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April 1977

'Ocular Hypertension' vs Open-Angle Glaucoma: A Different View

Arch Ophthalmol. 1977;95(4):586-587. doi:10.1001/archopht.1977.04450040052003

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After reviewing the preceding editorial prior to publication, we find that we must disagree with much of the pessimistic thesis and many of the conclusions of the authors. We agree with the authors' definition of ocular hypertension as a "condition where the angle is open, and the disc and visual field are normal, but the tension is above the normal range." It is important to realize, however, that the "normal range" is purely a statistical definition—its relationship to glaucoma is based on the fact that the vast majority of patients with open-angle glaucoma have elevated intraocular pressures. In addition, the elevated intraocular pressure usually precedes glaucomatous damage to the optic nerve by a variable period of time. The fact that most patients with glaucoma have elevated intraocular pressure does not logically mean, however, that most patients with elevated intraocular pressure have glaucomatous optic nerve damage, or will, in fact, ever

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