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March 2010

Treatment of Ocular HypertensionHamlet's Lament Revisited

Author Affiliations

Author Affiliation: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Arch Ophthalmol. 2010;128(3):363-364. doi:10.1001/archophthalmol.2010.13

For those of us of a certain age, conventional wisdom stated that elevated intraocular pressure (IOP) caused glaucoma, and lowering IOP was the only effective way to prevent and treat it. We knew this because every textbook claimed it was so, and observational and anecdotal reports heralded the association. Inconveniently, a few nonophthalmologists, such as David Eddy and the federal Office of Technology Assessment, questioned this conventional wisdom.1 Fortunately, this forced us to dig deeper. Similar to Hamlet, who wrestled with the existential question, “To be or not to be,” we now struggle with the dilemma of “whom to treat and whom to watch.”

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