The investigators' perspective on the Collaborative Initial Glaucoma Treatment Study (CIGTS).

I N THE LATE 1980S, AN INFORMAL DIALOGUE BEgan between two University of Michigan senior faculty members: one, a glaucoma specialist, and the other, an expert in health behavior. The glaucoma specialist noted that many of his patients who needed a glaucoma-filtering surgery reported how much better they felt following surgery, because their glaucoma medications were no longer needed. A study was suggested to the health behavior expert wherein patients needing glaucoma-filtering surgery would be given a quality of life (QOL) questionnaire preoperatively and then another postoperatively to assess any differences. It was hypothesized that surgery should be offered sooner rather than later in the course of treating glaucoma to improve QOL by reducing the side effects commonly reported with glaucoma medications. But the health behavior expert instead suggested a more rigorous study that would involve patients with newly diagnosed glaucoma being randomized to initial treatment with medications or filtering surgery, with QOL instruments used