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Routine measurement of intraocular pressure by primary care physicians to screen patients for glaucoma is not recommended. Some patients with glaucoma have normal intraocular pressure (i.e., normal-pressure glaucoma), and many patients with elevated intraocular pressure do not have glaucoma (i.e., glaucoma suspects). Elevated intraocular pressure is a strong, modifiable risk factor for open-angle glaucoma, but it is not diagnostic.
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Patients at increased risk for open-angle glaucoma include blacks older than 40 years, whites older than 65 years, and persons with a family history of glaucoma or a personal history of diabetes or severe myopia. Open-angle glaucoma is an asymptomatic, progressive optic neuropathy characterized by enlarging optic disc cupping and visual field loss. Glaucoma is the second most common cause of legal blindness in the United States.
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