We thank Dr Philips for his interest in our meta-analysis on the association between blood pressure and open-angle glaucoma. As part of our inclusion/exclusion criteria, we excluded studies that did not adjust for age, as age is a strong risk factor for both glaucoma and hypertension, and could confound the measures of association. In our search, we identified the paper by Drs Leighton and Philips as relevant to the study topic but excluded it from the meta-analysis as it did not adjust for age in the design or the analysis. In our meta-analysis, we identified a robust association between blood pressure and intraocular pressure. We also identified a significant association between hypertension and open-angle glaucoma, but there was significant heterogeneity across study designs. Although the study of the association between blood pressure and glaucoma development has a long history, additional prospective studies are still needed to fully understand the role of blood pressure in glaucoma development.
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