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Zhuang H, Zheng NX, Lin L. Watching intense movies increase IOP of primary open angle glaucoma patients: A prospective study. J Fr Ophtalmol 2023; 46:882-895. [PMID: 37085357 DOI: 10.1016/j.jfo.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE To investigate intraocular pressure (IOP) changes while viewing smartphone movies under artificial intelligence (AI) monitoring. METHODS In all, 48 subjects were recruited from the glaucoma clinic of Xianyou maternal and child health hospital from January 2018 to March 2020. The research consisted of three parts. In part 1, movies rated by the Motion Picture Association of America (MPAA) were viewed via smartphones of various screen sizes under AI supervision for 90minutes, at a distance of 40cm. IOP and biological parameters including anterior chamber angle, Schlemm's canal (SC) cross-sectional area, heart rate, systolic and diastolic blood pressures (SBP and DBP) were measured and analyzed. In part 2, blue-blocking glasses (BB glasses) were worn to repeat the above experiments. In part 3, the efficacy of AI in decreasing attention loss was analyzed. In addition, results were analyzed to determine whether interval breaks, prompted by AI, prevented IOP from rising. RESULTS In part 1, the mean IOP of primary open angle glaucoma (POAG) subjects' right eyes significantly increased by 4.828 and 4.974mmHg after watching R and NC-17 movies, respectively. In their left eyes, it increased by 2.876 and 5.767 after watching R and NC-17 movies, respectively. The maximum IOP difference was also increased by 4.782 and 4.510 on right and left eyes, respectively, after viewing NC-17 movies on a 6.1-inch screen. Furthermore, the SC became narrower, whereas heart rate, DBP and SBP increased in the POAG group. In addition, maximum IOP difference was significantly correlated with SC cross-sectional area, DBP and SBP in the POAG group. In part 2, symptom scores were improved by BB glasses; however, IOP was not decreased. In part 3, attention loss was significantly decreased by AI monitoring. On the contrary, AI also prevented IOP from rising via promoting interval rest. CONCLUSION Watching adult movies (NC-17) can significantly increase the IOP of POAG patients. AI can prevent IOP from rising by promoting interval rest when viewing NC-17 movies.
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Affiliation(s)
- H Zhuang
- Department of Ophthalmology, Maternal and Child Health Hospital of Xianyou County, 351200 Putian City, Fujian Province, China.
| | - N-X Zheng
- Fujian Center for Disease Control and Prevention, 350000 Fuzhou city, Fujian Province, China.
| | - L Lin
- Department of Ophthalmology, Women and Children's Hospital, School of Medicine, Xiamen University, 361000 Xiamen city, Fujian Province, China.
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Somani N, Beukes E, Street A, Lindsay R, Smith L, Allen PM. Effectiveness of music-based interventions to address well-being in people with a vision impairment: a scoping review. BMJ Open 2023; 13:e067502. [PMID: 37709316 PMCID: PMC10503321 DOI: 10.1136/bmjopen-2022-067502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES The objectives of this review were to identify the types of music-based interventions and associated accessibility challenges for people who have visual impairment (VI) and their reported effects on psychological, physiological and social well-being. DESIGN A scoping review was developed according to the Joanna Briggs Institute methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and guidelines. A narrative synthesis was conducted to map out the types of music-based interventions undertaken and to compare the therapeutic outcomes. The studies were evaluated according to the music reporting checklist. RESULTS In total 5082 records were identified, 69 full-text articles were screened and 13 studies were included. Eleven studies included younger children and teenagers, two focused on adults with acquired VI. Ten studies involved active music therapy strategies and three used passive music listening. Eleven of the studies focused on social outcomes and two reported mental health. Although the studies reported that music-based intervention strategies improved psychosocial well-being in people with a VI, conclusions could not be drawn as robust outcome measures were not generally used and only four of the studies included any statistical analysis. CONCLUSIONS Although potential was evident, details of intervention protocols and training requirements were not sufficiently reported and further, high-quality evidence-based studies are required.
