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Primary Open-Angle Glaucoma

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Provider and Setting Î The performance of certain diagnostic procedures (e.g., tonometry, pachymetry, perimetry, optic disc/RNFL imaging, and photography) may be delegated to appropriately trained and supervised personnel. Î However, the interpretation of results and medical and surgical management of the disease require the medical training, clinical judgment, and experience of the ophthalmologist. (III, G, S) Counseling and Referral Î It is important to educate and engage patients in the management of their condition. Patients should be educated through oral, written, and online information about the disease process, the rationale and goals of intervention, the status of their condition, and the relative benefits and risks of alternative interventions so that they can participate meaningfully in developing an appropriate plan of action. (G, S) Î Patients should be encouraged to alert their ophthalmologists to physical or emotional changes that occur when they are taking topical ocular hypotensive agents. (G, S) Î Patients considering keratorefractive surgery should be informed about the possible impact laser vision correction has on reducing contrast sensitivity and decreasing the accuracy of IOP measurements. (III, G, S) Î Patients with glaucomatous optic neuropathy considering implantation of a multifocal intraocular lens should be informed of the risk of reduced contrast sensitivity. (III, G, S) 9

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