Prevention of primary angle-closure glaucoma in Asia

It has been estimated that 3.9 million people worldwide will be blind owing to primary angle-closure glaucoma (PACG) by 2010, and that this figure will rise to 5.3 million by 2020.1 The majority of those affected will be living in Asia. These figures have been calculated using data accumulated from a number of population-based glaucoma surveys conducted in various countries in Asia over the last decade.2–8 Credit for highlighting the magnitude of the problem goes to the researchers who conducted these studies in which emphasis has been placed on carrying out gonioscopic examinations on all subjects and in using the International Society of Geographic and Epidemiological Ophthalmology (ISGEO)-standardised diagnostic definitions of glaucoma and angle closure.9 In this month’s issue of the BJO, Casson et al10 (see page 856) report the prevalence of pre-glaucomatous angle closure in Myanmar in their comprehensive population-based survey. This paper focuses on the number of subjects aged ≥40 years classified as at risk of primary angle-closure suspects (PACS) and in the early stages of established primary angle closure (PAC) but with no evidence of glaucomatous optic neuropathy (prevalence 5.7% and 1.5%, respectively). The subdivision of the angle closure into PACS, PAC and PACG is part of the ISGEO classification and follows what is currently believed to be the natural history and assumed progression of the disease. Estimates for the …