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Affiliation(s)
- Nurbanu Somani
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Eldre Beukes
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Alexander Street
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Rosie Lindsay
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
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Wu ACL, Choy BNK. Psychological interventions to reduce intraocular pressure (IOP) in glaucoma patients: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:1215-1227. [PMID: 36441225 DOI: 10.1007/s00417-022-05912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/07/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Glaucoma has been increasing recognised to cause significant mental health burden to patients while psychological factors also play important roles in the development and progression of glaucoma. This review presents the current evidence of the impact of psychological interventions in glaucoma patients to improve their holistic care in terms of both physical and mental health by modulating psychological symptoms and supporting glaucoma control. METHODS A literature search was conducted on PubMed for relevant studies up to February 2022. Types of psychological interventions include meditation, autogenic relaxation, music, hypnosis, motivational interviewing, psychological nursing and bright light exposure. Outcomes investigated were ocular parameters including intraocular pressure, mental health, patient motivation and satisfaction, and overall quality of life. RESULTS Seventeen studies investigating the effects of psychological interventions on improving the care of glaucoma patients were reviewed. Daily meditation for 30 to 60 min has been shown to be effective in improving glaucoma control in terms of reducing intraocular pressure by 1.5 to 6.1 mmHg and improving ocular perfusion and quality of life. The impacts of music, autogenic training and psychological nursing on glaucoma control, vision outcomes and psychological symptoms are also promising while bright light exposure has shown some effects on sleeping quality. However, there is insufficient basis to support the adoption of motivational interviewing or hypnosis in glaucoma patients yet. CONCLUSION Psychological interventions, especially meditation, can play a bigger role in the holistic care of glaucoma patients by controlling disease progression as an adjunct to conventional approaches and alleviating the mental health burden caused by the disease through stress reduction and emotional regulation. They empower patients to gain greater control of their disease and provides additional advantages of low cost, non-invasiveness and minimal side effects. Future research should involve well-conducted randomised trials with larger sample sizes and longer duration of intervention and follow-up to establish the long-term benefits for glaucoma patients.
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Affiliation(s)
- Anson Chun Long Wu
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Bonnie Nga Kwan Choy
- Department of Ophthalmology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China.
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4
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Somani N, Beukes E, Street A, Lindsay R, Allen PM. Music-based interventions to address well-being in people with a vision impairment: protocol for a scoping review. BMJ Open 2022; 12:e054268. [PMID: 35260456 PMCID: PMC8905951 DOI: 10.1136/bmjopen-2021-054268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Music-based interventions are used to improve well-being in individuals who are psychologically vulnerable and have long-term illnesses. To date, no study has systematically assessed the literature on music-based interventions aimed at improving well-being in people who have a vision impairment (VI). The purpose of the current protocol is to provide the methodology for a scoping review, to explore the therapeutic outcomes and strategies used in music-based interventions aimed specifically at people with a VI. METHODS AND ANALYSIS This scoping review protocol was developed according to the Joanna Briggs Institute methodology and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist and guidelines. The anticipated start date for this study was July 2021. The proposed review will include studies that use music therapeutically as part of a treatment intervention for all VI populations. Studies that meet the inclusion criteria with regards to population, concept and context will be included. Electronic database searches will be conducted independently by two researchers and include MEDLINE, EMBASE, CINAHL Plus, PsycINFO and Web of Science. Further searches will include the reference lists of included studies and grey literature. A narrative synthesis will be conducted to map out the types of therapeutic music interventions undertaken and to compare therapeutic outcomes. ETHICS AND DISSEMINATION As the methodology of this study consists of collecting data from publicly available articles, it does not require ethics approval. The findings of the planned scoping review are important to guide the development of future interventions, or strategies, that will attempt to use music to improve well-being in people with a VI. The results will be disseminated through a peer-reviewed publication and conference presentations.
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Affiliation(s)
- Nurbanu Somani
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Eldre Beukes
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Alexander Street
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Rosie Lindsay
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
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Muralidharan S, Ichhpujani P, Bhartiya S, Singh RB. Eye-tunes: role of music in ophthalmology and vision sciences. Ther Adv Ophthalmol 2021; 13:25158414211040890. [PMID: 34497975 PMCID: PMC8419534 DOI: 10.1177/25158414211040890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
Although the healing effect of music has been recognized since time immemorial, there has been a renewed interest in its use in modern medicine. This can be attributed to the increasing focus on holistic healing and on the subjective and objective aspects of well-being. In ophthalmology, this has ranged from using music for patients undergoing diagnostic procedures and surgery, as well as for doctors and the operation theatre staff during surgical procedures. Music has proven to be a potent nonpharmacological sedative and anxiolytic, allaying both the pain and stress of surgery. This review aims to explore the available evidence about the role of music as an adjunct for diagnostic and surgical procedures in current ophthalmic practices.
