Patients with glaucoma, even at the early stage, read slowly and with more errors as compared with normal subjects, according to a study. While we tend to think of primary open angle glaucoma as a generally slow-moving process, it can have important consequences early on. Functional ability can be significantly affected despite the patient not having field loss or easily detectable optic nerve damage. Even early glaucoma has a detrimental effect on the magnocellular visual pathway, which controls eye fixation and saccadic eye movements.
This study invites us to alter our perspective of glaucoma as a disease of peripheral vision loss. Reading, aside from being a critical skill, can also improve quality of life. Studies report that up to 50% of retinal ganglion cells are already dead when a visual field defect is detectable. Clearly, this should serve as motivation for employing any techniques and technology at our disposal to expedite detection and diagnosis. We must also not dismiss nonspecific complaints of patients with daily tasks that we don’t conventionally associate with preperimetric glaucoma. Reading charts such as the Radner Reading Chart may serve to detect, classify and grade visual impairment for our patients. Finally, a greater emphasis should be placed on vision rehabilitation assessment and treatment for glaucoma sufferers in practice at every stage of this insidious disease.
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