Disability due to glaucoma: criteria, vision, visual field, groups, documents, and rehabilitation

Glaucoma is a group of chronic diseases that damage the optic nerve and can gradually lead to visual field defects. Disability associated with glaucoma is assessed not by the diagnosis itself, but by the extent to which visual function is persistently impaired and the extent to which these impairments limit independent living, work, mobility, reading, self-care, and safety. [1]

In many patients, glaucoma is controlled for years with drops, laser, or surgery, and central visual acuity remains high. In this situation, a person may have a diagnosis, be monitored by an ophthalmologist, undergo regular perimetry and tomography, but not have grounds for disability if visual function is preserved and there are no significant limitations in daily life. [2]

Disability becomes a concern when glaucoma results in significant and persistent vision loss: visual field narrowing, central or paracentral defects, decreased visual acuity, vision loss in one eye while the other is affected, or severe bilateral impairment. Corrected vision in the better-seeing eye is especially important, as it determines a person's actual functional capacity. [3]

The World Health Organization (WHO) estimates that glaucoma is a major cause of visual impairment and blindness worldwide; among causes of distance vision impairment or blindness, glaucoma accounts for approximately 7.7 million cases. This underscores the societal significance of the disease, but does not mean that every case of glaucoma automatically leads to disability. [4]

The main goal of modern care is to prevent the patient from becoming disabled: to detect the disease early, reduce intraocular pressure, monitor the optic nerve and visual field, promptly strengthen treatment and connect visual rehabilitation if limitations have already appeared. [5]

Table 1. When glaucoma does not equal disability, and when the issue becomes relevant

Situation	Disability is not usually considered	Disability can be discussed
Diagnosis of glaucoma	If vision and visual field are preserved	If there are persistent, pronounced violations
Intraocular pressure	It does not in itself give disability	Important as a factor in progression
Visual acuity	Good with correction	Significantly reduced in the better seeing eye
Field of view	No significant narrowing	Narrowed to functionally dangerous values
One eye	The second eye sees well	The second eye is also damaged or the only eye is affected
Stage	Early and stable	Severe, advanced, terminal
Everyday life	The person copes on his own	There are limitations in reading, walking, orientation, and work.

Source of the table: [6]

How glaucoma leads to disability

Glaucoma damages the optic nerve, and the optic nerve is not a "lens" that can be replaced, like the crystalline lens in cataracts. When nerve fibers die, lost areas of the visual field are usually not restored, so the main threat of glaucoma is irreversible functional limitation. [7]

In the early stages, a person often sees clearly straight ahead, but gradually loses peripheral vision. This is especially dangerous for independent movement, because peripheral vision helps notice steps, curbs, people, cars, furniture, obstacles, and movement to the side. [8]

With bilateral damage, the visual field deteriorates more significantly from a practical standpoint because the second eye no longer compensates for the defects of the first. Studies on quality of life in glaucoma show that bilateral visual field loss is associated with difficulties in reading, mobility, driving, and daily activities. [9]

Disability in glaucoma is often related not only to how many lines a person can see on a chart, but also to the location of visual field defects. Paracentral defects, inferior defects, bilateral loss, and damage to the better-seeing eye can limit real-life performance more than a single visual acuity number would indicate. [10]

Therefore, a person with glaucoma may complain not just of “bad vision,” but of specific everyday problems: stumbling, afraid of stairs, walking unsteadily in the twilight, stopped driving, reading worse, finding objects more slowly, avoiding the street, and feeling dependent on others. [11]

Table 2. Which visual impairments in glaucoma most often lead to limitations

Violation	How it manifests itself in everyday life	Why is it important for disability?
Narrowing of the visual field	Tunnel or fragmented vision	Limits orientation and safety
Paracentral defects	Difficulty reading and fixation	Affects central tasks
Two-way loss of field	Less compensation by the second eye	Greatly reduces independence
Reduce contrast	Difficulty seeing steps, gray objects, faces	Impairs real vision
Poor vision at dusk	Difficulty on the street and when driving	Increases the risk of falls
Loss of vision in the better seeing eye	A sharp decline in functional reserve	Key expert indicator
Combination of glaucoma and cataracts	Mixed image quality degradation	Requires clarification of the causes of vision loss

Source of the table: [12]

What vision indicators are assessed when asking about disability?

