People living in developing countries have the highest risk of developing blindness from glaucoma.¹² In east Asia, angle closure glaucoma predominates, whereas in Africa, the Indian subcontinent, and in Hispanic populations open angle forms are more common.¹³ Treatments vary depending on the type of glaucoma and the setting. In this week's BMJ a trial in South Africa by Murdoch's group shows that trabeculectomy augmented with β radiation significantly increases the success rate of surgery compared with surgery alone.4 However, people receiving β radiation also had a higher risk of operable cataract. Balancing the benefits of surgery with the risk of cataract formation is dependent on the setting in which glaucoma occurs.

Access to eye care is important, and as most ophthalmology services are in urban centres people often have to travel far.⁵⁶ In Ghana, for example, people in rural areas present …