Risk of glaucoma among patients with benign essential blepharospasm.
OBJECTIVE
Debate exists whether intraocular pressure fluctuation is a risk factor for glaucoma. Patients with benign essential blepharospasm (BEB) experience intermittent, ultra-short-term intraocular pressure elevations from frequent blinking and spastic eyelid closure. This article explores the development of incident glaucoma after BEB diagnosis.


METHODS
Medicare claims files were used to identify patients with a diagnosis of BEB from 1994 to 2000. An equal-sized control group consisting of patients without BEB was created using one-to-one propensity score matching. The patients with BEB and those in the control group were followed for the development of one of the following main outcome measures: primary open angle glaucoma (POAG), closed angle glaucoma (CAG), or other glaucoma (besides POAG and CAG) over the following 2,190 days.


RESULTS
There were 1,350 persons in each group, consisting of 29% men, 94% of whom were white, with a mean age of 76 years. In the unadjusted model, BEB patients did not develop POAG (hazard ratio [HR], 1.159; 95% confidence interval [CI], 0.876-1.534), CAG (HR, 1.477; 95% CI, 0.711-3.066), or other glaucoma (HR, 1.306; 95% CI, 0.904-1.886) more often than controls. Adjusting for age, gender, race, number of visits to the ophthalmologist, and other eye disease, a diagnosis of BEB did not affect the risk of POAG (HR, 1.152; 95% CI, 0.870-1.525), CAG (HR, 1.448; 95% CI, 0.696-3.015), or other glaucoma (HR, 1.296; 95% CI, 0.896-1.873).


CONCLUSIONS
BEB is not a risk indicator for POAG, CAG, or other forms of glaucoma.
Lee
Michael S
MS
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA. mikelee@umn.edu
Harrison
Andrew R
AR
Grossman
Daniel S
DS
Sloan
Frank A
FA
D000368:Aged; D001764:Blepharospasm / Q000150:complications* / Q000175:diagnosis; D016208:Databases, Factual; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States