When assessing visual disability, they typically consider not only the diagnosis but also measurable visual functions: best-corrected visual acuity, visual field, central scotomas, the condition of the better-seeing eye or the only eye, the persistence of impairments, and the impact on daily activities. This approach is consistent with the modern logic of assessing functioning, not just the disease name. [13]

Visual acuity measures how well a person distinguishes fine details with optimal correction by glasses, contact lenses, or other means. In glaucoma, visual acuity can be maintained for a long time, so a normal letter chart does not rule out severe visual field defects. [14]

Visual field testing is especially important in glaucoma because the disease often affects peripheral vision. In the United States, for example, official Social Security Administration regulations specifically state that diseases that can cause visual field loss, such as glaucoma, typically require visual field testing. [15]

The International Classification of Diseases, Eleventh Revision, also takes into account not only visual acuity but also the narrowing of the central visual field; blindness can be classified by the degree of narrowing of the central visual field of the better seeing eye to less than 10 degrees. [16]

For the patient, this means that it is important to bring to the expert assessment not only the “glaucoma” diagnosis, but also the results of perimetry, optical coherence tomography, visual acuity data with correction, information on intraocular pressure, operations, laser treatment and the dynamics of the disease. [17]

Table 3. Medical indicators important in glaucoma-related disability

Indicator	What does it mean?	Why is it important?
Visual acuity with correction	How well does the better eye see?	Affects reading and everyday autonomy
Field of view	How much space does a person see?	The main indicator for glaucoma
Central scotomas	Blind spots near the fixation	Interfere with reading and facial recognition
The better seeing eye	Patient's functional reserve	Often the main criterion for expert evaluation
The only eye	Special clinical situation	Loss of reserve is especially dangerous
Stages of glaucoma	The degree of damage to the nerve and field	Helps to assess the prognosis
Dynamics of progression	Is the condition getting worse?	Affects treatment and re-examination
Previous surgeries	They show the severity and stability of the process	Important for expert history

Source of the table: [18]

Russian criteria: how visual impairment is typically assessed

Legal criteria for disability vary by country, so there is no universal "glaucoma disability group" applicable to all countries. In Russia, Order No. 374n of the Russian Ministry of Labor, dated July 26, 2024, has been in effect since March 1, 2025. [19]

According to this order, the criterion for establishing disability for adults is a persistent impairment of bodily functions of the second or higher degree, that is, in the range of 40 to 100 percent, if it leads to limitations in life activities and the need for social protection. For visual impairments, a target rehabilitation group 3.1 is provided – due to blindness or low vision. [20]

The order specifies the following guidelines for visual acuity in adults: visual acuity of the better-seeing or single eye with a maximum tolerable correction of more than 0.1 to 0.3 inclusive corresponds to a score of 40-60 percent; 0.1-0.05 - 70-80 percent; 0.04-0 - 90-100 percent. These values are important, but the decision is made taking into account the entire expert picture. [21]

Regarding the field of vision, the order specifies: a concentric narrowing of the visual field of the better-seeing or single eye of less than 40 degrees up to and including 20 degrees corresponds to 40-60 percent; less than 20 degrees up to and including 10 degrees - 70-80 percent; less than 10 degrees - 90-100 percent. For glaucoma, this is especially important, because the visual field is often affected earlier and more severely than central acuity. [22]

It's important to understand: disability percentages do not automatically equate to a household "group" without a procedure. First, the disability itself is established based on criteria for persistent impairment and limitations in life activities, then the disability group is determined: the first group corresponds to 90-100 percent, the second to 70-80 percent, and the third to 40-60 percent. [23]

Table 4. Russian guidelines for vision assessment according to Order No. 374n

The better seeing or single eye indicator	Assessment of functional impairment	Possible logic of expert severity
Visual acuity greater than 0.3	10-30 percent	Usually below the disability threshold for this reason alone
Visual acuity more than 0.1 to 0.3 inclusive	40-60 percent	May correspond to the third group if there are restrictions
Visual acuity 0.1-0.05	70-80 percent	May correspond to the second group
Visual acuity 0.04-0	90-100 percent	May correspond to the first group
Field of view from 60 to 40 degrees inclusive	10-30 percent	By itself, it is usually below the threshold
Field of view less than 40 to 20 degrees inclusive	40-60 percent	May correspond to the third group
Field of view less than 20 to 10 degrees inclusive	70-80 percent	May correspond to the second group
Field of view less than 10 degrees	90-100 percent	May correspond to the first group

Source of table: [24]

Glaucoma stages and the likelihood of disability

Early glaucoma typically does not lead to disability if central visual acuity is preserved, the visual field has no significant bilateral defects, intraocular pressure is controlled, and the person maintains independence in everyday life and work. However, the early stage requires treatment and monitoring, as the goal is to prevent progression to functionally significant vision loss. [25]

