Author Affiliations: Glaucoma Service, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia (Dr Dreyer), and CNS Research Institute, Brigham and Women's Hospital, and Program in Neuroscience, Harvard Medical School, Boston, Mass (Dr Lipton).
Conventional wisdom defines
glaucoma as "a collection of ophthalmic disorders in which the
intraocular pressure [IOP] is sufficiently elevated to cause
excavation and degeneration of the optic disc"
(Figure 1).1 The glaucomas are a
leading cause of irreversible blindness both worldwide and in the
United States.2 Although early physicians could not
differentiate between visual loss from glaucoma and cataract, our
understanding of glaucoma really dates to 1622. Richard Banister, a
British oculist, wrote, "if one feele the eye by rubbing upon the
eie-lids that the eye be growne more solid and hard than naturally it
should be . . . the humour settled in the hollow nerves be growne
to any solid or hard substance, it is not possible to be
cured."3 Although his
examination retains some currency,
we have made some therapeutic progress in the ensuing 377 years.
Nonetheless, much about this disease is still enigmatic.
Dreyer EB, Lipton SA. New Perspectives on Glaucoma. JAMA. 1999;281(4):306-308. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jct80029