Loading...
Please wait, while we are loading the content...
Similar Documents
What would Socrates have made of normal tension glaucoma?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Jay, Jeffrey L. |
| Copyright Year | 1995 |
| Abstract | Editorials What would Socrates have made of normal tension glaucoma? The paper in this issue of the BJO by Hitchings et al (p 402) on surgery for normal tension glaucoma is a valuable pragmatic study which shows the benefit of trabeculectomy. It should, however, lead us to contemplate the fundamental nature of the conditions we label low (or normal) tension glaucoma. Socrates might well have enjoyed a dialogue on this subject. He encouraged the idea that a concept only became valid once it could be defined in abstract terms rather than by reference to specific concrete examples. We are still far from that ideal in low tension glaucoma. Indeed, it is often the absence of certain features which guides our definition. This is hardly satisfactory as it may cause inadvertent inclusion of other diseases even in the more rigorous scientific studies. True high pressure primary open angle glaucoma is itself difficult to define, especially in the early stages.' The intraocular pressure fluctuates and a single sample measurement will often yield a normal result.2 The optic disc and visual field abnormalities depend on subjective methods of assessment with many causes for misinterpretation. Whether we should use the term tension or pressure is open to semantic argument. Examination of the use of the word 'normal' rather than 'low' in this paper is more constructive. The first negative feature in the definition of this disease is the persistent absence of raised intraocular pressure yet Hitchings et al include patients with pressures up to 24 mm Hg when examined by diurnal phasing. It is, therefore, likely that some of these cases are in the lower pressure ranges of true 'high pressure' primary open angle glaucoma. Despite the poor quality of many treatment trials,3 this disease is known to benefit from medical or surgical treatment to lower the pressure.4 The present study, although of considerable size for such a thorough investigation of this rare disease, is too small to allow separation of the results in unequivocal low pressure eyes from those who have pressures which are sometimes slightly raised. The authors have followed the sequence of investigation necessary in low tension glaucoma. In addition to a continued search for raised pressure it is recommended5 that several features must be excluded: a history of eye disease which might have caused a temporary rise in intraocular pressure-for example, trauma, uveitis, treatment with topical steroids, etc; examination findings … |
| Starting Page | 399 |
| Ending Page | 400 |
| Page Count | 2 |
| File Format | PDF HTM / HTML |
| DOI | 10.1136/bjo.79.5.399 |
| PubMed reference number | 7612546 |
| Journal | Medline |
| Volume Number | 79 |
| Issue Number | 5 |
| Alternate Webpage(s) | http://bjo.bmj.com/content/bjophthalmol/79/5/399.full.pdf |
| Alternate Webpage(s) | http://bjo.bmj.com/content/79/5/399.full.pdf |
| Alternate Webpage(s) | https://doi.org/10.1136/bjo.79.5.399 |
| Journal | The British journal of ophthalmology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
