The overall goal of this project is to estimate and compare the incidence of primary open angle glaucoma (POAG) and visual impairment among a representative sample of black and white residents of east Baltimore. The study design will be a prospective cohort design with participants from the original Baltimore Eye Survey serving as the cohort for longitudinal follow-up. The original cohort will first be screened through the National Death Index in order to identify those subjects who have died in the eight years since the baseline prevalence survey. An estimated 4,319 persons will be alive for participation out of the initial 5,341 persons. Subjects will be traced and contacted for participation in the follow-up round. Data collection will consist of a detailed in-home interview covering ophthalmic and medical histories since the baseline survey, general health care and eye care utilization, and an updated history of smoking, alcohol consumption and other risk factors. In addition, subjects will receive a detailed screening examination consisting of anthropometry, refraction and visual acuity, visual fields, tonometry, stereophotography of the optic disc and macula, and photographs of the lens for cataractous opacification. Subjects who are abnormal on any of the screening tests will be referred to the Wilmer Eye Institute for definitive examination by one of the attending staff. Analysis will consist of estimating the eight-year incidence from those without disease at baseline for visual impairment, glaucoma, age- related macular degeneration and diabetic retinopathy. In addition, risk factor analysis will be conducted to investigate associations for the development of POAG and to characterize those who have progressive disease.
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