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Difficulties of daily tasks in advanced glaucoma patients - a videotaped evaluation

Objective

The purpose of this study was to perform an objective videotaped evaluation of the difficulties of eyedrop instillation and daily tasks in patients with advanced glaucoma with visual impairment

Methods

A prospective observational study was performed in advanced glaucoma patients with visual impairment, during 5 months. Patients completed a survey (with demographic questions, quality of life, compliance and eyedrop instillation) with interview and video recording in specific daily tasks (eyedrop instillation, climbing stairs, walking in a crowded room and in an irregular floor). Ophthalmologic evaluation was performed and its results registered in a form. Correlation was searched between limitation in quality of life, tasks’ performance and visual fields.

Results

25 patients were included, corresponding to 12h of videotaping. All patients reported being capable of self-instilling eyedrops. 68% of them reported no difficulty instilling the eye drops at home, however 20% of the patients were unable to instill a drop in the eye in the objective evaluation. 72% of the patients stated never touching the eye with the bottle but 40% touched the ocular surface with the bottle. There was a moderate difficulty in the other tasks, with some patients exhibiting proprioceptive mechanisms of adaptation to impaired vision. There was a tendency of correlation between limitation in tasks and visual field defects, but no statistically significant.

Conclusion

Patients with advanced glaucoma and visual impairment have marked difficulty in eye drop instillation and daily tasks, with a poor awareness of their inabilities. Some patients have proprioceptive adaptations that allow them to perform better than expected in tasks.

Glaucoma; Video recording; Quality of life; Patient compliance; Activity of daily living


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