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Affiliation(s)
- Shruti Muralidharan
- Glaucoma Service, Department of Ophthalmology, Government Medical College & Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Professor, Glaucoma Service, Department of Ophthalmology, Government Medical College & Hospital, Sector 32-A, Chandigarh 160030, India
| | - Shibal Bhartiya
- Glaucoma Facility, Department of Ophthalmology, Fortis Memorial Research Institute, Gurgaon, India
| | - Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Wong MM, Tahir T, Wong MM, Baron A, Finnerty R. Biomarkers of Stress in Music Interventions: A Systematic Review. J Music Ther 2021; 58:241-277. [PMID: 33822108 DOI: 10.1093/jmt/thab003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one's physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.
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Affiliation(s)
| | | | | | - Annilee Baron
- McMaster University, Hamilton, ON, Canada.,Music Therapy Academy, Hamilton, ON, Canada
| | - Rachael Finnerty
- McMaster University, Hamilton, ON, Canada.,Music Therapy Academy, Hamilton, ON, Canada
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Luo Z, Li M, Ye M, Ji P, Lou X, Huang J, Yao K, Zhao Y, Zhang H. Effect of Electrical Stimulation of Cervical Sympathetic Ganglia on Intraocular Pressure Regulation According to Different Circadian Rhythms in Rats. Invest Ophthalmol Vis Sci 2021; 61:40. [PMID: 32976562 PMCID: PMC7521184 DOI: 10.1167/iovs.61.11.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose The purpose of this study was to investigate the relationship between circadian rhythm and intraocular pressure (IOP), and to explore whether electrical stimulation of cervical sympathetic ganglia (SCG) can regulate IOP via neurotransmitter distribution around the Schlemm's canal (SC) in rats. Methods Sprague Dawley rats were housed under normal (N-normal), constant dark (N-dark), and constant light (N-light) rhythms (n = 6 per group). Electrical stimulation (intermittent wave [20 hertz {Hz}, 2 mA, 10 minutes]) was used to stimulate the SCG. Atropine sulfate eye gel was applied three times a day. DiI was injected into the SCG and anterior chamber. The cross-sectional area and circumference of SC were evaluated using hematoxylin-eosin staining. Immunofluorescence staining was used to evaluate dopamine-β-hydroxylase (DβH) expression in SC endothelial (SCE) cells. Results N-Dark increased the IOP, decreased the cross-sectional area of SC, and increased DβH levels in SCE cells. Nerve projection between SC and SCG was detected, and electrical stimulation of SCG upregulated DβH expression in SCE cells. Under normal and constant light rhythms, electrical stimulation of SCG increased DβH and decreased the cross-sectional area and circumference of SC, while simultaneously increasing IOP and decreasing IOP fluctuations. After paralyzing the ciliary muscles, electrical stimulation of SCG decreased the cross-sectional area and circumference of SC under normal and constant light rhythms. Conclusions N-Dark increased DβH in SCE cells, reduced the cross-sectional area of SC, and increased IOP. Under the normal and light rhythms, electrical stimulation of SCG increased DβH in SCE cells, reduced the cross-sectional area and circumference of SC, and in turn elevated IOP and decreased IOP fluctuations.
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Affiliation(s)
- Zhaoxia Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mu Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Ye
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pingting Ji
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaotong Lou
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingqiu Huang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Yao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yin Zhao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Zhang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
How to cite this article: Dada T, Mahalingam K, Gupta V. Allostatic Load and Glaucoma: Are We Missing the Big Picture? J Curr Glaucoma Pract 2020;14(2):47–49.
