Randomized Clinical Trials on Medical Treatment of Glaucoma: Are They Appropriate to Guide Clinical Practice?-Reply

In reply  We are pleased that Novack and Robin and Vogel and coauthors agreed with us that clinical trials on medical treatment of glaucoma do not provide relevant information for clinical practice. Some of their points, however, call for careful consideration, and we would like to present our counterarguments. Novack and Robin argue that we overlooked many studies that measured visual field changes. Let us be clear on this. The vast majority of studies to which they refer compared one drug with another without the use of an untreated control group. With such a design, one cannot answer the basic question of whether any treatment is better than no therapy.Novack and Robin also believe that we unfairly emphasized the lack of coherence and consistency of clinical trials in the medical treatment of glaucoma. Indeed, we did say in our article¹ that lack of consistency and coherence is not