Moderate glaucoma can already create difficulties in everyday life, especially with bilateral visual field defects. The patient may have difficulty finding their way in the dark, be more careful when walking up and down stairs, and experience difficulty driving. However, disability depends on the visual field of the better eye, visual acuity, and limitations in daily activities. [26]

Severe glaucoma often requires expert evaluation because visual field defects can affect both hemifields, extending to the center of fixation and impairing reading, orientation, work, and safety. In severe cases, repeatable perimetry results and progression data are particularly important. [27]

Advanced and terminal glaucoma can lead to low vision, near-blindness, or complete blindness. In this situation, treatment is aimed at preserving residual vision, controlling pain and pressure, and promoting rehabilitation, as it is usually impossible to restore damaged nerve fibers. [28]

A special situation occurs when one eye is already lost or severely weakened, while the other has glaucomatous changes. Even if the formal indicators have not yet reached severe thresholds, the clinical risk is very high, because damage to the better-seeing or only eye quickly reduces functional independence. [29]

Table 5. Glaucoma stage and risk of disability

Stage	A typical situation	Risk of disability
Suspected glaucoma	There is a risk, but no proven damage.	Usually no
Early glaucoma	Structural features, visual field may be normal	Usually low when stable
Moderate glaucoma	There are persistent visual field defects	Depends on the two-sidedness and everyday life
Severe glaucoma	Defects close to the center or in both hemifields	Significantly higher
Advanced glaucoma	There is little field of view left	Often requires expert assessment
Terminal glaucoma	Residual vision or blindness	High risk of disability
Single sighted eye with glaucoma	The visual reserve is limited	Requires particularly strict control

Source of table: [30]

What documents and examinations are required for an expert assessment?

When assessing disability due to glaucoma, it's important to not only document the diagnosis but also demonstrate the persistence and severity of the impairment. Typically, ophthalmologist reports are required, along with a diagnosis indicating the type of glaucoma, stage, condition of both eyes, intraocular pressure, previous surgeries, laser procedures, treatment plan, and follow-up. [31]

Key measurements are visual acuity with optimal correction and visual field. Expert systems typically consider the better-seeing or single eye, as it determines a person's ability to navigate, read, work, and care for themselves. [32]

Perimetry must be performed reliably and repeatably. Social Security Administration regulations, for example, specifically state that visual field testing is generally required for glaucoma, and for some assessment purposes, automated static threshold perimetry of the central 24-30 or 30 degrees is used. [33]

Optical coherence tomography alone does not replace visual field assessment, but it does help confirm structural damage to the optic nerve: thinning of the retinal nerve fiber layer and ganglion cell complex. Current guidelines consider structure and function as complementary data. [34]

If a patient has comorbidities such as cataracts, diabetic retinopathy, macular degeneration, or the effects of trauma or surgery, it is important to distinguish between the extent of vision loss due to glaucoma and other causes. This impacts the prognosis, rehabilitation plan, and expert opinion. [35]

Table 6. What to prepare for a medical and social examination for glaucoma

Document or research	Why is it necessary?
Ophthalmologist's discharge	Confirms diagnosis, stage and treatment
Visual acuity with correction	The main indicator of central vision
Perimetry	The main indicator of the visual field in glaucoma
Optical coherence tomography	Proves structural nerve damage
Intraocular pressure measurements	Show disease control
Operation and laser data	Confirm the severity and treatment history
List of drops	Shows current therapy and tolerability
Conclusion on labor restrictions	Important for assessing vital activity
Data on concomitant eye diseases	Helps to understand the overall cause of low vision
Dynamics over several visits	Proves the persistence of violations

Source of table: [36]

Work, driving, reading and household independence

Glaucoma can limit work not only in cases of low visual acuity but also in cases of severe visual field loss. Occupations that require peripheral vision, rapid orientation, heights, moving machinery, transportation, precise visual tasks, or night vision can become hazardous with progressive visual field loss. [37]

Driving is particularly sensitive to glaucomatous defects because drivers must see traffic to the side, pedestrians, road signs, traffic lights, mirrors, adjacent lanes, and obstacles. A 2026 systematic review indicates that glaucomatous visual field loss affects driving limitations and cessation, and is also being studied in relation to the risk of road traffic accidents. [38]

Reading in glaucoma can be impaired not only by visual acuity, but also by paracentral defects, decreased contrast, difficulty keeping track of a line, and fatigue. This is especially noticeable in cases of bilateral damage, poor lighting, small print, and the combination of glaucoma and cataracts. [39]

Mobility is one of the most common areas of limitation. Research shows that in glaucoma with bilateral visual field loss, walking, orientation, spatial awareness, and safety are more often affected, and in advanced disease, the risk of falls and injuries increases. [40]

The psychological aspect is also important: fear of going blind, dependence on relatives, anxiety when going outside, refusal to drive, and decreased independence can all increase social isolation. Therefore, expert and medical assessments must consider not only the figures but also the patient's real life. [41]

Table 7. What limitations most often occur with glaucoma?

