Excessive reliance on intraocular pressure to detect glaucoma leaves many affected patients undiagnosed and untreated; visualisation of the optic disc is a dying art that needs to be revived
Intraocular pressure (IOP) is measured by tonometry. In our community, mean IOP is around 15 mmHg, with a normal range (mean ± 2 SD) regarded as 10–21 mmHg. This information is irrelevant to the diagnosis of glaucoma.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, Melbourne,VIC; and Department of Ophthalmology and University of Melbourne Department of Surgery, Royal Melbourne Hospital, Melbourne, VIC.
- 1. Hollows FC, Graham PA. Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population. Br J Ophthalmol 1966; 50: 570-586.
- 2. Sommer A, Tielsch JM, Katz J, et al. Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey. Arch Ophthalmol 1991; 109: 1090-1095.
- 3. Klein BE, Klein R, Sponsel WE, et al. Prevalence of glaucoma. The Beaver Dam Eye Study. Ophthalmology 1992; 99: 1499-1504.
- 4. Mitchell P, Smith W, Attebo K, Healey PR. Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study. Ophthalmology 1996; 103: 1661-1669.
- 5. Kerrigan-Baumrind LA, Quigley HA, Pease ME, et al. The number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci 2000; 41: 741-748.
- 6. Sample PA, Bosworth FC, Blumenthal EZ, et al. Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma. Invest Ophthal Vis Sci 2000; 41: 1783-1790.
- 7. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006; 90: 262-267.
- 8. Rochtchina E, Mitchell P. Projected number of Australians with glaucoma in 2000 and 2030. Clin Experiment Ophthalmol 2000; 28: 146-148.
- 9. Wong EYH, Keeffe JE, Weih LA, et al. Detection of undiagnosed glaucoma by eye health professionals. Ophthalmology 2004; 111: 1508-1514.
- 10. Hitzl W, Ortner C, Hornykewycz K, et al. Resource use and costs for a glaucoma screening program in Austria: an 8-year review: a cost-consequence analysis based on the Salzburg-Moorfields Collaborative Glaucoma Study. Eur J Ophthalmol 2006; 16: 92-99.
- 11. Hewitt AW, Bennett SL, Fingert JH, et al. The optic nerve head in myocilin glaucoma. Invest Ophthalmol Vis Sci 2007; 48: 238-243.
- 12. Robin TA, Muller A, Rait J, et al. Performance of community-based screening using frequency doubling technology and Heidelberg retinal tomography. Ophthalmic Epidemiol 2005; 12: 167-178.
- 13. Odberg T, Jakobsen JE, Hultgren SJ, Halseide R. The impact of glaucoma on the quality of life of patients in Norway. I: results from a self-administered questionnaire. Acta Ophthalmol Scand 2001; 79: 116-120.
- 14. Zegers RHC, Reinders EF, de Smet MD. Primary open-angle glaucoma: the importance of family history and role of intraocular pressure. Med J Aust 2008; 188: 312-313.