A First-Year’s Perspective

Learning how to accommodate each patient’s hardships may be the biggest obstacle.

By Sumana Kommana, MD

A patient once said to me, “Two years ago, when I was first seen in this clinic, my only vision was what was remaining in my left eye. I was taking the drops that the doctors gave me. When I went back to my home country, I felt that the drops were no longer helping, so I stopped using them. Then, one day, I woke up and saw complete darkness, and, from that day on, I just learned to live without my sight.”


I saw this patient only once, at the beginning of my residency, but I can still vividly remember him and his pleasant demeanor. I can’t help but wonder if we could have handled his care differently. Could we have simplified our explanation of glaucoma to better convey the gravity of the disease? Did we adequately reinforce the necessity of his eye drops? If we had altered our approach, could we have at least preserved the little vision he had 2 years ago?


Glaucoma is a difficult disease for physicians to explain and an even harder disease for patients to understand. Most patients can understand a cataract because they can see it, and most patients can understand a corneal abrasion because they can feel it. But having to explain to a patient with 20/20 to 20/30 vision that he or she has severe glaucoma and needs surgery is a task unlike any other.

The first few months of residency have come with a steep learning curve. To my surprise, expanding my clinical knowledge and examination skills has been only half the battle. Discovering how to manage the expectations of my patients was an unforeseen hurdle; however, learning how to adapt to and accommodate each patient’s individual hardships was possibly the biggest obstacle of all.


Glaucoma care is not simple, and postoperative management can be far from perfect. However, it is the complexity of the disease and the promising future of the subspecialty that continue to appeal to me most. n

Albert S. Khouri, MD | Section Editor
Associate Professor, Program Director of the Ophthalmology Residency, and Director of the Glaucoma Division at Rutgers New Jersey Medical School in Newark, New Jersey
Financial disclosure: None

Sumana Kommana, MD
Resident, Temple University, Philadelphia, Pennsylvania
Financial disclosure: None


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