Sphere of life	What can be violated?
Job	Inability to safely perform visually intense or dangerous tasks
Driving	Loss of peripheral vision, risk of noticing an obstacle too late
Reading	Slow reading, line loss, need for large font
Movement	Fear of stairs, curbs, crowds, twilight
Household chores	Difficulty searching for objects, cooking, cleaning, and using equipment
Self-service	It's more difficult to take medications, navigate the bathroom, and get dressed.
Social activity	Less time out of the house, dependence on companionship
Psycho-emotional state	Anxiety, decreased confidence, fear of falling

Source of table: [42]

Treatment as a prevention of disability

The primary proven method for reducing the risk of disability in glaucoma is to control intraocular pressure. Current guidelines emphasize that treatment should maintain pressure at a level at which visual field loss will not significantly impair the patient's quality of life over the course of their life. [43]

Treatment may include eye drops, laser treatments, and surgery. The choice depends on the type of glaucoma, stage, initial pressure, target pressure, rate of progression, tolerance of drops, patient age, comorbidities, and the severity of functional limitations. [44]

Selective laser trabeculoplasty has emerged as an important first-line option for open-angle glaucoma and ocular hypertension in NICE guidelines. Six-year results from the LiGHT study showed that primary selective laser trabeculoplasty provided good long-term control and reduced the need for incisional surgery compared with initial eye drop treatment. [45]

Surgical treatment is considered when drops and laser therapy fail to provide sufficient control, the disease progresses, or very low target pressures are required. Surgery does not restore lost vision, but it can help preserve remaining visual reserve. [46]

Adherence is critical to preventing disability: regular use of drops, proper technique, monitoring for side effects, attending routine checkups, and timely reinforcement of therapy. If a patient discontinues treatment due to lack of pain or burning from the drops, the risk of further vision loss increases. [47]

Table 8. How treatment reduces the risk of disability in glaucoma

Measure	How it helps
Target intraocular pressure	Reduces the risk of further nerve damage
Drops	Reduces blood pressure with regular use
Selective laser trabeculoplasty	May reduce the need for daily drops
Operation	Helps with poor blood pressure control
Perimetry in dynamics	Shows whether the field of vision is deteriorating
Optical coherence tomography	Monitors structural progression
Side effects management	Maintains adherence to treatment
Patient education	Reduces the risk of spontaneous discontinuation of therapy

Source of table: [48]

Vision rehabilitation: help is needed not only for complete blindness

Vision rehabilitation is not a "last resort when nothing else can be done." The World Health Organization states that vision rehabilitation helps people with irreversible vision loss maximize their remaining functions, improve their quality of life, and participate in society. [49]

The American Academy of Ophthalmology, in its vision rehabilitation guidelines, emphasizes that even early or moderate vision loss can lead to disability, anxiety, and impairment of safety, daily functioning, and quality of life. Therefore, patients should be referred for rehabilitation not only in cases of total blindness, but also in cases of genuine difficulties in daily life. [50]

Rehabilitation for glaucoma differs from rehabilitation for central vision loss because many patients' primary concerns are visual field, orientation, contrast, and twilight vision. Therefore, support may include training in spatial scanning, improved lighting, contrast markings, safe home organization, and mobility training. [51]

Technical aids may include magnifiers, electronic magnifying glasses, screen readers, large-print devices, voice assistants, contrast markers, special phone settings, orientation canes, and mobility training. The choice of aid depends on whether reading, walking, work, self-care, or communication is impaired. [52]

The rehabilitation approach is also important when registering disability, because the goal of social protection is not only to record the impairment, but also to help the person maintain independence, security, participation in society and access to work or education, as far as possible. [53]

