Primary angle-closure glaucoma. Inheritance and environment.

The picture of primary angle-closure glaucoma accompanied by its shallow anterior chamber is so distinct that for many years it has evoked considerable curiosity concerning possible genetic determination. Family trees were published (Sedan and Sedan-Bauby, 1949; Waardenburg, I96I) and attempts were made to fit the inheritance into a genetic pattern-but without convincing success. Authors seemed to be more interested in studying selected families of special interest than in making a genetic enquiry into all their glaucoma cases (FranSois, 196I). Furthermore, many studies were made before the use of gonioscopy, which separated glaucoma into different types (Barkan, I938; Sugar, 1941). Later, discussion centred upon whether closed-angle or open-angle glaucoma occurred in the same families (Weekers, Gougnard-Rion, and Gougnard, 1955). One of the aims of these studies was to support the hypothesis that primary glaucoma is not a single disease; but with the realization that different forms of primary glaucoma can occur in the same individual, any reason to doubt that they could occur in the same families disappeared.