Phacoemulsification has been linked to lowered intraocular pressure (IOP) in patients with glaucoma, ocular hypertension, anatomic narrow angles and in glaucoma suspects ("glaucoma"), but the reported magnitude of change has varied. Patients with glaucoma who underwent phacoemulsification ("surgical") between June 2010 to May 2015 were matched one-to-one to patients who did not ("non-surgical") on age, gender, type of glaucoma, baseline IOP, and number and type of glaucoma medications. Electronic medical record information was used to compare the matched surgical and non-surgical groups. Main outcome measures were change in IOP, change in number of glaucoma medications and likelihood of a glaucoma procedure within 36 months after phacoemulsification. IOP measures were obtained from Goldmann applanation tonometry when available (45%), and otherwise from Icare, Tono-pen, noncontact tonometry and pneumotonometry.

Among 16,169 matched pairs, average IOP after the index date was lower in the surgical than non-surgical group throughout follow-up to 36 months. The difference was greatest during one to 18 months, during which IOP increased by 0.22 mmHg from 16.49 mmHg in the average non-surgical patient; and decreased by 0.99 mmHg from 16.50 mmHg in the average surgical patient (difference-in-difference, 1.21 with 95% CI, 1.12 to 1.30 mm Hg). The difference-in-difference was greatest for patients with ocular hypertension (2.00 mmHg) and for patients with preoperative IOP ≥20 (2.46 mmHg). A subgroup analysis with matched patients using only Goldmann applanation tonometry found similar results. By 30 to 36 months, 5% fewer surgical patients used an ophthalmic medication. In the surgical group, the odds of selective laser trabeculoplasty was reduced in patients with ocular hypertension or glaucoma suspect, while the odds of glaucoma surgery were elevated in surgical patients with primary open-angle glaucoma.

In this community-based study, the association of phacoemulsification for cataract with IOP reduction was lower than in past referral-based studies. Researchers wrote that surgeons should expect to reduce intraocular pressure approximately 1 to 2 mmHg with phacoemulsification in patients with preoperative IOP less than 20 mmHg.

A cross-sectional, retrospective study of nursing home patients examineed data from Delaware nursing homes to determine prevalence of age-related eye diseases (AREDs), vision impairment and blindness, and to compare the findings with the results of 11 US investigations of vision and eye health in nursing homes. Twenty nursing homes in Delaware participated in the study, yielding comprehensive eye examination records for 2019 study participants.

The overall prevalence of vision impairment or blindness was 63.8% and was greater than 60% for each age, sex and race category. Prevalence of vision impairment or blindness was 68.4% among patients with cataracts, 69.4% among patients with macular degeneration, 70.5% among patients with glaucoma and 68.4% among patients with diabetic retinopathy. Prevalence of blindness was 14.1%. Among patients with AREDs, prevalence of blindness ranged from 15% for patients with cataracts to 22.6% for patients with diabetic retinopathy. When compared with other investigations, investigators found wide variation in vision and eye factors reported, and wide variation in the prevalence of those factors. Only four studies diagnosed both AREDs and visual function. Seven studies reported AREDs, and seven reported vision impairment and/or blindness. Vision impairment or blindness ranged from 29% to 67%; cataract ranged from 32% to 83%; macular degeneration ranged from 4.6% to 70.7%. Glaucoma ranged from 5.3% to 41.4%; diabetic retinopathy ranged from 1.7% to 3.1%.

Comprehensive eye examinations showed that vision impairment and blindness affected 63.8% of nursing home residents. Compared with other studies, there was a wide range of vision factors reported, and wide variation in the prevalence of vision impairment or blindness, and AREDs. This investigation suggested the importance of eye care in nursing homes and the importance of reporting standard vision and eye health factors to inform policy and practice.

Estrogen is essential in maintaining various physiological features in women, and a decline in estrogen levels is known to give rise to numerous unfortunate symptoms associated with menopause. To alleviate these symptoms, hormone replacement therapy with estrogen is often used and has been shown to be fruitful in improving quality of life in women suffering from postmenopausal discomforts. An often-forgotten condition associated with menopause is the optic nerve disorder, glaucoma. As such, estrogen may also have an impact in maintaining the retinal ganglion cells (RGCs), which make up the optic nerve, thereby preventing glaucomatous neurodegeneration. This review aimed to provide an overview of possible associations of estrogen and the glaucoma subtype primary open-angle glaucoma (POAG) by evaluating the current literature through a PubMed-based literature search. Multiple in vitro and in vivo studies of RGC protection, as well as clinical and epidemiological data concerning the well-defined retinal neurodegenerative disorder POAG were reviewed.

Investigators reported that, overall, deficiencies in retinal estrogen may potentially instigate RGC loss, visual disability and eventual blindness. They added that estrogen replacement therapy may therefore be a beneficial future treatment. However, they suggested that more studies are needed to confirm the relevance of estrogen in glaucoma prevention.