Primary open angle glaucoma


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Primary open angle glaucoma is an optic nerve damage syndrome associated with an open anterior chamber angle, which is associated with elevated or sometimes only moderate intraocular pressure.

The main symptoms of the disease include the gradual changes in vision. Unfortunately, the primary glaucoma of an open angle is an incredibly insidious disease, and often does not show any signs until it is in a very advanced stage.

Causes of primary open angle glaucoma

Primary open-angle glaucoma is the most common type of glaucoma, affecting even one in 200 people over the age of 40. The risk factors for this kind of eye disease include:

  • older age – after 40 years old,
  • cases of the disease occurring in the family – is a disease can be inherited,
  • high intraocular pressure,
  • low blood pressure,
  • diabetes,
  • myopia and similar eye diseases,
  • narrowing of the cornea,
  • diseases of the retina,
  • disorders of the cardiovascular system involving hypoxia in the vicinity of the optic nerve,
  • ethnic origin – the population of black people are at increased risk of disease.

Primary open angle glaucoma can occur as a result of high intraocular pressure, but it also applies to cases where it is moderate.

Doctors point to two theories about what may be the basis for the mechanisms of the development of optic nerve damage:

  • Ischemic theory – talk about disorders due to problems with blood circulation and microvascular impairment within the optic nerve;
  • Theory of mechanical damage – when long-term intraocular pressure exerts pressure on the nerve fibers causing them to disappear, collapse and ischemia.

The symptoms of primary open angle glaucoma

The early symptoms of primary open angle glaucoma are very rare. Usually, patients begin experiencing visual impairment when optic nerve atrophy is present. Often, however, they can feel the limitation of the field of view (no view on the sides), problems with vision while driving or reading. The disease mainly affects the elderly, especially men, gradually increasing the defects in the field of view.

Primary glaucoma develops in both eyes, but the process is uneven. Dropouts view appearing in one of the eyes around the nasal quadrants, often superimposed on the area of the field of vision in the other eye, which in the early stages of the disease is not detected and is diagnosed only in very advanced stages.

The main symptoms of primary glaucoma include:

  • vision problems – the sensation of seeing through the fog, seeing the rainbow wheel, in particular in the area of light sources,
  • headaches, eye aches, and pains in their surroundings,
  • tearing eyes,
  • problems with the selection of appropriate glasses as a result of ongoing changes in the optical system.

Stages of primary open-angle glaucoma

Because primary open angle glaucoma is a progressive disease that gradually worsens the field of vision, there are four basic stages of disease development, each of which is more advanced:

  • Stage I – enlargement of the Mariotte blind spot, the appearance of darkness in the lower or upper area of the field of vision. The problem with time is deepening, creating a big bruise of Bjerrum.
  • Stage II – narrowing of the field of view from the nasal area.
  • Stage III – the disease affects both halves from the side of the nose, gradually approaching the central field of vision, they begin to appear and the island of central vision in the temporal field of vision.
  • Stage IV – central vision disappears, only the minimal field of view in the temporal area remains.

Diagnosis and treatment of primary open angle glaucoma


Prevention and regular eye examination allows for relatively early detection of glaucoma, and thus help to carry out the appropriate treatment that will contribute to preventing irreversible changes in both anatomical and functional elements in the eye. Regular eye tests are recommended especially after the age of 40. Its time when we should examine the optic disk and intraocular pressure, which in most cases is responsible for the appearance of glaucoma.

Specific studies to help diagnose primary open-angle glaucoma include:

  • gonioscopy,
  • visual acuity for far and nearsightedness,
  • examination of the anterior wall of the eye,
  • tonometry,
  • examination of the field of vision,
  • analysis of the vascular bundle and eye shield,
  • examination of the fundus and the width of the neural retinal ring.

Treatment of the disease depends on the stage of development of the disease, but it requires compliance with medical advice and frequent checkups. Open primary glaucoma can only be treated on the principle of inhibiting the progression of optic nerve damage so as to maintain the best possible visual acuity.

It is important to control intraocular pressure, inhibit the development of the disease or maximize it’s slowing down. The main methods of primary open-angle glaucoma treatment include:

  • laser treatment – trabeculoplasty,
  • pharmacological treatment,
  • surgical treatment.

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