Glaucoma Blindness at a Tertiary Eye Care Center.
BACKGROUND
Glaucoma is an important cause of irreversible blindness. This study describes the characteristics of a large, diverse group of glaucoma patients and evaluates associations between demographic and clinical characteristics and blindness.


METHODS
Data were gathered via retrospective chart review of patients (N = 1,454) who were seen between July 2007 and July 2010 by glaucoma service providers at Duke Eye Center. Visual acuity and visual field criteria were used to determine whether patients met the criteria for legal blindness. Descriptive and comparative statistical analyses were performed on the glaucoma patients who were not blind (n = 1,258) and those who were blind (n = 196). A subgroup analysis of only those patients with primary open-angle glaucoma was also performed.


RESULTS
In this tertiary care population, 13% (n = 196) of glaucoma patients met criteria for legal blindness, nearly one-half of whom (n = 94) were blind from glaucoma, and another one-third of whom (n = 69) had glaucoma-related blindness. The most common glaucoma diagnosis at all levels of vision was primary open-angle glaucoma. A larger proportion of black patients compared with white patients demonstrated vision loss; the odds ratio (OR) for blindness was 2.25 (95% CI, 1.6-3.2) for black patients compared with white patients. The use of systemic antihypertensive medications was higher among patients who were blind compared with patients who were not blind (OR = 2.1; 95% CI, 1.4-3.1). A subgroup analysis including only patients with primary open-angle glaucoma showed similar results for both black race and use of systemic antihypertensive medications. The relationship between use of systemic antihypertensive medications and blindness was not different between black patients and white patients (interaction P = .268).


CONCLUSIONS
Data were based on chart review, and associations may be confounded by unmeasured factors.


CONCLUSIONS
Treated systemic hypertension may be correlated with blindness, and the cause cannot be explained solely by race. In addition, this study demonstrated that there is continued disparity between black patients and white patients with regards to blindness from glaucoma.
medical student, University of California, San Diego, San Diego, California.
Jordan S
JS
Stone
associate professor of ophthalmology, Duke University; director of clinical research, Durham Veterans Affairs Medical Center, Durham, North Carolina.
Kelly W
KW
Muir
associate professor of biostatistics, Duke University, Durham, North Carolina.
Sandra S
SS
Stinnett
assistant professor of ophthalmology, Duke University, Durham, North Carolina jullia.rosdahl@duke.edu.
Jullia A
JA
Rosdahl
D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005901:Glaucoma / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D012189:Retrospective Studies; D063128:Tertiary Health Care