The Pharmaceutical Journal
Vol 280 No 7492 p273
8 March 2008

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• Darzi review
• Glaucoma
• Minor ailment scheme
• Community pharmacy (2)
• Clinical trials
• Hospital pharmacy

Letters to the Editor

Glaucoma

Keep an eye open

From Dr R. Woodford, MRPharmS

In her masterly update on glaucoma treatment, (PJ, 23 February 2008, pp219–22), Lucy Titcomb noted the effect of vascular risk factors for primary open angle glaucoma (POAG) and the requirement for regular monitoring of that condition.

Li Yim and Montgomery¹ have discussed apparent discrepancies in the effect of elevated blood pressure on the risk of developing POAG, as reported in the Blue Mountains Eye Study and the Barbados Eye Study.

To reconcile the differences in the results from those studies, the authors emphasise the importance of perfusion pressure of the optic nerve head (defined as diastolic blood pressure minus intraocular pressure). They point out that care must be taken to avoid over-treating systemic hypertension in POAG patients because this may exacerbate nocturnal hypotension, leading to further embarrassment of the optic nerve head.

It behoves pharmacists to keep an eye open for all patients with glaucoma and encourage them to attend their clinic appointments, especially those being enthusiastically treated with antihypertensives.

Roger Woodford
Portsmouth

Reference
1. Li Yim J, Montgomery D. Risk factors for glaucoma. Geriatric Medicine 2007;3:43–8.

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