Greenidge K C, Dweck M
J Natl Med Assoc. 1988 Dec;80(12):1305-9.
Glaucoma is the leading cause of blindness in blacks. Black patients usually present to the ophthalmologist with more extensive optic nerve damage as compared with whites, and the disease process follows a malignant course even after intervention is initiated. Consequent to a greater amount of iris pigmentation, blacks require medications in higher concentrations to receive significant lowering of intraocular pressure. Patients with darker, thicker irides are more prone to have subacute angle-closure glaucoma, which requires gonioscopy and the recognition of subtle details that may be difficult to interpret. If medical therapy fails, the results of noninvasive surgical intervention, such as argon laser trabeculoplasty, and traditional surgical intervention, such as trabeculectomy, have a much lower success rate in the black population when compared with studies of the general population.It is essential that the primary physician be aware of the early signs and risk factors for glaucoma, which are herein outlined in detail. Only through early recognition, proper referral, and aggressive treatment can the incidence of blindness secondary to glaucoma be decreased.
青光眼是黑人失明的主要原因。与白人相比，黑人患者通常就诊于眼科医生时视神经损伤更为广泛，而且即使开始干预后，疾病进程仍呈恶性发展。由于虹膜色素沉着较多，黑人需要更高浓度的药物才能显著降低眼压。虹膜颜色更深、更厚的患者更容易患亚急性闭角型青光眼，这需要进行前房角镜检查并识别可能难以解释的细微细节。如果药物治疗失败，与普通人群的研究相比，非侵入性手术干预（如氩激光小梁成形术）和传统手术干预（如小梁切除术）在黑人人群中的成功率要低得多。初级医生必须了解青光眼的早期症状和危险因素，本文对此进行了详细概述。只有通过早期识别、适当转诊和积极治疗，才能降低青光眼导致失明的发生率。
