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Open-Angle Glaucoma(Chronic Glaucoma; Glaucoma)
Definition

Glaucoma describes a group of eye disorders that causes damage to the optic nerve. This degenerative eye disease is one of the leading causes of chronic blindness in the US. Open-angle glaucoma is the most common form of glaucoma in the United States.

Open-angle glaucoma can often be controlled well with proper treatment, and most patients who receive treatment will maintain their vision.

Glaucoma

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Causes

Open-angle glaucoma is caused by increased intraocular pressure. Within the eye, fluid is made and then drained from the eye. If either the fluid is made too quickly (not common) or drains too slowly, then the pressure of the eye can increase, leading to damage to the optic nerve.

This damage to the optic nerve can lead to a decrease in peripheral vision and may eventually cause blindness.

Risk Factors

Glaucoma is more common in African American and Hispanic people. Other factors that may increase your chance of getting glaucoma include:

  • Family history of glaucoma
  • Glaucoma in one eye—This increases the risk of developing glaucoma in the other eye.
  • Increased intraocular pressure
  • Diabetes
  • High blood pressure
  • Injury to the eye
  • Certain eye abnormalities, such as congenital defects
Symptoms

Many patients with open-angle glaucoma experience few or no symptoms until the disease has progressed to the very late stages. Other symptoms may include:

  • Loss of peripheral vision
  • Tunnel vision
  • Blindness
Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Eye exam with pupil dilation
  • Tonometry —a test to determine intraocular pressure
  • Visual field test to determine vision loss
  • Slit lamp examination—the use of a low-power microscope combined with a high-intensity light source, allows a narrow beam that can be focused to examine the front of the eye
  • Photographs of the optic nerve
  • Gonioscopy—to examine the outflow channels of the angle
  • Analysis of the nerve fiber layer around the optic nerve
Treatment

The goal of treatment is to reduce intraocular pressure. Talk with your doctor about the best treatment plan for you. Options include:

  • Medications—Eye drops, and rarely pills, are often administered to reduce intraocular pressure.
  • Laser treatment—Laser treatment may be used to reduce intraocular pressure in some people.
  • Surgery—Surgery may be done to open a new outflow channel from the eye.
Prevention

Open-angle glaucoma can't be prevented. Regular eye exams are important to screen for eye conditions such as glaucoma.

RESOURCES:

The Glaucoma Foundation
http://www.glaucomafoundation.org

Glaucoma Research Foundation
http://www.glaucoma.org

CANADIAN RESOURCES:

Glaucoma Research Society of Canada
http://www.glaucomaresearch.ca

The Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

Distelhorst J, Hughes G. Open-angle glaucoma. Am Fam Physician. 2003;67(9):1937-1944.

Facts about glaucoma. National Eye Institute website. Available at: http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp. Accessed July 17, 2014.

Open-angle glaucoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 16, 2014. Accessed July 17, 2014.

Vision screening recommendations for adults 40 to 60. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/midlife-adults-screening.cfm. Accessed July 17, 2014.

Vision screening recommendations for adults over 60. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/seniors-screening.cfm. Accessed July 17, 2014.

Vision screening recommendations for adults under 40. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/living/young-adults-screening.cfm. Accessed July 17, 2014.

Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet. 2004;363:1711.

What is glaucoma? American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm. Updated September 1, 2013. Accessed July 17, 2014.

What is glaucoma? Glaucoma Research Foundation website. Available at: http://www.glaucoma.org/glaucoma. Accessed July 17, 2014.



Last reviewed June 2014 by Eric Berman, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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