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PURPOSE:This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. METHODS:A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. RESULTS:Univariate analysis showed that initial IOP>31?mmHg, age of>?60years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP>31?mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95%confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95%CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95%CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones CONCLUSIONS:Subjects with initial IOP>31?mmHg were nearly three times more likely to present with advanced glaucoma than those with IOP<32?mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects.Eye (2005) 19, 528-534. doi:10.1038/sj.eye.6701533 Published online 6 August 2004 [ABSTRACT FROM AUTHOR]