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CLINICAL RESEARCH C
Screening, Diagnosis, and Management of Open Angle Glaucoma:
An Evidence-Based Guideline for Canadian Optometrists
S.MacIver OD, FAAO Introduction
University of Waterloo,
School of Optometry Glaucoma is the most common form of irreversible blindness in the world,
and Vision Science and second only to cataract among all causes of blindness. There is still
1,2
no universally agreed-upon definition of glaucoma, and as such, it remains
D.MacDonald OD, FAAO a condition for which there are differing views on the classification of indi-
Ilex Eye Associates viduals within the continuum of suspicion through diagnosis. Regardless,
there appears to be consensus that glaucoma refers to a group of diseases
C.Lisa Prokopich OD, MSc that manifest as a characteristic progressive optic neuropathy and retinal
University of Waterloo, ganglion cell loss that eventually leads to a permanent loss of visual field.
3
School of Optometry
and Vision Science Glaucoma is a major public health issue because individuals are typically as-
ymptomatic until end stages of the disease when the associated vision loss is
significant and irreversible. Studies have shown that the prevalence of unde-
tected glaucoma is as high as 50% even in high income areas including North
America and Australia, increasing to 90% in middle and low income areas such
as Asia and Africa. This is at least in part a result of inadequate screening tools
4
and strategies to detect this asymptomatic disease: without more individuals
accessing routine eye examinations, glaucoma will continue to go undetected.
Vision loss from glaucoma imposes significant societal and economic bur-
dens that increase with disease severity: the direct costs of vision loss from
glaucoma exceed $300 million annually in Canada, and approach $2 billion
across North America. 5,6
CANADIAN JOURNAL of OPTOMETRY | REVUE CANADIENNE D’OPTOMÉTRIE VOL. 79 SUPPLEMENT 1, 2017 5
