Blindness And Glaucoma : A Multicenter Data Review

Purpose:To evaluate the prevalence and causes of blindness in patients followed in the Glaucoma Units of 8 European University Eye Clinics. Methods:696 consecutive charts of patients who received diagnosis of glaucoma in at least only eye were evaluated. Blindness was diagnosed using WHO criteria: best corrected visual acuity (BCVA)<1/20 and/or visual field deterioration (VF) within 5 central degrees. Results:Monolateral blindness occurred in 150 cases (22%); bilateral blindness in 28 cases (4%); it was based on VF, VA, or VF+VA criteria respectively on 70%, 30, 45% of cases. Causes of blindness were POAG (32%), macular diseases (20%), ACG (12%), retinal vascular diseases (12%), retinal detachment (10%), myopia (6%), amblyopia (4%), endophthalmitis (4%). Blindness due to glaucoma (both POAG and ACG) was already present at first admission into study Glaucoma Units in 85% of cases, whereas 10 cases (15%) developed blindness in the course of follow-up. All these patients had very severe VF defects at presentation (range from -20 to -31 dB), received glaucoma surgery and maximum tolerated medical treatment and showed a VF slope of 1 dB per year. Conclusions:In European academic glaucoma clinics, blindness due to glaucoma is a very frequent problem and it is due to VF deterioration in most cases; late diagnosis and late referral still remain the two main factors associated with it.