Progression to blindness of patients with primary open angle glaucoma

Aims: to establish the proportion of patients with treated primary open angle glaucoma (POAG) who progressed to blindness, and identify factors that may have contributed to progression. To establish the proportion of POAG patients who achieved eligibility for blind or partial sight registration but who were not registered.;Methods: a retrospective, cross-sectional, longitudinal follow-up, cohort study of patients with POAG attending the Leicester Royal Infirmary in 1982.;Results: 258 patients were followed up for a mean of 11.2 years. Four point three percent (11/258) of patients were blind at the diagnosis of POAG. At the end of follow-up 34.5% (89/258) were blind, 17.4% (45/89) were blind from POAG alone and 17.1% (44/89) were blind from other causes, either alone or in combination with POAG. Regression analysis identified the visual field in the better eye at diagnosis (p<0.00005), the mean follow-up intraocular pressure in the better eye (p<0.005) and age at diagnosis of POAG (p<0.002) as being risk factors for progression to blindness. Odds ratios (OR) for progression to blindness from all causes revealed an OR=0.53 (95%CI;0.31,0.90) for visual acuity better than or equal to 6/18 in the better eye at diagnosis, OR=0.18 (95%CI;0.07,0.43) for early visual field defect in the better eye at diagnosis and OR=0.40 (95%CI;0.21,0.77 (for early visual field defect in the worst eye at diagnosis. For patients aged between 65-74 years it was estimated that patients with POAG were >2.5 times more likely to become blind than the age matched general population and for those 75 years patients with POAG were >1.8 times likely to become blind. Fifty-one of the 90 patients who were eligible for blind or partial sight registration were not registered during the follow-up period.;Conclusion: despite treatment, over a third of patients with POAG progressed to blindness during their follow-up period.