Critical analysis of the classification of glaucomas issued by the European Glaucoma Society in 2008

Abstract

Constantin-Dan BordeianuEmergency Hospital Ploiesti, Prahova, RomaniaPurpose: To critically analyze the 2008 European Glaucoma Society classification of glaucomas, in order to reveal its advantages and shortcomings.Methods: The paper tries to determine the extent to which this classification is clear (being based on a coherent and consistently followed set of criteria), is comprehensive (framing all forms of glaucoma), helps to understand the sickness (using a logical framing system), and facilitates therapeutic decision making (offering direct therapeutic suggestions).Results and conclusion: The paper shows that, compared with all the previous classifications, the 2008 European Glaucoma Society classification is one step ahead (in the way of classifying the group of secondary angle-closure glaucomas), two steps behind (in rejecting two useful categories of congenital glaucoma), and similar in several respects: that it is based on criticizable fundamental and secondary criteria that cannot cover all forms of sickness gathered at a particular crossing; that it uses several equally weighted criteria for one single crossing (division); that it frames one clinical entity in several clinical categories; that it does not reflect reality in some aspects; and that it does not offer direct therapeutic suggestions: after framing a case in a scheme built on the basis of gonioscopic observation, it requires a second stage of pathogenic analysis, so that the ophthalmologist is able to decide the correct treatment only in the third stage. All these considerations justify the efforts to find a new classification that will be able to correct the abovementioned shortcomings.Keywords: glaucoma, classification of glaucomas, shortcomings of the 2008 EGS classification