Physician, Heal Thyself
The perils of diagnosing patients as "glaucoma suspects"
Ray Radford | | Hot Topic
Few of us would claim that glaucoma management is ideal: we lack the tools to predict the course of disease in any individual, and we are frequently required to make clinical decisions under time-limited and stressful conditions. But the reality may be even worse than we thought: the truth is that most of the patients we label as “glaucoma suspects” will neversuffer glaucoma-related vision problems. Yet we send them from our clinics burdened with the fear of encroaching blindness, and often recommend unpleasant therapies or traumatic surgery to manage a risk we cannot quantify.
Other than waiting for better predictive tools, is there anything we can do to change this state of affairs? I believe so. Firstly, we glaucoma specialists need to adopt a more patient-centric approach and take greater account of the patient’s own risk attitude and individual needs. And secondly, we need to reflect more deeply on the extent to which our decisions are affected by unconscious bias and limited knowledge. These actions are within the capability of every glaucoma physician, and would, I believe, result in better, more individualized patient care.
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