Lecture examines glaucoma as systemic disease

Robert Ritch, MD, professor of clinical ophthalmology at the New York Medical College, chief of glaucoma services at the New York Eye and Ear Infirmary, and medical director of The Glaucoma Foundation, presented glaucoma in a different light as the ocular manifestation of a more systemic disease.

The two glaucomas examined (exfoliative glaucoma and normal-tension glaucoma) had very different origins. It was concluded that these are also characterized by findings that are linked to other disorders as well, he said.

"I would like to advocate that many of the different disease which we categorize together as glaucoma have associated systemic manifestations," Dr. Ritch said. "We're finding a series of other risk factors that are connected to ocular disease."

The data Dr. Ritch cites are from studies, including a recent finding linking exfoliative glaucoma with genetic variations in the formation of elastic tissue, as proof that glaucoma is not just an isolated disease of the eye.

It has been found in studies that patients with exfoliative glaucoma have a higher incidence of other disease such as Alzheimer's and vascular diseases, according to Dr. Ritch. Patients with normal-tension glaucoma experience damage to the optic nerve even when pressure within the eye seems to remain normal, he said. However, patients with the disease exhibit other risk factors, including reduced blood flow or ischemia.