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Some Young Chinese Being Mistakenly Diagnosed With Glaucoma
STANFORD, CA – April 25, 2007 — Many young and middle-aged people of Chinese ancestry told they are at risk of going blind from glaucoma may be getting incorrect information, say researchers at the Stanford University School of Medicine.
After following a cluster of 16 such patients for seven years and observing more than 100 others, the researchers have concluded that there’s a new syndrome occurring in the Chinese population, and it may be less likely to lead to severe vision loss or blindness than typical glaucoma. Their results are published in the March issue of Ophthalmology.
When Kuldev Singh, MD, MPH, professor of ophthalmology, began seeing a number of young Chinese males 15 years ago who had been diagnosed with glaucoma, he became suspicious that perhaps they had another syndrome. “I started to see a lot of Chinese men with advanced glaucoma at a young age,” said Singh. “Most were otherwise healthy and active and thus were surprised that they had this disease.”
Dr. Singh noticed that not only were these patients young Chinese males, but almost all were nearsighted and many had normal eye pressure. Most glaucoma patients have high eye pressure, which is thought to lead to optic nerve damage. To see so many similar patients including many with normal pressure was unusual. The combination of similarities among the patients led Singh to question whether these individuals, including some as young as 25, had glaucoma rather than another syndrome. So instead of the normal, aggressive course of treatment for young glaucoma patients, Singh kept most of the patients on low doses of pressure-lowering eye drops as a precaution. As he suspected, none of the patients progressed toward blindness during the course of the study.
Dr. Singh began sharing his experience with doctors around the world and found he was not the only one with patients with these symptoms. Singh said he thinks that optic nerve damage in these patients is caused by their nearsightedness, and that others have reported that nearsightedness is increasing in the Chinese population. Since nearsightedness rarely gets worse in people after their 30s, the optic nerve damage may ultimately slow or stabilize in such patients.
Singh calls the findings preliminary, and said further studies are needed. “If they don’t appear to be progressing toward blindness right now,” he said, “they shouldn’t be treated as if they have a blinding condition.” Singh hopes his paper acts as a warning to doctors to look closely at this population when diagnosing glaucoma, so they won’t rush patients to surgery when it’s not needed.
SOURCE: Stanford University Medical Center