AUTHOR=Liu Hua , Chen Chen , Chen Zhuo , Li Qian , Li Quan , Liu Wei 

TITLE=Factors associated with delayed first ophthalmological consultation for primary glaucoma: a qualitative interview study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1161980

DOI=10.3389/fmed.2023.1161980

ISSN=2296-858X

ABSTRACT=Background: Glaucoma has an insidious onset with non-specific early symptoms, often leading patients to delay in seeking help. However, postponing the first ophthalmological consultation can result in delayed diagnosis and treatment, with adverse effects on vision. This study explored the factors associated with delayed first ophthalmological consultation in patients with primary glaucoma, with the overarching aim of informing measures to reduce delayed consultation and avoid the consequent adverse outcomes. 
Methods: We adopted a phenomenological approach. Semi-structured interviews were conducted with patients admitted to a tertiary eye hospital in Tianjin, China, from January 2021 to April 2021. We identified 46 patients with glaucoma who delayed their visit to the eye clinic for various reasons. Data were analyzed by Colaizzi’s 7-step method. 
Results: We identified four major themes and 16 sub-themes. The major themes were as follows: 1) occult symptoms that are difficult to identify; 2) insufficient knowledge and understanding of glaucoma-related risks and harm; 3) perceived difficulties in accessing medical care; and 4) inadequate support system. 
Conclusions: In order to avoid patient delay and consequent irreversible damage to the visual field in patients with primary glaucoma, it is essential that medical staff identify symptoms more effectively, change habitual medical behavior of the patients, adopt a medical union model, and promote the use of a social medical support system to address practical difficulties in delivering adequate care.