Glaucoma is an eye disease strongly associated with ageing, and it can lead to irreversible visual impairment and eventually blindness if not treated. While glaucoma is one of the leading causes of blindness globally, the effects of glaucoma and its treatment on the individual’s well-being and societal costs have remained uncertain at the population level due to the rarity of population-based survey data and national registers around the world.
“In Finland, we have access to comprehensive health examination surveys conducted by the Finnish Institute for Health and Welfare that represent the Finnish adult population and include comprehensive information on the development of eye diseases, vision, and well-being in the 21st century Finland. We also have access to multiple nationwide registers that complement the results from the health surveys, for example, by including information on the use of health care services and glaucoma medication”, Petri Purola says.
By using these population-based data, the aim of the dissertation was to evaluate the overall effects of glaucoma on the Finnish adult population and society. According to the results, glaucoma is associated with worsened generic health-related quality of life and mental health, yet this detrimental influence of glaucoma is more related to the impaired vision caused by the condition than the diagnosis and awareness of the disease itself. Glaucoma treatments also showed no detrimental effect on well-being.
“The information directed to the public on the risks of glaucoma and the prevention of blindness should be strengthened to prevent the deleterious effects of impaired vision. These observations should also encourage the promotion of early detection of glaucoma and the importance of glaucoma therapies and the adherence to them”, Purola says.
Glaucoma is also associated with significant societal costs. For example, the additional health care expenditures of glaucoma were approximately 202 million euros annually, which corresponds to almost one percent of the total expenditures of health care in Finland. Glaucoma patients were also granted early retirement more often than the general population. The increased health care resource consumption and reduced work ability are most likely linked to the glaucoma-related vision loss and the increased number of co-morbidities due to the generally older age of glaucoma patients.
“Importantly, the share of glaucoma care and other eye care was only 13% of these additional health care expenditures. The progression of vision loss can be prevented or at least reduced by glaucoma care. Therefore, timely diagnosis and effective treatment of glaucoma are vital in alleviating the economic burden of the disease on the society, Purola says”
Based on the health surveys and the 40-year data of the Finnish Register of Visual Impairment, the risk and severity of visual impairment due to glaucoma and other vision-threatening eye diseases have decreased in Finland during the past decades. These positive trends are likely explained by the improved diagnostics, therapies, and awareness of these diseases.
“The number of patients suffering from glaucoma and other vision-threatening eye diseases increased during the follow-up. As such, the concurrent decline in visual impairment is an encouraging trend. As the Finnish population ages, the prevention of visual impairment and its detrimental effects must be ensured in the future as well. This goal can be achieved, for example, by improving the accessibility to eye care in the new wellbeing services counties of Finland and by supporting the rehabilitation and services for the visually impaired, Purola states.”
After the dissertation, Purola’s next aim is to continue evaluating the trends in glaucoma and other eye diseases and visual impairment by using recently completed new health surveys in Finland.
Petri Purola was born in Virrat, ja he graduated with a Master’s degree from the Tampere University in May 2019. Since September 2019 he has worked as a researcher in the Eye and Vision Research group and in the Finnish Register of Visual Impairment of the Finnish Federation of the Visually Impaired.
Public defence on Friday 15 March
The doctoral dissertation of MSc Petri Purola in the field of Ophthalmology titled Social and Economic Impact of Glaucoma and Glaucoma Care in Ageing Population will be publicly examined at the Faculty of Medicine and Health Technology at Tampere University at 12 o’clock on Friday 15 March 2024 at Kauppi Campus, Arvo building, auditorium F114 (Arvo Ylpön katu 34, Tampere). The Opponent will be Professor Rupert Bourne from University of Cambridge. The Custos will be Professor Emeritus Hannu Uusitalo from Tampere University.