Lifetime visual disability in open-angle glaucoma and ocular hypertension.
OBJECTIVE
To study how many of the patients with treated glaucoma or ocular hypertension go blind during their lifetime and which factors are associated with blindness.


METHODS
The data on 106 consecutive patients who had died between 1991 and 2002 was retrospectively evaluated. At diagnosis 39 patients had primary open-angle glaucoma, 27 had exfoliation glaucoma, and 40 had ocular hypertension.


METHODS
Clinical records and causes of death were reviewed. Visual disability at the last visit before death was evaluated. Outcome measures were visual handicap and blindness based on visual acuity and/or visual fields.


RESULTS
At the last visit, 17 patients [16%, 95% confidence interval (CI) 9-23] were visually handicapped. Thirteen patients (14%) were bilaterally blind. Glaucoma was the cause of blindness in one or both eyes in 16 patients (15%, 95% CI 8-22) and in both eyes in 6 patients (6%, 95% CI 1-10). In the analysis of only 1 eye of each patient, the cumulative incidence of glaucoma-caused blindness was 6% (95% CI 2-11) at 5 years, 9% (95% CI 4-15) at 10 years, and 15% (95% CI 9-23) at 15 years. An advanced stage of glaucoma at diagnosis, fluctuation in intraocular pressure during treatment, the presence of exfoliation syndrome, and poor patient compliance increased the occurrence of blindness. Positive family history of glaucoma and vascular causes of death had no effect on visual outcome.


CONCLUSIONS
Glaucoma-caused blindness was associated with an advanced stage of glaucoma at diagnosis, fluctuation of intraocular pressure during treatment, the presence of exfoliation syndrome, and poor patient compliance. The risk of going blind from glaucoma in both eyes was 6%.
Forsman
Eva
E
Population Genetics Unit, Folkhälsan Institute of Genetics, University of Helsinki, Helsinki, Finland. eforsman@elisanet.fi
Kivelä
Tero
T
Vesti
Eija
E
D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D002423:Cause of Death; D004185:Disability Evaluation; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies; D015354:Vision, Low / Q000453:epidemiology / Q000209:etiology*; D014792:Visual Acuity