GLAUCOMA, OPEN-ANGLE

 Basic information

description

Glaucoma is a group of disorders that lead to damage to the optic nerve (the nerve connecting the eye to the brain). Open-angle glaucoma is the most common type of glaucoma. It typically occurs in both eyes and is a chronic, progressive condition that can lead to loss of vision. It affects all ages, but is diagnosed more often in older adults. It is often referred to as chronic open-angle glaucoma (COAG) or primary open-angle glaucoma (POAG). It is called secondary open-angle glaucoma when a known cause is found (such as an eye injury).

FREQUENT SIGNS & SYMPTOMS

• Usually, there are no warning symptoms.
• Later stages of the disease include loss of peripheral vision in small areas, blurred vision, halos around lights, blind spots, and poor night vision.

causes

• The exact cause of optic nerve damage in open-angle glaucoma is not certain. Increased internal eye pressure (intraocular pressure or IOP) is the main factor. IOP is maintained by a balance of fluid (aqueous humor) that flows into the front of the eye and then drains out. For unknown reasons, the drains become clogged or too much fluid is produced. The fluid builds up over time and eye pressure (IOP) increases. This causes damage to the optic nerve, which leads to vision loss.
• In some cases, the IOP remains normal, but optic nerve damage occurs due to decreased blood flow. This is called normal tension glaucoma.

risk increases with

• History of increased intraocular pressure.
• Adults over 45.
• Family history of glaucoma.
• Certain medical conditions (e.g., diabetes and high blood pressure).
• Myopia (nearsightedness).
• Previous eye injury or other eye disorders.
• Regular, long-term steroid use.
• African Americans over age 40.

PREVENTIVE MEASURES

• Get regular eye exams. Your eye care provider will recommend a routine depending on your age, general health, and your risk factors for eye problems.
• Get medical care for any changes in your vision.

expected outcomes

The disorder can usually be controlled with treatment to prevent further vision loss.

possible complications

Optic nerve damage that cannot be reversed. A permanent vision loss can occur.

 diagnosis & treatment

general measures

• An eye exam is usually done by an eye doctor (ophthalmologist). It includes a tonometry exam (measures pressure within the eyeball) and visual field test (to see how your vision is affected). An ophthalmoscope is used to see into the eye to view the optic nerve. A person has glaucoma if their eye exam shows changes to the optic nerve and blind spots.
• There is no cure. The goal is to protect the optic nerve from future damage and possible loss of vision. Treatment may include drug therapy, laser surgery, eye operations, or a combination of methods.
• Laser surgery can help improve the draining of the excess fluid. Other eye surgery may be done to open up the draining area and relieve pressure.
• To learn more: Glaucoma Foundation, 80 Maiden Lane, Suite 700, New York, NY 10038; (800) 452-8266; website: www.glaucomafoundation.org.

medications

One or more types of eye drops to lower pressure inside the eye will be prescribed. Follow the instructions and schedule carefully, even if symptoms improve. If eye drops do not control the pressure, oral drugs (taken by mouth) will usually be prescribed.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of chronic glaucoma.
• Any sign of eye infection develops.
• Pain begins in the eye.
• Redness occurs in the eye.
• Vision changes suddenly.

Special Notes: