Ayear ago, at the age of 55, I was diagnosed as having normal-tension glaucoma. I had an upper visual field loss in both eyes—about 20% of the field in the right eye and about 30 % in the left eye, in which the area of loss was close to the centre of the visual field and therefore potentially threatened fixation. This added to my lifelong myopia, which I now know is a risk factor for glaucoma. Like many patients with a chronic condition, I read extensively about glaucoma after receiving the diagnosis. However, I had the advantage of epidemiological expertise, a special interest in screening and diagnosis,1 2 and a deep-seated belief in the importance of patient involvement in decision making.3 I will discuss issues that were important to me as a patient and that highlight potential improvement in management. Many of these points may be generalisable to other chronic conditions. Health care often involves a partnership between practitioner and patient sharing the best evidence, deciding how to make decisions, and incorporating patient preferences.4

The correct procedure for using eyedrops: (left) pulling open the bottom eyelid to insert the drops and (right) pressing on the tearduct for two minutes to prevent drainage into the nose/mouth

MEDISCAN/DANIEL GEE