To summarize recent work from clinical and epidemiological studies that describe how, and at what stage, glaucoma affects the performance of important vision-related activities.
Difficulties with the extremes of lighting are the most frequent complaint in glaucoma. Individuals with bilateral glaucoma also self-report difficulty with a broad array of tasks, including reading, walking, and driving. Bilateral glaucoma is associated with driving cessation and limitation, bumping into objects, slower walking, and falls. Some, but not all, studies also demonstrate higher accident rates in glaucoma. Measurable effects on reading speed have only been observed with field damage severe enough to affect binocular central acuity.
Glaucoma with bilateral visual field loss is associated with increased symptoms and a measurable decline in mobility and driving. Further work is necessary to establish whether unilateral glaucoma has a significant impact on patients, to determine whether reading difficulty is common in patients with bilateral glaucoma, and to establish the effects of lighting conditions on task performance in glaucoma.
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Correspondence to Pradeep Ramulu, MD, PhD, Wilmer Eye Institute, Johns Hopkins Hospital, 600 N. Wolfe Street, Maumenee B110, Baltimore, MD 21287, USA Tel: +1 410 614 1994; fax: +1 410 955 1985; e-mail: firstname.lastname@example.org