Bilateral glaucomatous damage has a worse effect on a patient’s quality of life than unilateral damage. The Salisbury Eye Evaluation project found that mobility performance, such as the speed to complete an obstacle course and the ability to perform tandem stands, was not significantly affected unless glaucomatous visual field loss is bilateral.1 The Los Angeles Latino Eye Study found that a 5-decibel visual field loss in the better-seeing eye (suggesting bilateral damage) was associated with a significant reduction in driving difficulty, whereas the same amount of visual field loss in the worse-seeing eye (suggesting unilateral damage) was associated with less driving difficulty.2 Given the debilitating effects of bilateral glaucoma, when clinically treating patients with glaucoma, it is important for physicians to know the answers to the following questions:
Varma R, Jiang X. The “Curse” of the Fellow Eye in Glaucoma. JAMA Ophthalmol. 2018;136(10):1156–1157. doi:10.1001/jamaophthalmol.2018.3267
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