Sir,

We thank the respondents for their helpful discussion concerning Cross et al.1 We fully endorse all their comments regarding the need to optimise utilisation of primary eye-care services by the community they serve. In our paper, we focused on the problems perceived and experienced by younger members of the African Caribbean community in an area of profound social deprivation in inner city Birmingham. The key to early glaucoma detection is to set up a community-based case-finding system, accessible and acceptable to the entire local community, which takes proper account of the need for culturally sensitive service delivery. There is a high prevalence of blinding disease in young African-Caribbeans, and the system must be responsive to the particular needs of this young working constituency.