The feature lineup in this year's Annual Glaucoma Issue re­flects a reality that becomes clearer every year. The glaucomas may be the least understood and most challenging diseases that ophthalmologists face. For each new research advance, for each new surgical technique or new drug developed, there seem to be two steps to the side and one to the rear.

Even with an annual issue devoted to reporting advances in combating glaucoma, big-picture pro­gress and can sometimes get lost in the shuffle. It may easy to forget that just a few years ago, there were no OHTS results providing de­finitive data on treatment benefits. The confounding role of central cor­neal thickness was just theoretical. For the most part, though, as elsewhere in me­dicine, it's small steps that define progress in this battle.

In that regard:

• Chris Kent reports this month (p. 38) on the ever-elusive grail of glaucoma progression software. Are we there yet? In terms of detection, no. But there are good reasons to believe that the newest software can be an integral part of the management of glaucoma.

• Dr. Lama Al-Aswad reports (p. 60) on cases in which Avastin, a cancer drug widely used off-label in retinal disease, appears to benefit cases of anterior segment neovascularization that can lead to glaucoma.

• Dr. Stan Berke provides (p. 66) what many surgeons have been awaiting for a long time: long-term data from a large trial on the benefits of endocyclo­photocoagulation, in this case, in cat­aract patients on medically controlled glaucoma.

 • Drs. Jim Tsai and M.A. Karim share the latest thinking (p. 54) on normal-tension glaucoma, whose very definition is still being debated.

 • Walt Bethke rounds up (p. 46) leading glaucoma specialists for an in-depth anal­ysis of the state of combined cataract and glaucoma filtration procedures and concludes … it all depends.

Clearly there's a long, long way to go even in defining and understanding, let alone treating, the glaucomas. But it's worthwhile to acknowledge the evidence that for all of the steps involved, we're moving forward.