Table 9. What may be included in rehabilitation for glaucoma

Problem	Possible help
Narrowing of the visual field	Space scanning training
Poor vision at dusk	Improved lighting, highlighting risk areas
Risk of falls	Contrasting step edges, handrails, obstacle removal
Reading difficulties	Electronic magnifiers, large print, audio formats
Losing orientation on the street	Mobility training, cane, accompaniment
Difficulties with the phone	Accessibility settings, voice input
Working with documents	Magnification, contrast, reading programs
Anxiety and addiction	Training, psychological support, social services

Source of table: [54]

Common mistakes when applying for disability benefits for glaucoma

The first mistake is thinking that a certificate diagnosing glaucoma is sufficient. An expert assessment requires objective data: corrected visual acuity, visual field, optic nerve condition, tomography data, pressure dynamics, and a description of life limitations. [55]

The second mistake is bringing old or unreliable visual fields. In glaucoma, perimetry should be current, well-performed, and preferably repeatable, because the visual field is often a key indicator of functional limitation. [56]

The third mistake is underestimating the second eye. Assessments are usually based on the better-seeing or single eye, so severe damage to one eye with a well-preserved second eye may be assessed differently than bilateral damage with loss of functional reserve. [57]

The fourth mistake is stopping treatment after submitting documents. Even if disability has already been established or is expected, treatment remains important: the goal is to preserve residual vision, reduce the risk of pain, prevent further visual field loss, and support independence. [58]

The fifth mistake is waiting until complete blindness to seek rehabilitation. Current guidelines for vision rehabilitation emphasize that assistance is needed when visual impairment interferes with safety, reading, work, mobility, or everyday tasks. [59]

Table 10. Mistakes and correct tactics

Error	What is the correct way?
"The diagnosis itself will prove everything"	Prepare measurable vision indicators
"Enough pressure"	Visual field, acuity and optic nerve are required
"The field of view can be old"	It is better to have up-to-date reliable perimetry
"One eye is unimportant"	The function of the better seeing and single eye is important
"Disability will replace treatment"	Treatment is necessary to preserve residual vision.
"Rehabilitation is only for the blind"	Help is needed even with everyday restrictions
"If I can see the letters, there are no problems."	Glaucoma affects the visual field.
"Drops can be cancelled in a group setting."	You cannot stop treatment without consulting an ophthalmologist.

Source of table: [60]

FAQ

Do people with glaucoma qualify for disability benefits? Yes, disability benefits are possible, but not based on the diagnosis itself, but rather on persistent, severe visual impairment and limitations in daily activities. Typically, the assessment includes corrected visual acuity, visual field, the better or single eye, and actual limitations in daily life, work, and mobility. [61]

Which glaucoma most often leads to disability? Disability is most often associated with severe, advanced, terminal, rapidly progressing, bilateral glaucoma, as well as with damage to a single or better-seeing eye. The risk is higher if there is significant narrowing of the visual field, central defects, or a combination with other eye diseases. [62]

Is it possible to receive disability benefits even with normal visual acuity but a narrow field of view? Yes, it is possible, because with glaucoma, the primary problem is often related to the field of view. According to Russian criteria, a visual field narrowing of less than 40 degrees in the better-seeing eye or the only eye falls within the range that can be considered expert-significant in the presence of life limitations. [63]

What visual field parameters are important? The degree of visual field loss, central and paracentral defects, bilaterality of the lesion, the reliability of perimetry, and the impact of defects on real-life situations are all important. Different countries use different expert methods, but in glaucoma, the visual field is almost always the key document. [64]

What level of visual acuity can qualify for disability in Russia? According to Order No. 374n, in adults, visual acuity in the better-seeing or single eye with a maximum tolerable correction of more than 0.1 to 0.3, inclusive, corresponds to 40-60 percent; 0.1-0.05 corresponds to 70-80 percent; and 0.04-0 corresponds to 90-100 percent. The final decision also depends on the person's limitations in life activities. [65]

What disability level is possible with glaucoma? In Russia, disability level 3 typically corresponds to 40-60 percent of permanent functional impairment, level 2 – 70-80 percent, and level 1 – 90-100 percent. In glaucoma, this may depend on visual acuity, visual field, the better eye, and limitations in daily activities. [66]

If one eye is almost completely blind and the other is perfectly sighted, will disability be granted? Not always. Expert criteria are often based on the better-sighted or single eye, so if the second eye is well-preserved, disability may not be established. However, the decision depends on specific indicators, occupation, daily restrictions, and national regulations. [67]

What examinations are required before a medical and social assessment? Typically, an ophthalmologist's report, corrected visual acuity, perimetry, optical coherence tomography, intraocular pressure, information on treatment, surgeries, laser, disease dynamics, and concomitant eye diseases are required. [68]

