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 61. I should note that glaucoma primarily strikes older
 individuals, usually adults in their mid- to late 50_s and
 early to late 60's. Mro Randall is very young_ relative to
 most glaucoma patients. Until recently_ it was felt very few
 people Mr. Randall's age got glaucoma_ _owevet_ as information
 is better collected_ it appears now that glaucoma among younger
 adults is much more common than once believed.
 62. There is another class of _End Stage _ glaucoma
 patients. These are patients whoa despite all available
 therapies, medical and surgical_ cannot gain control over their
 elevated lOP. Many of the patients admitted into my program at
 the University of _orth Carolina had undergone multiple
 surgical procedures in an effort to gain control over their
 ..... lOP° These procedures had failed and the°patients urgently
 needed to find another way to lower their: IOP into a "safe _
 range before they lost even more vision°
 63_ There is one final group within _End Stage" glaucoma_
 patients who are blind. All of the emphasis_ in glaucoma
 treatment is designed to prevant blindness. What is seldom
 discussed is the problems confronted by patients whoa while
 blinds continue to suffer from the consequences of elevated
 ocular tensions.
 64. If uncontrolled, these elevated ocular tensions may_
 in blind patients_ result in serlous additional injury to the
 eyeball. In many cases the final outcome of failure to control
 these problems -- and the elevated pressure which drives them
 -- will result in the surgical removal of the eye®
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