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Contempo 1999
January 27, 1999

New Perspectives on Glaucoma

Author Affiliations

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).

JAMA. 1999;281(4):306-308. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jct80029

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.

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