Glaucoma is the second leading cause of visual loss in the world and the leading cause of blindness in African Americans. As clinicians, we evaluate the progression of glaucoma using visual fields, intraocular pressure and optic disc appearance;however, the relationship between these measures and functional impairment is virtually unknown except through patient self-report, which may or may not be reliable. The goal of glaucoma management is to preserve the ability of patients with glaucoma to carry out activities of daily living in order to live safely and independently. This pilot study uses a comprehensive assessment of clinical, functional, and self-reported measures in the clinic and home to characterize the impact of glaucoma on a person's visual function and quality of life. Such a comprehensive evaluation including functional measures and home assessments has never been used in glaucoma patients. The candidate's specific goals for this pilot study are 1.) to better understand how glaucoma affects visual function and daily life in older adults 2.) to determine the stage of glaucoma, if predictable, at which visual impairment begins 3.) to determine which measures best distinguish various stages of glaucoma. This pilot study is a multidisciplinary collaboration between the Department of Ophthalmology and Visual Sciences and the Program in Occupational Therapy at Washington University School of Medicine, St. Louis, Missouri. Information on the effects of glaucoma on functional impairment, will enable clinicians to make evidence-based decisions about aggressiveness of clinical treatment and to counsel patients more effectively regarding safe and independent living. The candidate is currently pursuing a masters in public health degree from Saint Louis University and will be actively involved in operational and analysis meetings for randomized multi-center clinical trials including the Ocular Hypertension Treatment Study. The long-term goal of the candidate is to use knowledge gained from this pilot study, her MPH program, and participation in multicenter clinical trials to design future randomized, prospective, multi-center clinical trials using interventions to improve visual function and reduce functional impairment in glaucoma patients. Intervention studies, which may include rehabilitative programs, improved home lighting, or changes in clinical management, could decrease morbidity, increase safety and independence, and improve quality of life for glaucoma patients.
| Bhorade, Anjali M; Yom, Victoria H; Barco, Peggy et al. (2016) On-road Driving Performance of Patients With Bilateral Moderate and Advanced Glaucoma. Am J Ophthalmol 166:43-51 |
| Bhorade, Anjali M; Perlmutter, Monica S; Wilson, Brad et al. (2013) Differences in vision between clinic and home and the effect of lighting in older adults with and without glaucoma. JAMA Ophthalmol 131:1554-62 |
| Bhorade, Anjali M; Wilson, Bradley S; Gordon, Mae O et al. (2010) The utility of the monocular trial: data from the ocular hypertension treatment study. Ophthalmology 117:2047-54 |
