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Everything You Need to Know About Open-Angle Glaucoma

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Written by- Gina Walters
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Glaucoma is the primary cause of vision loss and blindness, affecting nearly 2.5 million people in the U.S.

Open-Angle Glaucoma is the most common form of the condition. 

It typically occurs due to elevated eye pressure but can often go undiagnosed and worsen the symptoms. 

People with a family history of Glaucoma, Diabetes, or severe Myopia are more prone to Open-Angle Glaucoma.

Also, African and White populations over 40 years are more likely to develop Open-Angle Glaucoma. 

You may go years without realizing you have it since Open-Angle Glaucoma develops gradually without any pain. 

Although the disease can not be treated, eye drops and laser surgery can aid in reducing the progression of Open-Angle Glaucoma.

This article will highlight the symptoms, causes, and treatment of Open-Angle Glaucoma.

Open-Angle Glaucoma causes

The exact cause behind Open-Angle Glaucoma is not well-defined.

However, experts believe that poor drainage system of your eyes could be the probable cause.

Your eyes continuously secrete a fluid known as aqueous humor to keep themselves moist.

Upon the production of new fluid, old fluid has to drain out of the eyes through a drainage angle to keep intraocular pressure balanced.

A blockage or other issue at a deeper level of this drainage system could be a cause behind Open-Angle Glaucoma. 

Another possibility is that an excess of fluid in your eye is creating an outflow issue. 

Both result in a slower rate of fluid drain, increasing the pressure inside your eye.

Most of the time, it’s unclear what’s producing the extra fluid in your eye or what’s clogging it.

Over time, the increased eye pressure can damage the optic nerve that sends signals to your brain, eventually leading to blindness or vision loss.

Protect your sight from getting damaged from Glaucoma. Read our article: Understanding Glaucoma: Causes, Symptoms, Diagnosis, and Treatment, to learn more about Glaucoma

Glossary:
Drainage angle is the area formed at the intersection of your eye’s colored part, iris, and the clear cornea from which the fluid comes out.It resembles a strainer with a network of small holes leading to drain pipes underneath.

Open-Angle Glaucoma symptoms

Blurry-visionSource: piotr_malczyk
Blurry vision(Symptom)

Open-Angle Glaucoma does not show any symptoms initially; thus, many people are unaware that they have the condition.

Since this form of Glaucoma often affects peripheral vision first, the unaffected eye may be able to compensate for the visual loss in the affected eye.

This gives a false indication that there is no visual loss occurring.

But eventually, both eyes start to suffer. 

The loss of vision becomes apparent only when around 40% of the optic nerve fibers are destroyed.

Afterward, you could notice missing letters in words when reading, or you might miss a stair when you walk. 

Here the central field vision is usually the last one to suffer any damage.

Considering using Glaucoma eye drops to protect your vision loss? Read our article: Understanding Glaucoma Eye Drops: Types, Uses, and Side Effects, to know more.

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  • Risk factors of Open-Angle Glaucoma

    Although the increased eye pressure (intraocular pressure) is considered the cause behind Open-Angle Glaucoma, several other risk factors make you prone to the condition.

    You are more likely to get Open-Angle Glaucoma if you:

    Want to know more about different types of Glaucoma? Read our article: Different Types of Glaucoma: A Guide to Causes and Treatment

    Suggestion:
    Get your eyes checked regularly for Glaucoma if any of your family members have the condition.

    Open-Angle Glaucoma treatment

    Laser eye surgerySource: bojanstory_from_Getty_Images
    Laser eye surgery

    Although the damage to the optic nerve and the resulting visual issues are irreversible, the progression of Open-Angle Glaucoma can be slowed with proper diagnosis and treatment.

    The aim of treatment is to lower eye pressure (Intraocular Pressure) using laser therapy, medication, or surgery, thereby reducing intraocular pressure by 20 to 40 percent. 

    Medications

    To lower intraocular pressure, Glaucoma eye drops—often generic beta-blockers or prostaglandin analogs like Latanoprost and Bimatoprost are typically the first line of treatment. 

    Prostaglandins improve the outflow of the retained liquid from the eyes, whereas beta-blockers aim to reduce the production of fluid within the eyes.

