External Influences Upon Ocular Homeostasis

Glaucoma is the second leading cause of blindness in the United States, yet its pathogenesis
is poorly understood. This is an insidious disorder since the loss of peripheral vision which
occurs first usually is not noticed by the victim. Approximately 1 million people in the
United States have glaucoma, but are not aware of it. Glaucoma is not always associated with
elevated intraocular pressures so that vision screenings which measure just intraocular
pressure without assessing the optic nerve will also miss these patients with glaucomatous
damage. Therefore, patients are often diagnosed only when they have severe irreversible
vision loss. Vascular insufficiency or abnormal autoregulation versus mechanical pressure
damage has been proposed as a major factor in the development of glaucoma. Presently, therapy
is based upon lowering intraocular pressure. If a contributing intermittent pressure
elevation factor can be elucidated and characterized, specific treatment modalities may then
be developed and their effectiveness can be monitored.

Inclusion Criteria:

- Patients with autonomic dysfunction

- Patients with open-angle glaucoma

- Patients with normal-pressure glaucoma

- Normal subjects

Exclusion criteria:

- Medical students

- Prisoners

- Pregnant women