Why is perimetry so important in glaucoma? Because glaucoma often affects the visual field first and most severely, while central acuity can remain good for a long time. Without perimetry, the real limitations in orientation, safety, driving, and independence can be underestimated. [69]

Can glaucoma interfere with work, even when a person is reading a chart? Yes. A person may see letters clearly straight ahead, but have a narrowed field of vision, poor lateral orientation, difficulty seeing in dim light, a risk of falls, and limitations for driving or performing dangerous occupations. [70]

Can you drive with glaucoma? This depends on the country's laws, visual field width, visual acuity, bilaterality of the defects, and a medical report. Glaucomatous visual field loss is associated with limited or even cessation of driving, so this issue should be discussed with an ophthalmologist and local regulations should be verified. [71]

Is disability due to glaucoma permanent? Not always. It depends on the persistence of the disorder, prognosis, age, national regulations, and the possibility of improvement after treatment or surgery. Even with established disability, ophthalmological monitoring usually continues because residual vision must be preserved. [72]

Is it possible to prevent disability from glaucoma? In many cases, the risk can be significantly reduced by early detection, monitoring intraocular pressure, regularly checking the visual field and optic nerve, adhering to treatment, and promptly undergoing laser or surgical interventions when indicated. [73]

What to do if vision is already significantly impaired? Glaucoma treatment should be continued to preserve residual vision, while also incorporating visual rehabilitation: improved lighting, magnifiers, electronic aids, safe mobility training, home adaptation, and social support. [74]

Is rehabilitation necessary if a person has not yet been granted disability status? Yes. Vision rehabilitation is useful not only after a disability has been granted; it is necessary when vision already interferes with reading, walking, work, safety, self-care, or spatial orientation. [75]

Key points from experts

Robert N. Weinreb, MD, Distinguished Professor of Ophthalmology, Director of the Hamilton Glaucoma Center, University of California San Diego. His key message regarding disability in glaucoma is that the key to preventing loss of independence is to identify optic nerve damage early, evaluate its structure and function over time, and maintain intraocular pressure at an individually safe level. [76]

Steven J. Gedde, MD, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, is one of the lead authors of the American Academy of Ophthalmology's Preferred Practice Pattern for Glaucoma. His practice thesis: glaucoma severity and risk of disability should be assessed not by a single pressure number, but by stage, visual field, optic nerve, rate of progression, and the impact of the disease on quality of life. [77]

David S. Friedman, MD, PhD, MPH, Director of Glaucoma Service and Medical Director of Clinical Research at Mass Eye and Ear, has an important thesis on the societal implications of glaucoma: late detection, angle-closure mechanisms, treatment adherence, and access to follow-up directly impact the risk of irreversible vision loss and disability. [78]

Louis R. Pasquale, MD, professor of ophthalmology at the Icahn School of Medicine at Mount Sinai and a glaucoma specialist, argues that similar intraocular pressure in different patients does not mean equal risk; functional outcome is influenced by genetics, vascular factors, optic nerve vulnerability, and the duration of progression. [79]

Anne L. Coleman, MD, PhD, Fran and Ray Stark Professor of Ophthalmology and Professor of Epidemiology at the UCLA Fielding School of Public Health, is particularly relevant to the topic of disability: glaucoma should be assessed not only as an eye disease but also as a cause of limitations in quality of life, mobility, access to care, and social independence. [80]

Mary Lou Jackson, MD, a vision rehabilitation specialist, is the lead author of the American Academy of Ophthalmology's Vision Rehabilitation Preferred Practice Pattern. Her practice thesis: When vision loss is irreversible, the goal of medicine goes beyond treating the eye; it also includes helping patients read, move around, live safely at home, participate in society, and maintain emotional well-being. [81]

Result

Disability is possible with glaucoma, but it is determined not by the diagnosis itself, but by persistent visual impairment and limitations in daily life. The most important indicators are corrected visual acuity, visual field, the condition of the better-seeing or single eye, bilaterality of the lesion, stage, progression dynamics, and actual daily limitations. [82]

For glaucoma, the visual field is particularly important: a person may see the central letters well, but be functionally limited due to field constriction, defects near the center, poor orientation, risk of falls, and the inability to drive or work safely in certain conditions.[83]

The most correct strategy is not to wait for disability, but to prevent it: have regular check-ups, monitor intraocular pressure, undergo perimetry and tomography, do not cancel treatment on your own, discuss laser or surgery in a timely manner, and start visual rehabilitation at the first significant limitations. [84]