title: Determinants of severity at presentation among young patients with early onset glaucoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical, socio-economic, and demographic factors associated with the severity at presentation among juvenile primary open angle glaucoma (JOAG) patients.
  
  
  METHODS
  Age at diagnosis, family history, baseline intraocular pressure (IOP), access to health-care, socio-economic status, and glaucoma awareness among 80 unrelated JOAG patients presenting between 10 years and 40 years of age were analyzed for their association with the severity at presentation. Severity at presentation was graded based on worse eye visual field using the advanced glaucoma intervention study score and on binocular visual field defects at presentation.
  
  
  RESULTS
  Patients with a positive family history presented 4 years earlier (P = 0.045, confidence interval [CI]: 0.09-8.8) compared to those without a family history. Lower socio-economic status (Odds ratio [OR] 5.7, P = 0.01, CI: 1.5-22), and higher baseline IOP (OR 7, P = 0.003, CI: 1.9-26) were associated with severe glaucomatous visual field defect at presentation. A negative family history was associated with a 10 times likelihood of presenting with a severe glaucomatous field defect (OR 0.1, P = 0.007, CI: 0-0.5).
  
  
  CONCLUSIONS
  Clinical, socio-economic, and demographic factors are contributory to the severity at presentation among young patients with early onset glaucoma. Presence of a family history is associated with an earlier presentation among these patients and a reduced risk of the severe presentation.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Viney
authors.initials: V
authors.lastname: Gupta
authors.forename: Rajat M
authors.initials: RM
authors.lastname: Srivastava
authors.forename: Ramanjit
authors.initials: R
authors.lastname: Sihota
authors.forename: Jasbir
authors.initials: J
authors.lastname: Kaur
authors.forename: Sandip
authors.initials: S
authors.lastname: Kumar
authors.forename: Digvijay
authors.initials: D
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007194:India / Q000453:epidemiology; D007429:Intraocular Pressure; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014065:Tonometry, Ocular; D014794:Visual Fields; D055815:Young Adult