Study suggests new framework for understanding glaucoma

The authors provide a potential framework for developing a definition of glaucoma that encompasses its various forms. They conclude that a fundamental inadequacy of previous frameworks is any reference to the pathogenesis of glaucomatous optic neuropathy, which remains unclear and could be due to a unifying mechanism or a raft of mechanisms. They say that the notion of glaucoma as a single concept may become a historical curiosity.

They write that the diverse conditions that comprise glaucoma are united by the clinical characteristic of glaucomatous optic neuropathy. Evidence suggests that the primary site of neurological injury is at the optic nerve head. This fact enables the conditions to be grouped, irrespective of the causal mechanism(s).

The authors propose that the term "experimental glaucoma" be restricted to references to animal models with demonstrable features of glaucomatous optic neuropathy and/or evidence of primary axonopathy at the optic nerve head.

They conclude that an improved understanding of glaucoma will lead to better definitions and that it is prudent to be skeptical of any scientific paradigm.