    Other medications like carbonic anhydrase inhibitors, cholinesterase agonists, and cholinesterase inhibitors are often prescribed along with eye drops to treat the condition.

    Also, oral osmotic diuretics such as mannitol may be recommended to treat Open-Angle Glaucoma.

    Know about the Glaucoma medicines to avoid with our article: Glaucoma Medications to Avoid: What You Need to Know

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    Laser surgery

    Selective Laser Trabeculoplasty (SLT) is often recommended for patients who do not respond to medications.

    According to the Glaucoma Research Foundation, this procedure is quite effective for patients who are already on some eye drops.

    The surgery involves the use of laser light that causes a chemical shift in the eye tissue.

    This, in turn, leads to better fluid drainage within your eye.

    As a result, your eye’s internal pressure may drop by 20 to 30 percent.

    Approximately 80% of patients found SLT effective, and the results usually last for three to five years.

    Surgery

    Laser Trabeculoplasty and Trabeculectomy are the most commonly performed surgeries to treat Open-Angle Glaucoma.

    Laser Trabeculoplasty: For individuals who do not respond well to eye drops, Laser Trabeculoplasty may be the initial surgical choice. 

    This is also recommended in the case when eye drops have effectively lowered intraocular pressure without stopping optic nerve degeneration.

    In these treatments, the trabecular meshwork’s drainage is enhanced by the use of a laser.

    Trabeculectomy: Patients whose Open-Angle Glaucoma has not improved with eye drops or Trabeculoplasty may consider this alternative. 

    By creating a tiny passage between the conjunctiva and the front of the eye, this treatment enables the drainage of excess fluid from the eyes into the blood circulation.

    This further aids in lowering intraocular pressure.

    Warning:
    Prolonged and increased alcohol intake may affect your eyes, leading to the development of Open-angle Glaucoma. Consult your doctor if you are worried about your sight.

    Conclusion

    Open-Angle Glaucoma is the most prevalent form of Glaucoma, affecting most of the population in the U.S.

    Increased intraocular pressure is the major cause of Open-Angle Glaucoma; however, several other risk factors make you more susceptible to this eye condition.

    Untreated Open-Angle Glaucoma may result in permanent vision loss or perhaps blindness. 

    Your doctor may recommend eye drops like prostaglandin analogs and beta-blockers to reduce eye pressure to slow down the progression of Open-Angle Glaucoma.

    If medications do not work for you, the doctor may recommend laser treatment and surgery like Laser Trabeculoplasty and Trabeculectomy to treat the condition.

    Frequently Asked Questions

    What medications affect Open-Angle Glaucoma?

    Intake of corticosteroids and medications for Hypertension makes you more prone to Open-Angle Glaucoma.

    What causes Open-Angle Glaucoma?

    Open-Angle Glaucoma occurs when the drainage channels in your eyes become more resistant. 
    However, they seem open and operating correctly. 
    Your optic nerve may experience increased pressure from the accumulation of fluid in your eye over months or years. 
    This, in turn, leads to vision loss or blindness.

    How bad is Open-Angle Glaucoma?

    Open-Angle Glaucoma can lead to progressive vision loss if not diagnosed and treated on time. 
    This kind of Glaucoma can progress slowly for years before causing any discernible vision loss.

    What is the pressure range for Open-Angle Glaucoma?

    A book published by Statpearls mentions that the pressure range for Open-Angle Glaucoma is below 22 mm of Hg.

    Who is at risk for Open-Angle Glaucoma?

    People above 40 years of age and members of African-American and Hispanic racial communities are at more risk of getting Open-Angle Glaucoma.
    Also, people with a family history of Glaucoma and having undergone any eye surgery are more likely to develop the disease.

    How is Open-Angle Glaucoma diagnosed?

    Open-angle Glaucoma is usually diagnosed with a thorough eye examination.
    To diagnose Open-Angle Glaucoma, your doctor may perform Glaucoma tests like Ophthalmoscopy, Gonioscopy, visual field examination, and measurement of central corneal thickness and intraocular pressure.

    Is Open-Angle Glaucoma painful?

    No, Open-Angle Glaucoma is not painful. 
    The intraocular pressure of many individuals with Open-Angle Glaucoma rises gradually over time, and since this change is slow, there is no frequent eye pain.

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