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August 11, 2008

Finding Risks for Glaucoma

Arch Ophthalmol. 2008;126(8):1138-1139. doi:10.1001/archopht.126.8.1138

Glaucoma is in the midst of a paradigm shift, moving from the somewhat static staging of the disease to a more evidence-based risk assessment of the individual patient. This shift applies both to patients with confirmed glaucoma and to those at risk of developing the disease, be they individuals with ocular hypertension or those suspected of having glaucoma on some other basis. Other medical specialties have for years provided individualized risk assessments to their patients based on solid evidence from the laboratory and clinical trials. For example, oncologists have long been able to prognosticate using histopathology and clinical factors. More germane to glaucoma, however, is the field of cardiovascular medicine, in which well-designed population-based surveys and clinical trials have led to widely accepted models of cardiovascular disease risk. These models of risk, simple enough to be deployed as a slide rule, checklist, or Web site, can motivate patients to alter modifiable risk factors and help focus the clinician's effort on those individuals at highest risk.

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