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    Hollow victory: Why our glaucoma victory felt meaningless

    The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.


    It’s an oft-repeated mantra among those of us who treat glaucoma: The goal of glaucoma therapy is to maintain adequate functional vision until the patient dies. Like a lot of mantras, we spout it almost glibly. After all, we’re seldom actually there when the patient dies, so the full import of what we’re saying doesn’t hit home.

    And then there are those times when you nearly are, and it finally does.

    More from Dr. Brown: The challenges of treating a loved one

    A textbook win

    Paul (not his real name) was a 58-year-old, tall, handsome, and gregarious African-American gentleman who reminded me of the actor and singer Paul Robeson with his broad chest and booming bass voice. Every time I saw him I could imagine him breaking out into a chorus of the poignant lament “Ol’ Man River,” and for the rest of the day I couldn’t get the song out of my head.

    More from Dr. Brown: ICD-10: Not quite the end of days

    He had moderate open-angle glaucoma that was diagnosed early enough in his life to prevent blindness from ever being an imminent theat. His intraocular pressure (IOP) over time was well controlled with two topical meds, his optic nerve stable, and his visual field unchanged. A classic, textbook “win” if there ever was such a thing.

    When I saw him in August of last year for an IOP check, all had seemed fine. But somewhere between that visit and the time he returned for his annual visual field in early December, he had been diagnosed with terminal, Stage IV pancreatic cancer.

    Next: An intense tutorial on mortality

    Michael Brown, OD, MHS-CL, FAAO
    Dr. Brown has practiced medical optometry in a comanagement center and with the U.S. Department of Veterans Affairs Outpatient Clinic in ...

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    • Thank you Dr Brown for your article. It was filled with compassion for those experiencing the end of their life. I have also dealt with similar situations and have found them to be so meaningful. Your article allowed me the opportunity to reflect on them, and here I sit with tears in my eyes.

    Optometry Times A/V