Among 32 Negro patients with primary angleclosure glaucoma, typical acute congestive signs and symptoms were rarely noted. Subacute or chronic angle closure without symptoms was seen much more frequently. Diagnosis was established by a high index of suspicion of angle closure, and confirmed by mydriasis testing and gonioscopy. None of these 32 patients sought treatment within the first 48 hours, and only three within the first week of their disease. Eighteen sustained optic nerve cupping and visual loss attesting to the insidious nature of the disease. Peripheral iridectomy in 25 eyes resulted in deepening of the anterior chamber angle with peripheral anterior synechiae noted in only 11. Twenty eyes are well controlled, four without medication. The pressure was not normalized in five eyes.
Alper MG, Laubach JL. Primary Angle-Closure Glaucoma in the American Negro. Arch Ophthalmol. 1968;79(6):663-668. doi:10.1001/archopht.1968.03850040665003