In reply
We thank Dr Ekström for his interest in our study.1
Dr Ekström comments on the scarcity of population-based incidence data
on glaucoma and contributes information on an older Swedish cohort where pseudoexfoliation
is common. In addition to major differences in the ethnic composition, age
range, sample size, and environmental exposures of the study populations in
Sweden and Barbados, it is interesting to note the predominant type of glaucoma
identified by each study. Of the 13 incident cases in the Swedish study, 3
had primary OAG, and the remaining 10 cases were diagnosed as exfoliation
glaucoma. These results are in marked contrast to our report, which is based
on 67 incident cases of primary OAG in a black population where exfoliation
is extremely uncommon. Despite these major differences, both studies confirmed
the high risks associated with IOP of 21 mm Hg or more.