title: Presentation of glaucoma in an urban tertiary care hospital in South America: legal blindness and prevalence.
abstract: OBJECTIVE
  To determine disease severity in glaucoma patients who presented to a tertiary care service for the first time and to determine the prevalence of different types of glaucoma.
  
  
  METHODS
  Retrospective analysis of data of patients referred to the Glaucoma Service at the Santa Casa de Misericórdia de São Paulo, Brazil in 2007. A complete chart review from 448 patients was done; data regarding age, gender, ethnicity, family history, duration of the disease, previous treatment, best corrected visual acuity, cup-to-disc ratio, intraocular pressure, diagnosis and treatment were collected. Glaucoma was diagnosed by the presence of typical optic disk abnormalities, disregarding IOP values.
  
  
  RESULTS
  52.3% of patients presented visual acuity less than or equal to 20/200 and 67.7% presented cup-to-disc ratio between 0.8 and 1.0 in the worse-seeing eye; 13.4% of patients were considered legally blind. Primary open angle glaucoma was the most prevalent form of glaucoma (54.2%, 95% CI: 48.5-59.5) and chronic angle closure glaucoma was the second most frequent (11.5%, 95% CI: 8.25-15.5).
  
  
  CONCLUSIONS
  A considerable rate of patients (almost 60% in the better-seeing eye and 70% in the worse-seeing eye) presented with advanced glaucoma. Strategies that create conditions for early diagnosis are deemed necessary to reduce glaucoma-related blindness in the Brazilian population.
authors.affiliation: Department of Ophthalmology, Irmandade da Santa Casa de Misericórdia de São Paulo Hospital, R. Vergueiro, 2045 cj 1009, 04101-000, Sao Paulo, SP, Brazil. tammyht32@yahoo.com.br
authors.forename: Tammy Hentona
authors.initials: TH
authors.lastname: Osaki
authors.forename: Niro
authors.initials: N
authors.lastname: Kasahara
authors.forename: Mauricio
authors.initials: M
authors.lastname: Della Paolera
authors.forename: Ralph
authors.initials: R
authors.lastname: Cohen
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Nishiwaki-Dantas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005901:Glaucoma / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D015812:Glaucoma, Angle-Closure / Q000453:epidemiology; D005902:Glaucoma, Open-Angle / Q000453:epidemiology; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult