Individualized as opposed to standardized care for glaucoma patients – the key to success. The use of the DDLS and the Colored Glaucoma Graph

• Authors: Jaromir Wasyluk , George Spaeth

Title variants

PL

Indywidualne kontra standardowe podejście do pacjenta – klucz do sukcesu w leczeniu jaskry. Zastosowanie skali DDLS i Colored Glaucoma Graph

• Languages of publication: EN PL

Abstracts

EN

Glaucoma is first cause of irreversible blindness worldwide. Statistical data, such as that obtained from randomized clinical trials, can only rarely be appropriately applied to individual glaucoma patients. This relates to many “statistically” so called normal or abnormal parameters in every field, medical and nonmedical. One area in which the shortcomings of the standardized approach is most apparent is in regard to the diagnosis and treatment of glaucoma. In this article, we note the difficulties attendant to using the average to mean healthy and the statistically different to mean unhealthy. There is a better way, which is to use each person as her or his own control. For example, age is a poor glaucoma indicator. Yet it is essential to have a good idea of life expectancy and it is not difficult to make such an estimate by considering factors other than age. We present our outlook on the diagnostics, monitoring and prognosing the outcomes of glaucomatous neuropathy not only from the ophthalmological, but also from a humanistic point of view.

PL

Jaskra jest globalnie pierwszą przyczyną nieodwracalnej ślepoty. Statystyki opierające się na licznych randomizowanych badaniach naukowych, prowadzonych na całym świecie od wielu lat, nie zawsze znajdują zastosowanie wobec konkretnego, indywidualnego pacjenta. Ma to miejsce w przypadku wielu „statystycznie” prawidłowych lub nieprawidłowych wartości, zarówno w kwestiach medycznych, jak i niemedycznych. Te niedostatki wynikające z szablonowego podejścia do pacjenta są szczególnie istotne w diagnostyce i leczeniu jaskry. W niniejszym artykule zwracamy uwagę na trudności w definiowaniu „przeciętnego” jako „zdrowego” oraz „odbiegającego od statystycznej normy” jako „chorego”. Lepszą drogą dla danego pacjenta jest traktowanie jako punktu odniesienia jego samego. Przykładowo, wiek chorego nie stanowi zbyt dobrego prognostyku jaskry – ważniejsze jest oszacowanie przewidywanej długości życia. Nie jest to trudne, biorąc pod uwagę inne czynniki zdrowotne niż sam wiek. W poniższym artykule przedstawiamy nasze spojrzenie na diagnostykę, rozpoznawanie, monitorowanie i rokowanie w jaskrze w ujęciu nie tylko okulistycznym, ale także humanistycznym.

Keywords

EN

glaucoma; intraocular pressure; optic nerve head; quality of life; visual field

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OphthaTherapy
• Year: 2015
• Volume: 2
• Issue: 4
• Pages: 240-257

Contributors

author

Jaromir Wasyluk

• Klinika Okulistyki, Wojskowy Instytut Medycyny Lotniczej w Warszawie

author

George Spaeth

• Wills Eye Hospital /Jefferson Medical College, Wills Eye Hospital, Philadelphia, USA

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• Document Type: article