When I started my ophthalmology residency, I viewed the physician as the primary player in the battle against eye pathology and the patient as a recipient. Experience—particularly a 3-month glaucoma rotation—showed me my error. The partnership between glaucoma patients and their providers is like a marriage: communication is essential to success.
The first point of potential miscommunication seems to occur with the initiation of topical medical therapy. Many patients I have met misunderstood the purpose of treatment, the proper dosing regimen, and the importance of adherence. I have encountered others who were unclear about the reason for laser therapy, and I have seen two individuals who had instilled the steroid drop in their nonoperative eye after trabeculectomy. One of them had already undergone subsequent placement of a glaucoma drainage device. Yet another patient presented to me in the emergency department concerned about an ocular growth, which turned out to be a scleral patch graft from tube placement several months earlier. I have had many patients who have undergone an incisional glaucoma procedure and asked me, “If the surgery was not going to improve my vision, why did I have it?” These experiences have taught me the importance of both thoroughly educating patients on the reasons for treatment prior to its initiation and setting realistic expectations.
Clear communication from physicians enlists patients in their own care. It enhances their ability to contribute to the success of their treatment, including if they see a different eye care provider in the future. Certainly, effective glaucoma care requires an invested and dedicated physician, but successful, long-term management requires a true team effort.
Section Editor Albert S. Khouri, MD
• associate professor and program director of the ophthalmology residency as well as director of the Glaucoma Division at Rutgers New Jersey Medical School in Newark, New Jersey
• (973) 972-2045; firstname.lastname@example.org
Kunjal K. Modi, MD
• second-year ophthalmology resident, Department of Ophthalmology, Rutgers New Jersey Medical School in Newark, New Jersey
• (973) 747-8476; email@example.com