Open-angle glaucoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan Bir Singh, M.B.B.S.[2]

Classification

Open-angle Glaucoma
Primary open-angle glaucoma (POAG) (H40.11)	not associated with known ocular or systemic disorders that cause increased resistance to aqueous outflow or damage to optic nerve usually associated with elevated IOP
Normal-tension glaucoma (H40.12)	considered in continuum of POAG; often used when IOP is not elevated
Juvenile open-angle glaucoma	used when open-angle glaucoma diagnosed at young age (typically 10-30 years of age)
Glaucoma suspect (H40.0)	normal optic disc and visual field associated with elevated IOP suspicious optic disc and/or visual field with normal IOP
Secondary open-angle glaucoma	increased resistance to trabecular meshwork outflow associated with other conditions (e.g. pigmentary-, phacolytic-, steroid-induced-) increased posttrabecular resistance to outflow secondary to elevated episcleral venous pressure (e.g. carotid cavernous sinus fistula)

Epidemiology and Demographics

Primary open-angle glaucoma (POAG) poses a significant public health problem. The estimated prevalence of POAG in the United States in individuals older than 40 years is 1.86% (95% confidence interval, 1.75%–1.96%), based on a meta-analysis of population-based studies. Applied to data from the 2000 US census, this percentage translates to nearly 2.22 million Americans affected. The number of POAG patients is estimated to increase by 50%, to 3.36 million in 2020.

The World Health Organization (WHO) undertook an analysis of the literature to estimate the prevalence, incidence, and severity of the different types of glaucoma on a worldwide basis. The data collected predominantly in the late 1980s and early 1990s, it was estimated the global population of persons with high IOP (>21 mm Hg) to be 104.5 million. The incidence of POAG was estimated at 2.4 million persons per year. Blindness prevalence for all types of glaucoma was estimated at more than 8 million persons, with 4 million cases caused by POAG. Glaucoma was theoretically calculated to be responsible for 12.3% of blindness. This makes glaucoma the second leading cause of blindness worldwide, following cataract.

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1