilitation. One gentleman suffering from glaucoma stated that he was diagnosed about seven years ago and when they first found it his IOP was 40 (average glaucoma pressures being in the teens). Now thanks to new medications they have reduced to 21 in his right eye and 18 in his left. His form of glaucoma is called “pigmentosis” which means the color of his eye flakes off. He has had laser surgery to open additional ducts in each eye to help reduce the pressure. His grandmother, father, and sister all also suffer from this disease. Because his glaucoma was detected so early he has not needed therapy to help him with his daily activities. He was unaware, though, that there was therapy even available. This shows that Occupational Therapists need to promote and market themselves in the treatment of vision. This is such a new and emerging field and many people are not aware of therapy being available to the One way that OT may be able to assist this gentleman is in the future. He has to puts drops in his eyes several times a day to keep the disease under control. Should his memory begin to fail as he ages we could help to make adaptations to aid him in remembering to use his eye drops. Also, should the disease progress any further we can help him to adapt his environment to make it easier for him to perform any daily activities that might become difficult for him.
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