Risk Assessment in Glaucoma and Ocular Hypertension

Assessing risk and making predictions is an essential part of healthcare. Risk models have been continuously developed in several areas of medicine and their use has significantly contributed to the management of many disorders. The identification of risk factors for development or progression of disease is a fundamental component in the construction of these models. The concept of risk factor has been part of the public lexicon for several decades, ever since the landmark Framingham Heart Study first reported in the early 1960s that cigarette smoking, elevated blood cholesterol, and high blood pressure were predictors of the likelihood of dying from heart disease. During the course of the study, other risk factors were identified and Framingham investigators started developing models to evaluate the global risk of cardiovascular disease on the basis of the summation of all major risk factors. Because longitudinal data were sparse, the initial models predicting risk levels owing to cardiovascular risk factors relied heavily on statistical modeling. As newer data from this and other studies were made available, more robust mathematical models were developed and, eventually, simplified point systems were established to facilitate assessment of an individual’s global risk of progression to an atherosclerotic cardiovascular event. Risk assessment and prevention has contributed significantly to reduce mortality from cardiovascular disease. The successful implementation of risk assessment in cardiovascular medicine has stimulated its application to several other areas. Recently, the concept of risk assessment has also been applied to ophthalmology, more specifically, for assessment of the risk of development and progression of glaucoma. The