Primary open angle glaucomaPrimary open angle glaucoma is the most common type of glaucoma. It is a progressive optic neuropathy that is associated with elevated intraocular pressure, progressive cupping or changes of the optic disc and visual field loss. There is painless gradual loss of vision especially the peripheral vision. It is usually bilateral or in both eyes but it can be asymmetrical.The angle is grossly opened on gonioscopy and looked healthy but microscopically there is resistance of the outflow of aqueous humor through trabecular meshwork which leads to decrease in drainage and increase in intraocular pressure.
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Glaucoma risk factors:1- Age: It occurs mainly in old age group, most commonly after the age of 60. It can occur at younger age in African American2- Race: It occurs more in African Americans than white. It occurs at younger age and will be more severe. The incidence of blindness will increase in this group 3- Family history of glaucoma: glaucoma may have genetic link. The risk of developing glaucoma will increase when there is family history of glaucoma 4- Medical conditions: Diabetic mellitus will increase the risk of it. High Blood pressure will increase also the risk of it, especially when it occurs with decrease in nocturnal blood pressure due to antihypertensive medications overdose which leads to ischemic damage to optic nerve..Migraine can also be a risk factor for glaucoma 5- Myopic patient: high incidence in patient with high myopia. 6- Central retinal vein occlusion (CRVO): Patient with CRVO will be at high risk for POAG and also patient with POAG will be at risk to develop CRVO. 7- Steroid use: the more duration and amount of the use of topical steroid, the higher the incidence of glaucoma. 8- Thin cornea. Thin cornea will underestimate IOP measurements and also eyes with thin cornea will be more susceptible to glaucoma Signs and symptoms of open angle glaucoma:Symptoms of glaucomaPrimary open angle glaucoma is a chronic disease and usually asymptomatic unless it is advanced1- It is painless condition 2- Gradual loss of peripheral vision 3- In advanced stages, more optic nerve fibers are damaged. This will lead to tunnel vision in which there is complete loss of vision except at the center of visual field 4- Total blindness in severe advanced cases Signs of glaucoma1- High intraocular pressure 2- Deep anterior chamber 3- Normal and open angle which can be examined by gonioscopy 4- Abnormal optic disc vs cup ratio in which the higher the cup to disc ratio, the higher suspicion of glaucoma These signs usually be helpful to differentiate between open angle glaucoma and angle closure glaucoma which have shallow anterior chamber and narrow angle
From primary open angle glaucoma to glaucoma main page Diagnosis of glaucoma Types of glaucoma Steriod induced glaucoma Normal pressure glaucoma Angle closure glaucoma Types of angle closure glaucoma Narrow angle glaucoma Pupillary block Pupillary block causes Phacomorphic glaucoma Other types of glaucoma Congenital glaucoma Malignant glaucoma Glaucoma treatments Eye drops for glaucoma Oral medications for glaucoma Glaucoma laser treatments Glaucoma surgical operation
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