Consider an easy-to-understand approach to a complex disease

“Glaucoma? Oh yeah. My grandma had glaucoma. Oh, wait. . . Maybe that was cataracts. They’re kind of the same, right?” If this dialogue sounds similar to one of many you’ve had over the years when educating your patients regarding glaucoma, you are not alone.

Let’s be truthful: Glaucoma can be a complex, nuanced and debilitating disease. In terms of awareness about the disease, I may have the edge up here in Minnesota because all my patients can identify with Kirby Puckett, a Minnesota Twins World Series Champ team member (’87 and ’91 people!) who had glaucoma. But even here, patients are still misinformed. (By the way, Puckett, who passed away in 2006, had a secondary glaucoma following a vascular occlusion issue, so no, it’s really not the same as open-angle glaucoma, which accounts for about 90% of U.S. glaucoma cases. But I don’t tell my patients that.)

Here are some tips for keeping it simple, clear and concise when educating your patients regarding glaucoma:


I educate my patients using my educational touch-screen wallboard, moving through the anatomy of the eye, going from anterior to posterior. Once I get to the optic nerve portion, I explain its connection to the brain, and that this is where I begin to look for signs or risks of glaucoma. I then pause briefly, looking for a “click” of recognition in my patients’ faces, or an, “Oh, yeah, I have a family history of that!” comment. Most commonly, though, I see blankness, which leads me to my next part…


I then move on, explaining that glaucoma is generally known by most to cause vision loss in the periphery. (A wave of the hands to the sides of the head demonstrates for those patients who don’t understand “periphery.” It happens. Remember that patients don’t remember everything they hear. I’m banking on them remembering my hand motions.) I mention that while you can’t necessarily feel it, glaucoma progresses, and can cause permanent vision loss. Stop.


This is where you customize the spiel to the patient. They are either “looking fine this year, but will continue to be monitored for change over time,” or a more lengthy conversation is warranted if there are suspicions, family history, evidence of ganglion cell complex or retinal nerve fiber layer changes on OCT, optic nerve head concerns, health concerns, etc. Whatever the situation, though, remember to keep it brief. The detailed explanation can come at their return visit with more complex testing.


Albert Einstein once said, “If you can’t explain it simply, you don’t understand it well enough.” Your patients trust you to know what you are doing. They also expect you to communicate effectively. You don’t have to educate to the “nth” degree for them to “get” it. Just as Kirby Puckett spent his entire major league baseball career with the Twins, so should your patient extend her loyalty to you. When you educate, keep knocking it out of the park with simple, big hits your patients will remember. OM