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Affiliation(s)
- Tanuj Dada
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Gillmann K, Hoskens K, Mansouri K. Acute emotional stress as a trigger for intraocular pressure elevation in Glaucoma. BMC Ophthalmol 2019; 19:69. [PMID: 30849950 PMCID: PMC6408777 DOI: 10.1186/s12886-019-1075-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Stress-induced activation of the sympathetic nervous system leads to a cascade of metabolic reactions. Emotional stress is a more specific form of stress in which the stressor is a psychological response to a situation subjectively perceived as traumatic. Stress hormones can have a wide range of effects on the body, however, it is still unclear if and how it can affect ophthalmic physiology. This report presents a case of severe ocular hypertension in which emotional stress was the only cause elicited, and explores potential aggravating factors. Case presentation A 78-year-old, personality type A, lady with a history of pseudo-exfoliative glaucoma presented with an acute asymmetrical raise in intraocular pressure (IOP) immediately following a family breakdown. Her IOP had previously remained stable following a deep sclerectomy in the right eye and an Ex-PRESS shunt in the left eye. Her examination was entirely normal otherwise, with a patent filtration and diffuse bleb as confirmed with anterior segment OCT imaging. Near-normalisation of her IOP was observed within 24 h, concomitantly with the reduction of her stress levels. No other cause for the transient acute hypertensive episode were found. Conclusions This case report suggests that acute emotional stress could severely affect IOP in patients suffering from glaucoma. This could be important when looking after glaucoma patients. It would also suggest that the personnality types, and the emotional and social context are more factors to take into account in glaucoma studies. These observations are based on a single case report and would need to be verified on a larger scale.
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Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland
| | - Kirsten Hoskens
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland. .,Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA.
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Finn S, Fancourt D. The biological impact of listening to music in clinical and nonclinical settings: A systematic review. PROGRESS IN BRAIN RESEARCH 2018; 237:173-200. [PMID: 29779734 DOI: 10.1016/bs.pbr.2018.03.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This systematic review explored the evidence base on the impact of listening to music on biological response in both clinical and nonclinical settings. Human studies exploring the effects of listening to recorded music on biological markers were included. Studies had to involve a non-music control condition. Keyword searches were carried out of five major databases (Cochrane/Wiley, PsycINFO, PubMed, Sage, and Science Direct) and bias was assessed using the Cochrane Risk of Bias Tool for Randomized Studies (RoB 2.0). Forty-four studies assessing the biological impact of music listening were identified: 27 in clinical settings and 17 in nonclinical settings. Eighty-two percent had examined the effects of short-term listening interventions, while the remainder had looked at longitudinal interventions. Thirteen of 33 biomarkers tested were reported to change in response to listening to music. The most commonly analyzed biomarker was the stress hormone cortisol, with half of clinical studies demonstrating a stress-reducing effect of music listening. Blood glucose was also found repeatedly to reduce in response to music listening. Many of the other biomarkers analyzed are also part of biological stress pathways, which suggests that the primary way by which music listening affects us biologically is via modulations of stress response. Effects were shown irrespective of genre, self-selection of the music, or duration of listening, although a majority did use classical music. The evidence base for understanding biological responses to music is still developing, but there is support for the application of listening to music, especially within clinical settings for stress reduction.
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Affiliation(s)
- Saoirse Finn
- Centre for Performance Science, Royal College of Music, London, United Kingdom
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom.
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Méndez-Ulrich JL, Sanz A. Psycho-ophthalmology: Contributions of Health psychology to the assessment and treatment of glaucoma. Psychol Health 2016; 32:330-342. [PMID: 28004586 DOI: 10.1080/08870446.2016.1268690] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Asymptomatic in its early stages, glaucoma is the second leading cause of blindness worldwide. While psychosocial factors are taken into consideration for a host of diseases such as cancer, heart disease and autoimmune conditions, to date, psychological issues have been ignored in the clinical management of glaucoma. OBJECTIVE This work reviews the most relevant contributions from a health psychology perspective for the assessment and treatment of glaucoma, which is emerging in the field of psycho-ophthalmology. METHOD To provide scientific evidence regarding contributions of psychology to the comprehension of glaucoma, a bibliographic review of three databases (Psicodoc, PsycInfo and Medline) was conducted, spanning the period between 1940 and 2016. RESULTS This review yielded a total of 66 studies published in the period analysed and identified three areas where health psychology has made substantive contributions to glaucoma screening, monitoring and treatment: the emotional impact on patients suffering from glaucoma, the adherence to treatment and the effects of stress on intraocular pressure. CONCLUSIONS A health psychology approach for research and therapy of glaucoma must focus on the management of the negative affect associated with the diagnosis, the optimisation of treatment adherence and the stress management of the intraocular pressure measurements.
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Affiliation(s)
- Jorge Luis Méndez-Ulrich
- a Faculty of Psychology, Research Group on Stress and Health, Department of Basic, Developmental and Educational Psychology , Universitat Autònoma de Barcelona , Catalonia , Spain
| | - Antoni Sanz
- a Faculty of Psychology, Research Group on Stress and Health, Department of Basic, Developmental and Educational Psychology , Universitat Autònoma de Barcelona , Catalonia , Spain
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