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Review Article
Medical Progress
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Volume 328:1097-1106 April 15, 1993 Number 15
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Open-Angle Glaucoma
Harry A. Quigley

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Our understanding of glaucoma has undergone dramatic changes in the past decade. The ferment has derived from new epidemiologic information, improved diagnostic methods, and developments in surgical and drug therapy. This review concentrates on primary open-angle glaucoma, the most prevalent form of the disorder in Western countries.

Definition

Primary open-angle glaucoma usually affects both eyes and combines a particular abnormal appearance of the optic disk (optic-nerve head) with a slowly progressive loss of visual sensitivity (Figure 1). The characteristic appearance of the glaucomatous optic disk is visible by ophthalmoscopy (Figure 2). The present standard for determining visual . . . [Full Text of this Article]

Abnormality of the Optic Disk

Loss of Visual Field

Epidemiologic Features

Prevalence

Risk Factors

Pathophysiologic Features

The Role of Connective Tissues in the Optic Disk

The Role of Vascular Function in the Optic Disk

The Role of the Trabecular Meshwork

Diagnosis

Tonometry

Gonioscopy

Examination of the Optic Disk and Nerve-Fiber Layer

Visual-Field Testing

Treatment

The Target of Treatment

Medical Treatment

Laser Treatment

Surgery

Secondary Surgical Options

Adjunctive Therapy

Expectations of Therapy


Source Information

From the Glaucoma Service and the Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore.

Address reprint requests to Dr. Quigley at Wilmer 120, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21205.

References


Related Letters:

The Medical Treatment of Open-Angle Glaucoma
Rossetti L., Orzalesi N., Liberati A., Quigley H. A.
Extract | Full Text  
N Engl J Med 1993; 329:735-736, Sep 2, 1993. Correspondence

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