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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Chronic Glaucoma; Primary Open-angle Glaucoma, POAG, Glaucoma)

Definition

Glaucoma is a groups of eye diseases that can damage the eye nerve. Damage to the nerve can lead to poor eyesight and blindness. Open-angle glaucoma is the most common type.

Early treatment can improve outcomes.

Glaucoma
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Causes

Fluid is made inside the eye. Glaucoma is caused by fluid that drains too slowly. This can increase pressure in the eye and damage the eye nerve.

Risk Factors

Open-angle glaucoma is more common in older adults. It is also more common in people of African and Hispanic descent.

Other things that may raise the risk are:

Symptoms

Open angle glaucoma may not have symptoms in the early stages. When symptoms happen, they may be:

  • Problems driving at night
  • Problems seeing things that are close up
  • Reading more slowly than usual

Diagnosis

The eye doctor will ask about symptoms and health history.

An eye exam will be done. Tests will include:

  • Tonometry—to measure eye pressure
  • Visual field test—to see if there is vision loss
  • Imaging of the eye nerve and other parts of the eye—to check for damage
  • Pachymetry—to check the thickness of the cornea (clear dome over the eye)
  • Gonioscopy—to see if fluid channels in the eye are open or closed

Treatment

The goal of treatment is to lower eye pressure. The doctor will watch for changes over time. Options are:

  • Eye drops—to reduce the fluid the eye makes or increase the flow of fluid
  • Laser treatment—to increase the flow of fluid
  • Minimally invasive glaucoma surgery (MIGS)—to drain fluid using stents, bypasses, or implants
  • Other surgery to drain excess fluid from the eye

Eyesight problems can be stressful. Care may include counseling and support groups.

Prevention

There are no guidelines to prevent open-angle glaucoma.

RESOURCES

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

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

CANADIAN RESOURCES

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

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

References

Eye health information for adults 40 to 60. American Academy of Ophthalmology Eye Smart website. Available at: https://www.aao.org/eye-health/tips-prevention/midlife-adults A. Accessed July 29, 2019.

Eye health information for adults over 60. American Academy of Ophthalmology Eye Smart website. Available at: https://www.aao.org/eye-health/tips-prevention/seniors. Accessed August 9, 2021.

Primary open-angle glaucoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-open-angle-glaucoma . Accessed August 9, 2021.

What is glaucoma? American Academy of Ophthalmology website. Available at: https://www.aao.org/eye-health/diseases/what-is-glaucoma . Accessed August 9, 2021.

What is glaucoma? Glaucoma Research Foundation website. Available at: https://www.glaucoma.org/glaucoma/. Accessed August 9, 2021.

8/9/2017 DynaMed Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T919533/Surgical-procedures-for-primary-open-angle-glaucoma : Manasses DT, Au L. The new era of glaucoma micro-stent surgery. Ophthalmol Ther. 2016;5(2):135-146.

8/9/2021 DynaMed Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114157/Primary-open-angle-glaucoma : Wang S, Liu Y, et al. Hypothyroidism as a risk factor for open angle glaucoma: A systematic review and meta-analysis. PLoS One. 2017 Oct 25;12(10):e0186634.

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