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How Are Glaucoma Patients Identified?

Quigley, Harry A. MD; Jampel, Henry D. MD, MHS

Original Articles

Purpose To determine the events that lead to the diagnosis of glaucoma.

Patients and Methods This prospective study administered a questionnaire to consecutive patients in a university glaucoma service with questions about the visit at which their glaucoma was diagnosed.

Results Among 308 patients (85% of those eligible) with glaucoma and those suspected of having glaucoma, more than half were diagnosed at a routine examination with no ocular symptom. One hundred fourteen of 202 (56%) of those patients were diagnosed with open angle glaucoma (OAG). Symptoms present at the diagnostic visit were infrequently related to glaucoma. Sixty-one percent of OAG patients (124 of 202) recalled elevated intraocular pressure (IOP) as the sole reason for their initial diagnosis; an additional 12% (24 of 202) recalled a combination of IOP with either disc or visual field findings. Only 18% (36 of 202) recalled being diagnosed due to disc or visual field damage alone.

Conclusion The detection of glaucoma is strongly associated with IOP measurement. Glaucoma is most frequently diagnosed at routine visits to eye care specialists at which patients either have no symptoms or have symptoms unrelated to glaucoma. Questionnaire information on large numbers of persons in the health care system may add to our knowledge of practice patterns.

From the Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Received for publication March 27, 2003; accepted June 19, 2003.

Reprints: Harry A. Quigley, MD, Wilmer 122, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.