Blindne and glaucoma: a comparion of patient progreing to blindne from glaucoma with patient maintaining viion

PURPOE: To compare patient becoming legally blind from glaucoma with thoe who did not go blind. DEIGN: Retropective, cohort, and cae-control tudy. METHOD: A retropective community-baed longitudinal tudy of reident of Olmted County, Minneota, who were newly diagnoed with open-angle glaucoma between 1965 and 1980 and followed through 1998. A cae-control tudy wa performed comparing patient progreing to legal blindne from glaucoma with aged-matched and viual field-matched patient not progreing to blindne. REULT: Fifty-ix of 290 patient progreed to legal blindne in at leat one eye over the 34-year period of the tudy. Mot who progreed to blindne had moderate to advanced viual field lo at the time of diagnoi of glaucoma. Thoe becoming legally blind had mean intraocular preure (IOP) on therapy lower than or imilar to patient who did not go blind, although the variability of IOP wa higher in the blind group. Different uceptibilitie to IOP were apparent, a ome eye with initially normal dik and viual field became blind at an IOP of 20 mm, while other did not woren. Change in medical therapy after progreion of viual field damage were le effective in lowering IOP in the group becoming blind than in the nonblind group. CONCLUION: Patient at greatet rik of blindne had viual field lo at the time of diagnoi of glaucoma. Different uceptibilitie to IOP were apparent, with ome patient becoming blind at preure that other tolerated without ignificant progreion. Thi ugget that continued monitoring of viual field and reaement of target IOP level when field damage occur are fundamental in the management of glaucoma