Thank you for your detailed response.  I've come to learn your replies
are among the more straightforward, more learned and more unbiased on
this board.

First, I read what you posted in a reply earlier, and I included NTG
only because a poster after you added that, and I made the presumption
this poster was adding more information about the study. Mind you, I
specifically left myself open for correction since my math is poor and I
never read the study.  It is, however, somewhat curious you never
challenged my mathemetical assumptions.

Second, you fall back on the "high likelihood" of the untreated
participants developing some optic nerve damage that would be seen in a
study extending "20 or 30 years."  I guess my query is how "high" a
likelihood?  And even granting your premise, there is a real possibility
that in a 20 or 30 year study, a fair number may still develop no nerve
damage.  That is what this study will purport to determine.  I would
welcome the outcome of a true longitudinal study--would the glaucoma
practitioners?  Also, in 20 or 30 years, "current technology" will
hopefully have improved, rendering the study moot.

Third, you cite some treatment side-effects.  I had conceded that
medications were not a major concern--you can always stop taking them.
My concern was the increased risk with surgery. As for "bordering on
ignorant and obnoxious," you ask about a basis for this opinion.  Just
as you cite your own practice of "NEVER" advising that surgery is a
"walk in the park," I can only refer to my personal experiences with
medical (not just glaucoma) practitioners...obtained in Manhattan.  I
have been treated at two of the major institutions here (NYEEI and Mt
Sinai) and by two of the more renowned glaucoma specialists.  The rush
to surgery (perhaps predicated on my condition) was at breakneck speed,
and more importantly, there was absolutely and unequivocally, a
minimization of the risks involved, if even disclosed.  I declined both
a trabeculectomy  and laser surgery.  The way it is phrased by the
doctors I've seen is always, "The benefits outweigh the risks."  And
after I've told them I've decided against it, they cannot fathom why
anyone would not do as the doctor says.  I've spent futile minutes (no
MD will give you more than a few) trying to explain a benefit/risk ratio
is very subjective; the MDs will say it is objective, and say your
alternative is to go blind. [so, I will not even attempt to do that
here]  The bottom line in glaucoma cases is that the specialist can do
no more after that, as great a researcher and healer tho s/he may be.
[and if that be obnoxious, it also be the truth...further, if it be
obnoxious, it might also be that having been mistaken for being gods,
MDs are humbled and at a loss when powerless to arrest a condition]

At one of these institutions, I was also very quickly urged to join a
study.  I was not advised of the risks and only after I asked for a full
disclosure, all of the release documents and a meeting with the study
coordinator did I get all of the details.  There was IMHO far more
concern for the study and the concomitant grants than the patient.  EG I
was prescribed a medication which directly caused me a severe
side-effect.  While it may have been a rare one, I was never told of it
and I did ask.    When I told the MD of it, there was not an eyelash
batted.  There are many more indicia, that I will not go into, in my
many years of dealing with top Manhattan MDs that can render any patient
very wary of the "medical establishment."  [and again IMHO I am not as
"ignorant" an individual or patient as some would like to think, by any
criteria anyone could choose]

I really don't see how it was inferred from my post that I was decrying
pharmaceutical company kickbacks.  But forgive me if I did somehow.
What I thought I was implying was that if surgery were found useless,
then a major source of funds would be eliminated for glaucoma specialist
who I can only guess must earn 50%(?) of their income from surgery.  I
did not really think that MDs make their living by getting rebates from
drug companies.

Lastly, you refer me to the many studies available.  From what I already
know--and I'm sure someone will correct me if I'm wrong, we cannot
overlook the fact that reducing IOP is reducing a risk factor.  It is
not yet a cause-effect relationship, right?  If you lower IOP to 4 B/L,
you can still go very blind, correct?  Reducing weight, lowering
cholesterol, stopping smoking, exercising, etc, may help, but do prevent
heart attacks--these are risk factors.

I think the math I spoke of earlier was glossed over.  100 of 1000
untreated ocular hypertensives (not NTG) went on to show true glaucoma,
but 900 did not. What say you of this?  Also, this last point on risk
factor has been given short shrift. They're interrelated.  I thought
the study findings were the core of my post; I added one sentence at the
end on surgery, the fisc and egos and that becomes the focus?

xxxxxxxxxxxxxxx

my original reply FYI:

 Is this study called,

Forgive me for being a bit naive about scientific studies, but I'm not
clear on what went on in this study.  Let's just assume a few things and
if my assumptions are poor or incorrect, feel free to correct them.

Let's suppose 1000 patients made up the untreated group (U) of NTG
patients and 1000 patients were in the treated (T) group [who were also
NTG?].  What I think the study then would say is that 100 of those in
Group U went on to show true glaucoma while only 50 in Group T.  From
that one could say the number of those left untreated who went on to
show true glaucoma was twice the number of those who were treated.  In
that sense, treatment is "significant" in reducing the "risk" of
glaucomatous optic nerve damage.

What appears to be left out is the status of 900 untreated NTG patients
who did not progress.  If I'm intrepreting this correctly, one could say
an NTG patient's chances are 9 out of 10 for no progression, even if
they do not get treated.  Moreover, nothing is said about the 950
treated NTG patients who did not progress.  The odds (risks) are only
900 to 950 that a patient will avoid progression if s/he continues in
treatment as opposed to continuing to avoid treatment. [this is where my
math may falter]

If "treatment" is merely medications, then sideffects are essentially
what can go wrong. When any sort of surgery (be it laser or the true
invasive kind) is thrown in, the risks are increased--although the
medical establishment and many posters here--would have us believe there
is minimal risk in most of the procedures described and espoused here.

If there is a more current survey of those who forego surgery and
followup on them, glaucoma patients would benefit greatly--but a result
that no treatment is nearly as effective as treatment would harm the
medical fisc, not to mention egos.