THE NEUROLOGIC EVALUATION OF PATIENTS WITH LOW-TENSION GLAUCOMA

Abstract

A hypothesized cause of low-tension glaucoma is chronic or intermittent ischemia of the optic nerve. Since the optic nerve are brain and both parts of the CNS and share a common blood supply, it was wondered if patients with low-tension glaucoma might also have clinical or radiographic evidence of cerebral atropy. Patients (27) with low-tension glaucoma were examined using neurobehavioral testing, electroenecephalography, computerized tomographic scan, neurological history and physical examination. In only a small number of patients were these abnormal. However, 12 of the 27 patients gave a history of common or classic migraine. This unexpected finding raises the possibility that migraine-related ischemia might be the pathogenic mechanism in some cases of low-tension glaucoma.