AimsTo determine which risk factors for blindness were most critical in patients diagnosed with high tension primary open angle glaucoma (POAG) in a large ethnically diverse population managed with a uniform treatment strategy.MethodsA longitudinal observational study was designed to follow 487 patients (974 eyes) with POAG for an average of 5.5 ± 3.6 years. Detailed ocular and systemic information was collected on each patient and updated every six months. For this study, blindness was defined as visual acuity of 20/200 or worse and/or visual field less than 20° in either eye. Known risk factors were compared between patients with blindness in at least one eye versus nonblind patients.ResultsThe patients with blindness had on average: higher intraocular pressure (IOP, mmHg): (24.2 ± 11.2 vs. 22.1 ± 7.7, p = 0.03), wide variation of IOP in the follow-up period (5.9 vs. 4.1 mmHg, p = 0.031), late detection (p = 0.006), poor control of IOP (p < 0.0001), and noncompliance (p < 0.0003). Other known risk factors such as race, age, myopia, family history of glaucoma, history of ocular trauma, hypertension, diabetes, vascular disease, smoking, alcohol abuse, dysthyoidism, and steroid use were not significant.ConclusionsThe most critical factors associated with the development of blindness among our patients were: elevated initial IOP, wide variations and poor control of IOP, late detection of glaucoma, and noncompliance with therapy.

Background: Although glaucoma is a leading cause of blindness worldwide, yet there are no large databases where risk factors, current management options and outcomes may be evaluated. With this concept in mind, Dallas Glaucoma Registry was established to focus on an ethnically mixed North Texas population. Methods: This is a retrospective, chart review of 2,484 patients (4,839 eyes) with glaucoma from three clinics. Data collected included: age, race, gender, intraocular pressure, visual acuity, central corneal thickness, cup-to-disk ratio, extent of visual field damage, glaucoma diagnoses, medical and surgical therapies. Results: The most prevalent glaucoma was primary open angle glaucoma accounting for 44.4% of patients, followed by glaucoma suspect (39.5%), secondary glaucoma (7.2%), angle closure glaucoma (6.8%), normal tension glaucoma (1.7%), and childhood glaucoma (0.5%). The mean (SD) age was 68.7 (13.8) and 41.3% were non Hispanic white, 37.0% were black, 10.4% were Hispanic and 11.3% were of other ethnic origin. Hispanic representation in glaucoma did not match their numbers in general population of North Texas. Conclusion: Large numbers of patients in the ongoing Dallas Glaucoma Registry do provide adequate data to better understand risk factors, early detection, improved screening targets, treatment options, outcomes and future studies.

Objective: To study whether there is an increase in the frequency of sensorineural hearing loss among patients suffering from primary open angle glaucoma, pseudoexfoliation syndrome and pseudoexfoliative glaucoma. Methods: This is a cross-sectional study conducted at the ophthalmology and ENT clinic of prince Ali Bin Al-Hussein military hospital between Jan.2012 and Aug 2013. All patients who attended to the ophthalmology clinic and found to have primary open angle glaucoma, pseudoexfoliation syndrome or pseudoexfoliative glaucoma were referred to the ENT clinic for hearing assessment after performing detailed ophthalmological-examination. Those results were compared with that of a control group. Results: Sensorineural hearing loss was found in 6% of patients in the control group and in 9.7% (p value > 0.05) of patients with primary open angle glaucoma. On the other hand it was found in 34.3 %(p value < 0.05) and 30.3 %(p value < 0.05) among patients with pseudoexfoliative glaucoma and pseudoexfoliation syndrome respectively. Conclusion: This study provides evidence regarding the effect of pseudoexfoliation of the eye and its severity on the frequency of sensorineural hearing loss which in turn suggests that pseudoexfoliation syndrome is a systemic disease which may have otological involvement manifested as sensorineural hearing loss.