The study was a collaborative effort involving the
University of Lund, Sweden, with centers in Malmö,
Helsingborg, and Lund, Sweden, as well as Stony Brook
University, Stony Brook, New York.

These results should be put into perspective, according to
Anders Heijl, M.D., Ph.D., chairman of the Department of
Ophthalmology at Sweden's Malmö University Hospital and
first author of the report. "Although the study closely
checked for possible glaucoma progression, many of the
patients remained stable over time, even those in the
control group," Dr. Heijl said. "On the other hand, despite
the clear effect of treatment, glaucoma progressed in as
many as 30 percent of treated patients after four years."

Dr. Heijl said that the time it took for glaucoma to
progress varied greatly among patients and was sometimes
rather short, even in treated patients. "This shows that in
many patients with rapidly progressing glaucoma, the
treatment used in this study was insufficient to halt
progression of the disease," Dr. Heijl said.

Dr. Heijl emphasized that treatment for early, newly
diagnosed glaucoma should be individualized and carefully
balanced. Before deciding on the best treatment option, eye
care professionals should consider several unique patient
factors, such as age, eye pressure levels, and disease
severity. "The study findings support the medical
community's growing contention that glaucoma treatment
should be tailored to the individual needs of the patient,"
Dr. Heijl said. "One option could include no initial
treatment, but subsequent treatment if the disease
progresses. Many glaucoma medicines have side effects, so
the decision not to treat the disease in its early stage --
but closely monitor patients -- can postpone or obviate the
need for medications."

Although the study results confirm the belief that reducing
eye pressure is beneficial, "they do not prove that
elevated eye pressure in itself is the primary cause of
glaucoma," said M. Cristina Leske, M.D., chair of the
Department of Preventive Medicine at Stony Brook University
and a study co-author. "However, because reducing eye
pressure slows the progression of glaucoma, eye pressure
levels are important in the course of the disease."

Dr. Leske said that the study treatment had few side
effects. The most important was an increase in nuclear
opacities, a type of cataract, but the number of related
cataract surgeries in the treated group was small.

Open-angle glaucoma affects about 2.2 million Americans age
40 and over; another two million may have the disease and
don't know it. Glaucoma occurs when the optic nerve is
damaged. In most cases, increased pressure in the eye is a
risk factor for this damage. The damage to the optic nerve
causes loss of peripheral (side) vision, although people
are often unaware that they have glaucoma. As the disease
worsens, the field of vision gradually narrows and
blindness can result. However, if detected early through a
comprehensive eye exam, glaucoma can usually be controlled
and serious vision loss prevented.

The Early Manifest Glaucoma Trial was co-sponsored by the
Swedish Research Council. A list of EMGT study centers and
principal investigators is attached.

The National Eye Institute is part of the National
Institutes of Health (NIH) and is the Federal government's
lead agency for vision research that leads to sight-saving
treatments and plays a key role in reducing visual
impairment and blindness. The NIH is an agency of the U.S.
Department of Health and Human Services.

Attachment: Glaucoma Trial Background
http://www.nih.gov/news/pr/oct2002/nei_Background.doc

Attachment: Early Manifest Glaucoma Trial Study Centers &
Investigators
http://www.nih.gov/news/pr/oct2002/nei_EMGTrial.doc