A new look at an old disease.

Despite 200 years of effort, much about glaucoma remains a mystery, and numerous critical questions remain unanswered. Are there subgroups of primary open-angle glaucoma, with different etiologies, risk factors, clinical presentations, and prognoses? What criteria should be adopted for important diagnostic tests, such as automated perimetry, to reduce the likelihood of variability? Is medical management of the disease truly efficacious? Should laser trabeculoplasty become the initial surgery of choice? Current answers to these and other important questions are reviewed in this survey of the many new research efforts exploring this old disease.