The glaucomas.Minerva Med 2001; 92(5):365-79MM
Glaucoma is the leading cause of irreversible blindness worldwide. The World Health Organization reported in 1995 that 5.1 million persons were bilaterally blind from glaucoma. Its morbidity and prevalence make it a significant public health problem. Because it is a treatable condition, it is important that medical professionals be familiar with this disease, which in most cases is not associated with signs and symptoms that may alert the patient or the physician of its presence. Glaucoma is a progressive optic neuropathy that leads to blindness if left untreated. Risk factors include elevated intraocular pressure, advanced age, African ancestry and positive family history. Several types of glaucomas have been described: acute and chronic, secondary and primary. Primary (Chronic) Open Angle Glaucoma is the most common, with a prevalence in the USA of 1.55%. Blacks are 4 to 5 times more affected than whites. Treatment of glaucoma consists of topical or systemic intraocular pressure lowering agents, laser treatment or surgery. Primary Open Angle Glaucoma is an often-unrecognized disease due to its slow course and lack of symptoms. Because the decline in vision may be slowed but not restored by treatment, it is important that this condition be diagnosed early in its course.