Glaucoma is the leading cause of irreversible blindness in theworld. It is estimated that by the year 2000, 66.8 million peoplewill be affected, of whom 6.7 million will be blind in botheyes.1 Glaucoma is an optic neuropathy in which the axons ofthe optic nerve die and the plates of lamina cribrosa collapse,leading to loss of optic-nerve tissue and excavation, or "cupping,"of the ophthalmoscopically visible optic-nerve head. When sufficientaxonal loss occurs, peripheral vision declines; loss of centralvision occurs much later. Most forms of glaucoma are painless,and the loss of vision is insidious.
From the Glaucoma Service, Department of Ophthalmology, University of Iowa College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, where reprint requests should be addressed to Dr. Alward.
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