Caronia Glaucoma Card vs Amsler Grid for Monitoring Patients with Advanced Glaucoma

Abstract

Purpose: Evaluate patient acceptance and efficacy of the Caronia Glaucoma Card (CGC) in monitoring patients with severe glaucoma. Methods: A retrospective study of consecutive patients with severe glaucoma who agreed to monitor their visual function. Patients were given a two-sided sheet of paper. On one side was printed an Amsler grid (AG) and on the other side was printed a CGC. The patient was given verbal and written instructions on how to perform each test. They were asked to use either one or both tests to monitor their visual function on a weekly basis. Upon return, they were asked which test they prefer and if they appreciated or noticed any change in their scotoma. Patient comments were recorded. Results: Sixty-seven patients were given the test card whose reported past ocular history consisted solely of severe glaucoma. Seventeen patients were eventually excluded. Fourteen patients had one eye that fulfilled the inclusion criteria for the study, while the other eye was excluded. Eighty-six eyes of fifty patients satisfied the inclusion criteria and were enrolled in the study. Thirty of the patients were male (60%) and 20 where female (40%). The average age was 71.8 +/- 10.7 years. They all carried a diagnosis of severe glaucoma. When asked the question which test design they preferred to use; 30 patients preferred the CGC (60%) while 8 patients preferred the AG (16%). Twelve patients found no difference between the 2 test designs (24%). (χ2 (2, 50)=16.480, ρ=0.000). Five patients noticed a change in their scotoma while using the card (5.8%, 5 of 86 eyes). All were exclusively using the CGC. Conclusion: The CGC is a convenient and inexpensive tool that was able to detect a change in scotoma. It may be helpful to add to the armamentarium in order to monitor glaucoma and its possible progression in patients with advanced disease.