Compliance and adherence: Lifelong therapy for glaucoma

The Early Manifest Glaucoma Trial randomized those with early diagnosed previously untreated glaucoma into two groups: no treatment or treatment with a combination of laser trabeculoplasty plus betaxolol ophthalmic solution. At a median follow-up of 8 years, 67% of all subjects progressed and treatment significantly decreased the rate of progression. Despite the initially optimistic news, the results are not as encouraging as they might seem. As one might imagine, 76% of the control group progressed. However, despite apparent treatment, 59% of the treated glaucoma patients also progressed. One would like to know why more than 50% of those under treatment still experience additional glaucomatous progression.