An effective model of clinical examination and monitoring of glaucoma patients

Abstract

Open-angle glaucoma is a chronic progressive optic neuropathy characterized by morphological changes in the optic nerve head and retinal nerve fibers layer in the absence of other eye diseases.Regular medical check-ups are necessary to assess the progression of glaucoma, to correct the treatment regimen or prescribe surgical interventions, to control the stabilization of the glaucoma process and to preserve visual functions for longer period. When planning the number of monitoring visits, it is necessary to carefully study the prognostic risk factors, since they are statistically associated with the development and progression of glaucoma. Closer observation of patients with glaucoma reduces the risk of irreversible changes in the organ of vision.Patient compliance is of particular importance in the progression of glaucoma. The adherence rate in the treatment of glaucoma is relatively lower compared to other chronic diseases that require lifelong treatment.Currently, there is no effective model of regular checkups for glaucoma patients, therefore this direction requires improvement and development, both in the standards and timing of patient examination, and in the use of remote methods of glaucoma control. The disadvantage of the current medical check-ups routine is the lack of individual approach to patients, lack of equipment in the offices of regional ophthalmologists, and lack of specialized glaucoma offices.The tense epidemiological situation during the Covid-19 pandemic, gave understanding that while in-person consultations and remote consultations (telemedicine) cannot replace each other, a combination of these methods is cost-effective, can reduce the uneven distribution of ophthalmic resources, reduce the burden on the doctor and the rate of misdiagnosis. The situation was aggravated by the closure of ophthalmological hospitals and an increase in the waiting time for consultation in higher specialized medical institutions, which probably entails an increase in patients with progression of the glaucomatous process and the economic burden on both the state and the patients themselves.Telemedicine should be gradually introduced into everyday practice, for which it is advisable to create a single database of glaucoma patients to track the glaucomatous process.