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Info centre > Posterior & retinal pathology
Open Angle Glaucoma

Primary Open-Angle Glaucoma (POAG)

Primary Open-Angle Glaucoma is a chronic eye disease where the optic nerve is damaged due to an intolerance to the pressure inside the eye (intraocular pressure). Known as the "silent thief of sight," it progresses slowly and painlessly, often without noticeable symptoms until significant damage has occurred.

The Silent Progression

Vision Loss

Peripheral Vision Loss

Vision loss typically starts with the side (peripheral) vision. Because central vision remains clear until the late stages, many people do not realize their sight is failing.

No Pain

Asymptomatic Nature

In its early stages, POAG causes no pain, redness, or obvious warning signs. Blind spots develop gradually, making regular eye exams the only way to detect the disease early.

Critical: Vision lost to glaucoma cannot be regained. Early detection and adherence to treatment are the only ways to preserve your remaining sight.

Causes and Risk Factors

While elevated intraocular pressure (IOP) is a major cause, several other factors increase your risk:

Risks
  • - Age: Risk increases significantly after age 40, and even more so after 60.
  • - Family History: Having a close relative with glaucoma increases your risk by 4 to 9 times.
  • - Ethnicity: African American and Latino populations are at a higher risk of developing the disease.
  • - Medical Conditions: Diabetes, hypertension, and high myopia (nearsightedness).
  • - Thin Corneas: Corneas thinner than 0.5 mm are a known risk factor.

Diagnosis and Monitoring

Because there is no cure, lifelong monitoring is required to slow or halt progression. Recommended exam frequency:

  • - Under 40: Every 2–4 years
  • - 40–54: Every 1–3 years
  • - 55–64: Every 1–2 years
  • - 65+: Every 6–12 months

Monitoring typically includes Intraocular pressure checks every 6 months and annual visual field testing.

Treatment Options

The primary goal is to lower intraocular pressure (IOP) to prevent further optic nerve damage.

1. Medications (Topical Therapy)

Most treatments begin with once-nightly eye drops such as Prostaglandin analogues or Beta-blockers. These are highly effective but must be used exactly as prescribed to work.

2. Laser and Surgical Therapy

If medications are insufficient, Laser Therapy can help improve fluid drainage. For advanced cases, surgical procedures like a trabeculectomy or drainage implants may be necessary to create new drainage pathways.

Clinical References

1. Glaucoma Research Foundation. Open-Angle Glaucoma Overview. Available at: https://www.glaucoma.org
2. The Glaucoma Foundation. Understanding POAG.
3. All About Vision. Glaucoma: Symptoms, Causes, and Treatments.
4. Stat: Over 3 million Americans have glaucoma; only half are aware they have it.