Patient’s perception on glaucoma and different types of treatment (medical versus surgical treatment)

Vieira, Augusto Alves Pinho; Guedes, Ricardo Augusto Paletta; Vieira, Rita de Cássia Padula Alves; Guedes, Vanessa Maria Paletta

doi:10.5935/0034-7280.20150048

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• Rev. bras. oftalmol. 74 (4) • Jul-Aug 2015 • https://doi.org/10.5935/0034-7280.20150048 copy

Patient’s perception on glaucoma and different types of treatment (medical versus surgical treatment)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the meaning and impact on their quality of life of having glaucoma and to understand the patients’ perception on the different types of treatment (medical or surgical).

Methods:

Through a qualitative research, focus groups were conducted with patients in clinical treatment (group 1) and patients who underwent glaucoma surgery in both eyes and were without medication (group 2). The responses were analyzed using the technique of content analysis.

Results:

Fear of blindness and lack of information about the disease were the most cited issues in relation to how it is like to having glaucoma. Medication costs, impact of drops on patients’ daily lives and the side effects were the main points discussed in relation to medical treatment. All patients in the surgical group preferred the current situation (without medication) when compared to the need for chronic use of medication. In the two groups, both glaucoma and its treatment had a profound impact on people, not only from a psychological standpoint, but also affecting their daily lives. Patients operated on for glaucoma appear to have less impact on their daily lives, but the concern about the disease persists.

Conclusion:

We identified the most significant negative aspects of glaucoma and its treatment from patients’ perspectives. Confidence in the correct indication of the type of treatment, clinical or surgical, and a solid relationship between the patient the doctor are determining factors for extra peace of mind of patients being treated for glaucoma.

Keywords:
Glaucoma, open-angle/psychology; Glaucoma, open-angle/therapy; Glaucoma, open-angle/surgery; Quality of life

Group 1:
Clinical	Age	Ethnicity	Sex	Education	Time since the discovery	Number of droplet
treatment	(years)				of the disease (anos)	per day per eye
Patient 1	75	white	M	High school	7	5
Patient 2	63	black	F	Elementary	3	3
Patient 3	69	black	F	Graduated	10	1
Patient 4	65	black	F	Elementary	11	5
Patient 5	93	white	F	Elementary	2	6
Patient 6	72	white	M	Graduated	4	3
Patient 7	63	white	F	Elementary	15	6
Patient 8	72	white	M	Elementary	1	3
Patient 9	83	white	M	Graduated	20	3
Group 2:
Clinical	Age	Ethnicity	Sex	Education	Time since the discovery	Number of droplet
treatment	(years)				of the disease (anos)	per day per eye
Patient A	78	black	M	Elementary	12	2
Patient B	59	black	F	Elementary	25	5
Patient C	80	white	F	High school	16	3
Patient D	55	white	M	Graduated	13	3
Patient E	81	white	F	High school	6	2
Patient F	47	white	M	Elementary	34	5
Patient G	70	white	F	Graduated	26	5
Patient H	68	white	F	High school	30	4
Patient I	58	white	F	Elementary	10	3

Sociedade Brasileira de Oftalmologia Rua São Salvador, 107 , 22231-170 Rio de Janeiro - RJ - Brasil, Tel.: (55 21) 3235-9220, Fax: (55 21) 2205-2240 - Rio de Janeiro - RJ - Brazil
E-mail: rbo@sboportal.org.br

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[1] Corresponding author: Augusto Alves Pinho Vieira. Rua Dr. Asclepíades da Paixão Lucas 147, Portal da Torre. 36037-462 Juiz de Fora MG. Phone:(32) 3231 2111; (31) 8811 3691 E-mail: augustovieira.med@gmail.com

Patient 4	“At first, I was very worried about blindness. I couldn’t read.”
Patient 5	“Really worried about being blind. I was afraid of falling; I was really concerned.”
Patient 8	“I heard glaucoma was blindness for sure. But the doctor said it wasn’t true at all.”
Patient 9	“I got, like, really worried. My mother was blind before dying.”

Patient 2	“Besides price, what I think is absurd is the amount. The amount is minimal! If we miss one drop, it is worth gold!”
Patient 3	“In one month the situation got worse: three people using eyedrops” (in the family).
Patient 4	“But it’s so expensive, so expensive that I came came up with the decision of asking the doctor if I could change the medicine”
Patient 2	“I put my eyedrops in two shelves, in the bathrooms... with a warning!”
Patient 6	“To me, it’s so bad to use eyedrops every ten minutes. I need a timer... to track time.”
Patient 8	“In this sense, this thing of instilling eyedrops at a certain time bothers me and makes me very uncomfortable.”

Patient A	“...anyway I would choose surgery... eyedrops are expensive and you’ll be using and not solving the problem of pressure.””...but the doctor seems confident.”
Patient B	“…I really prefer the surgery. And trust in God first and then the doctor.”
Patient D	“...surgery is the last stage.””So I think there are many risks in it (Authors’ note: regarding the indication of treatment), especially the trust relation between the patient and the doctor. Many times the doctor is more important than the medical or surgical treatment.”
Patient E	“... I feel better after the surgery because I think I’m free from the evil....””And when we find a doctor who gives us attention, who speaks clearly, objectively, we trust them and go on.”
Patient F	“…I trust better the surgery. Surgery nipped the evil in the bud.”
Patient G	“...my eye got very red when I instilled eyedrops. I prefer surgery.”””..in my case eyedrops were not working, so I had to go on surgery. But always trusting, because I knew God and the doctor were there for me.”
Patient H	“The eyedrops were not working for me... I was afraid of being blind.””We must trust the doctor.”
Patient I	“... I am allergic to drops. I can not use any eyedrops! So I had to go on surgery, you know...””...I also prefer the surgery because I really trust the doctor. First God, then her.”