Glare disability decreases mobility in patients with glaucoma, according to research published in the Journal of Glaucoma.

Photosensitivity with glare is a common symptom of glaucoma. This is the first study to show that glare disability is significantly greater among patients with moderate severe glaucoma and to demonstrate impact of glare disability on mobility in these patients, according to the investigators.

The researchers determined glare disability of 22 patients with glaucoma (5 with early defect, 12 with moderate defect, 5 with advanced or severe defect in visual field of better eye) with stable glaucomatous neuropathy and 12 age-matched control individuals through eye exams and halo radius measurements.


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Patients completed 4 indoor mobility courses with photopic lighting conditions (P, 235 lux) and mesopic and glare (M+G, 10 lux) lighting conditions. After encountering a dazzling spotlight at the bottom of the course, patients walked an 8-meter path. The researchers calculated the percentage of preferred walking speed (PPWS) by dividing patients’ walking speed of the course by the speed while walking a straight path.

Patients with moderate or severe glaucoma had significantly higher glare score in their worse eye (GS-WE) and glare score in their best eye (GS-BE), compared with controls. GS-WE and GS-BE were not significantly different between patients with moderate glaucoma and patients with severe glaucoma.

Patients with glaucoma had 9.3% longer mobility time, 6.3% slower PPWS, 5.5% slower walking speed (WS), and 2.4% longer distance travelled in the M+G condition than they did in the P condition. Control individuals had 5.5% longer mobility time and 3.6% slower PPWS in the M+G condition than they had in the P condition.

Under M+G conditions, patients with glaucoma had significantly lower WS (P =.049), PPWS (P =.038), and mobility time (P =.046) compared with control individuals.

Patients with glaucoma self-reported significantly higher workload with the NASA Task Load Index (NASA-TLX) under M+G conditions (34.4±14.8) than they had under P conditions (29.7±11.3, P =.017). Under those conditions, their scores (34.4±14.8) were significantly higher compared with those of the control individuals (25.5±6.2, P =.006). NASA-TLX did not change for control individuals between the conditions, and it was not significantly different between the 2 groups under P conditions.

Limitations of the study include lack of standard measurement for glare disability and its small sample size.

Reference

Bertaud S, Zenouda A, Lombardi M, et al. Glare and mobility performance in glaucoma: A pilot study. J Glaucoma. Published online September 10, 2021. doi:10.1097/IJG.0000000000001936