Open-angle Glaucoma: What Exactly Is It?

Open-angle glaucoma can lead to blindness if it is not treated in time. The real problem, however, is that it doesn’t always cause symptoms and can therefore go unnoticed for a long time.

Open Angle Glaucoma: What Exactly Is It?

Open-angle glaucoma is an eye disease that can lead to blindness. It causes damage to the optic nerve that leads to loss of vision in the field of vision. In addition, in many cases there is increased eye pressure.

Although there are both open-angle glaucoma and narrow-angle glaucoma, the former is the most common. Experts estimate that it accounts for 90% of the cases. This type of glaucoma is the second or fourth most common cause of blindness worldwide. The numbers vary by region.

Open-angle glaucoma is also known as primary or chronic glaucoma. It is a progressive disease that may not cause symptoms and therefore often goes unnoticed for a long time.

The possible causes of open-angle glaucoma

In most cases, open-angle glaucoma occurs when the drainage channels in the eye become blocked.  This leads to increased intraocular pressure and damage to the optic nerve.

The eye’s drainage system forms an angle from the iris to the cornea. From there it is connected to the outside world by canals. Open-angle glaucoma prevents fluid from flowing out of the eye properly because the ducts are either blocked or narrowed.

Since the fluid cannot drain outwards , the pressure in the eye increases, which damages the optic nerve.  This affects the patient’s vision.

In addition, some people’s optic nerves are more prone to increased intraocular pressure. Africans, for example, are at higher risk of developing this disease, as are people over the age of 60, especially those of Latin American origin, with a family history or those who suffer from diabetes.

Open angle glaucoma - person measures blood sugar level

The main symptoms

Open-angle glaucoma develops very slowly and often goes unnoticed for a long time.  In most cases, those affected only notice that something is wrong when they lose sight. At this point, however, the optic nerve is already severely damaged.

Those affected initially lose their peripheral or side vision. When the disease is very advanced, it also affects visual acuity. The disease is usually diagnosed during a routine examination.

How is open angle glaucoma diagnosed?

Open-angle glaucoma should ideally be detected early, before the damage to the optic nerve has progressed. Therefore, regular eye exams are recommended to get a timely diagnosis. If you belong to a risk group, you should get regular checkups.

Ideally, you should increase the frequency of check-ups as follows:

  • Before the age of 40.  One check-up every two to four years.
  • Between the ages of 40 and 54.  Once a year or once every three years.
  • Between 55 and 64 years.  Once a year or once every two years.
  • From the age of 65.  Once every six months or once a year.

Ophthalmologists can perform various tests to determine if a person has open-angle glaucoma. The most common testing procedures are as follows:

  • Tonometry. This test measures intraocular pressure, or intraocular pressure.
  • Ophthalmoscopy. The ophthalmologist can use it to look into the fundus and examine the optic nerve to identify possible damage.
  • Perimetry. A visual field test. Doctors can use it to determine if, and to what extent, open-angle glaucoma is affecting a patient’s vision.
  • Gonioscopy. It can be used to determine whether the angle between the iris and the cornea is open and wide or narrow and closed.
  • Pachymetry.  This test measures the thickness of the cornea of ​​the eye.

Ophthalmologists can either order and perform all of these tests or just some of them. However, you should know that open-angle glaucoma is not always easy to diagnose.

Treatment options

Open angle glaucoma - woman with one eye
Laser surgery is one of the current treatment options for open-angle glaucoma and other visual disorders.

Treatment for open angle glaucoma focuses on reducing pressure inside the eye. But there is no way to repair the damage to the optic nerve. This is why early diagnosis and treatment is so important.

There are three therapeutic strategies:

  • Drug treatment, usually in the form of eye drops. These ensure that the eyes produce less fluid or that fluid drainage is increased.
  • Laser treatment. This type of surgery helps the eyes to better drain fluids or to reduce fluid production in the eyes. It is an outpatient surgical procedure that usually helps lower pressure in the eye.
  • Conventional surgery. In this case, surgeons will redirect the fluid to correct a malfunction in the drainage system. In addition, the surgeons can also build new drainage channels.

Open-angle glaucoma is not always treated in the same way

The decision on the best treatment will depend on the condition of the optic nerve and the general health of the patient. Therefore, your ophthalmologist will talk to you about the advantages of each alternative and, depending on the individual case, recommend the most suitable method for you.

In addition, you should know that patients undergoing conventional or laser surgery may in many cases need to take medication later. Because the positive effects of the operation can wear off after a while.

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