Which patients are treated for glaucoma? An observational analysis.
OBJECTIVE
More than one million patients in the United States are treated for glaucoma, although little is known about the typical clinical characteristics of this group of patients and the type of therapy they receive. This study was conducted to describe the demographic and diagnostic characteristics of patients beginning long-term drug therapy for glaucoma.


METHODS
This cross-sectional study included 544 patients beginning topical glaucoma medication regimens who received care at a group model health-maintenance organization (HMO) located in central Massachusetts. The primary medical records of 544 patients beginning topical glaucoma medication between 1987 and 1990 were reviewed to ascertain the presence of three clinical findings: intraocular pressure (IOP) > or = 22 mmHg; optic disc changes including cup-to-disc ratio > or = 0.8, cup-to-disc asymmetry > or = 0.2, or morphologic disc changes consistent with glaucomatous optic neuropathy; and visual field defect consistent with glaucoma.


RESULTS
A majority of the 544 patients (86%) were diagnosed as having primary open-angle glaucoma (POAG) by their physicians. Almost half (44.7%) of these patients had only an elevation in IOP without other clinical findings, and 9% met none of the above criteria for glaucoma according to information in the medical record.


CONCLUSIONS
In this setting, most patients who were prescribed drug therapy for POAG were treated for an elevation in IOP alone in the absence of other ophthalmologic characteristics of glaucoma.
Bohn
R L
RL
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Gurwitz
J H
JH
Yeomans
S M
SM
Glynn
R J
RJ
Pasquale
L R
LR
Walker
A M
AM
Avorn
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D017889:Exfoliation Syndrome / Q000150:complications; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008916:Miotics / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D014794:Visual Fields
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D008916:Miotics; D009883:Ophthalmic Solutions