Over the past decade, there have been tremendous advances in diagnostic procedures, technologic innovations, treatment options, and multicenter clinical trial findings related to primary open-angle glaucoma onset and progression. This has resulted in a significant increase in our knowledge related to the detection and management of glaucoma and risk factors associated with this optic neuropathy. Concurrent with these innovations, Optometry has undergone significant steps forward in the diagnosis, management, and comanagement of patients with glaucoma. The progress that has occurred in the clinical evaluation of glaucoma and the enhancement of our understanding of basic pathophysiologic mechanisms associated with glaucoma is indeed remarkable.
Nine years ago, the Optometric Glaucoma Society (OGS) was founded, and many believe that it continues to be one of the premier meetings for them to attend during the year. Concurrent with the OGS meeting, many other clinical and scientific sessions have incorporated high-quality presentations on glaucoma. It is therefore no great surprise that, once again, a feature issue on glaucoma should be a top priority for Optometry and Vision Science (OVS).
In this OVS feature issue, there are many new approaches and creative methods that are described by a number of authors, and the large number of submissions made it a distinct challenge for the Guest Editors to decide which of the accepted articles should be included. Some of the articles (all of high quality) that were not included in this feature issue will appear in subsequent issues of OVS.
As we move forward with new procedures and techniques, it is also important to have an appreciation of the historical roots of our current practices. We are especially proud of the fact that in this issue, we have a collection of five publications that provide historical perspectives and overviews. These include histories of intraocular pressure measurement (Robert Stamper, MD), gonioscopy (Wallace L. Alward, MD), perimetry and visual field testing (Chris A. Johnson, PhD, FAAO, Michael Wall, MD, and H. Stanley Thompson, MD), surgical management of glaucoma (M. Reza Razeghinejad, MD, and George Spaeth, MD), and medical management and pharmacology of glaucoma (Tony Realini, MD). In a future OVS issue, John McSoley, OD, FAAO, will author the history of optic disc and retinal nerve fiber layer assessment.
Additionally, the standards and guidelines for perimetry, authored by the working group on perimetry standards from the Imaging and Perimetry Society (IPS), are included in this feature issue. This is the first time that these standards and guidelines have been published in a peer-reviewed journal for all to see.
Each of these review perspectives articles is authored by some of the foremost experts in these areas, and they serve as an unprecedented resource for both novice and experienced practitioners who diagnose and manage patients with glaucoma. Other than very early versions of Sir Stewart Duke-Elder's System of Ophthalmology, we know of no other literature source where such landmark articles can be found together. We are grateful to the authors of these articles for their willingness to spend the time and effort to provide these history perspectives. These articles alone are likely to bring a great deal of attention to this feature issue for many years to come.
An important part of this feature issue on Glaucoma is the outstanding original research articles related to optic disc evaluation (vertical cup-to-disc ratio percentiles and subjective judgment of optic disc features), new visual field techniques (predictors of future functional loss, Rarebit perimetry, and modeling patterns of glaucomatous visual field loss), and diagnostic and prognostic methods (brain-derived neurotrophic factor in glaucoma and correction equations for Goldmann applanation tonometry). Other interesting topics include advances in imaging techniques (manual segmentation of OCT images, comparison of scanning laser perimetry and OCT measures, and agreement between HRT I and HRT II scanning laser ophthalmoscope stereometric measures), structure-function relationships (structure-function relationships in glaucoma near fixation, comparison of axial lengths in occludable angle, and angle closure glaucoma), approaches to the management of glaucoma, cost-effectiveness of glaucoma treatment in Barbados and Ghana, and Valosin as a novel autoantigen in glaucoma.
In summary, this feature issue can be regarded as a current Almanac of the most salient issues in glaucoma, authored by some of the most prominent investigators.
The Editor-in-Chief, in his Editorial, has thanked all the Guest Editors for their assistance and guidance in assembling the collection of articles in this feature issue on glaucoma. And we, the Guest Editors, are in turn indebted to OVS, the Editor-in-Chief, Anthony J. Adams, OD, PhD, FAAO, and the Managing Editor, Kurt Zadnik, for their ongoing help in preparing this issue. Most importantly, we wish to offer our sincere and deepest appreciation to all the authors for their enthusiasm and labors in making this a truly remarkable and noteworthy contribution to the literature. We are delighted and very proud to be providing readers of OVS with this Glaucoma feature issue.
Chris A. Johnson, PhD, FAAO
Iowa City, Iowa
Douglas Anderson, MD
Murray Fingeret, OD, FAAO
New York, New York
David “Ted” Garway-Heath, MD
London, United Kingdom
Ronald Harwerth, OD, PhD, FAAO