Abstract：
Glaucoma is the second leading cause of blindness in India. Despite advances in diagnosing and managing glaucoma, there is a lack of India-specific clinical guidelines on glaucoma. Ophthalmologists often refer to the European Glaucoma Society (EGS) and Asia-Pacific Glaucoma Society (APGS) guidelines. A group of glaucoma experts was convened to review the recently released EGS guideline (fifth edition) and the APGS guideline and explore their relevance to the Indian context. This review provides the salient features of EGS and APGS guidelines and their utility in Indian scenario. Glaucoma diagnosis should be based on visual acuity and refractive errors, slit-lamp examination, gonioscopy, tonometry, visual field (VF) testing, and clinical assessment of optic nerve head, retinal nerve fiber layer (RNFL), and macula. The intraocular pressure target must be individualized to the eye and revised at every visit. Prostaglandin analogues are the most effective medications and are recommended as the first choice in open-angle glaucoma (OAG). In patients with cataract and primary angle-closure glaucoma (PACG), phacoemulsification alone or combined phacoemulsification and glaucoma surgery are recommended. Trabeculectomy augmented with antifibrotic agents is recommended as the initial surgical treatment for OAG. Laser peripheral iridotomy and surgery in combination with medical treatment should be considered in high-risk individuals aged <50 years. In patients with phakic and PACG, phacoemulsification alone or combined phacoemulsification and glaucoma surgery are recommended. Visual acuity, VF testing, clinical assessment of the optic disc and RNFL, and tonometry are strongly recommended for monitoring glaucoma progression.
摘要：
青光眼是印度第二大失明原因。尽管在诊断和治疗青光眼方面取得了进展，缺乏印度特有的青光眼临床指南.眼科医生经常参考欧洲青光眼学会（EGS）和亚太青光眼学会（APGS）指南。召集了一组青光眼专家来审查最近发布的EGS指南（第五版）和APGS指南，并探讨它们与印度背景的相关性。这篇评论提供了EGS和APGS指南的显着特征及其在印度方案中的实用性。青光眼的诊断应基于视力和屈光不正，裂隙灯检查,房角镜检查,眼压测定,视野(VF)测试,视神经乳头的临床评估，视网膜神经纤维层（RNFL），和黄斑。眼内压目标必须针对眼睛进行个性化处理，并在每次访问时进行修改。前列腺素类似物是最有效的药物，被推荐为开角型青光眼（OAG）的首选。在白内障和原发性闭角型青光眼（PACG）患者中，建议单独超声乳化或联合超声乳化和青光眼手术。推荐使用抗纤维化药物增强的小梁切除术作为OAG的初始手术治疗。年龄<50岁的高危人群应考虑激光周边虹膜切开术和手术结合药物治疗。在Phakic和PACG患者中，建议单独超声乳化或联合超声乳化和青光眼手术。视敏度,VF测试,视盘和RNFL的临床评估，和眼压测量法强烈建议监测青光眼进展。
