GLAUCOMA UPDATE - EPIDEMIOLOGY AND NEW APPROACHES TO MEDICAL-MANAGEMENT

Glaucoma describes a group of ocular conditions which involve progress ive optic nerve damage associated with loss of visual function and, fr equently, with elevated intraocular pressure. Recent estimates of worl dwide prevalence predict that 67 million people will suffer from glauc oma by the year 2000. Although the clinical features of glaucoma are r easonably well described, the pathogenesis of optic nerve damage remai ns unclear. Intraocular pressure (IOP) is accepted as an important ris k factor; however, it is clear that other factors play a role in the p athogenesis of the disease, and such factors may interact with IOP to greatly enhance its harmful effects. Many of the new therapeutic appro aches to the stabilisation and potential cure of glaucoma attempt to a ddress these non-IOP factors. The aim of the following paper is to con sider the implications of new estimates of disease prevalence, discuss theories related to optic nerve damage and outline new and future app roaches to the medical management of the disease. (C) 1998 Published b y Elsevier Science Ltd on behalf of The College of Optometrists.