Glaucoma: classification and terminology. Critical remarks

Clinical classification schemes are never static. As new knowledge accumulates — whether in pathogenesis, diagnostic improvements, novel treatment approaches, monitoring, or rehabilitation — there arises a need to refine the logical principles underlying classification.Nearly half a century has passed since the adoption of the current classification of primary open-angle glaucoma proposed by A.P. Nesterov and A.Ya. Bunin. During this time, significant advancements have been made: new insights into the pathogenesis of primary glaucoma have emerged, in vivo morphological assessment of certain structures has become possible, enhancing diagnostic capabilities; and new terminological constructs have appeared, requiring well-founded interpretation or serving as grounds for scientific discussion. These developments provide a basis for substantive revisions to the existing classification.The primary focus of this discussion is a clinical subtype of primary open-angle glaucoma — normal (low-) tension glaucoma. This article is dedicated to its reconsideration.