Open Angle Glaucoma: Treatment, Signs and Symptoms, Medications, Blindness And More

Jan 8, 2023
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Glaucoma is an eye disease that can damage the optic nerve in the eye. The optic nerve is responsible for capturing the visual details and sharing them with your brain. Glaucoma causes increased pressure inside your eye (increased intraocular pressure), which in turn damages the optic nerve. If untreated, this may lead to loss of vision or blindness. However, if you start treatment early, you may be able to prevent vision loss and slow the progression of the disease.

Glaucoma can be classified into various types. The two most common types of glaucoma are:

  • Open-angle glaucoma 
  • Acute angle-closure glaucoma (also known as narrow-angle closure glaucoma)

This article will discuss open-angle glaucoma, its symptoms, and treatment options. To know more, keep reading the article.

What is open angle glaucoma?

Open-angle glaucoma is the most common form of glaucoma. With this type of glaucoma, fluid builds up in the eye because the “drain” for fluid (called the trabecular meshwork) is partially blocked. This results in an increase in pressure (intraocular tension). The increase in intraocular pressure causes damage to the optic nerve. Open-angle glaucoma slowly progresses with time, and most people don’t have any symptoms until a large portion of their optic nerve is already damaged.

What is the difference between open and closed-angle glaucoma?

Open-angle glaucoma makes up 90% of all glaucoma cases. In open-angle glaucoma, the “drain” for fluid in the eye  is partially blocked. This results in a build-up of fluid which in turn increases the intraocular pressure. The increase in intraocular pressure causes damage to the optic nerve.

Closed-angle glaucoma, which is commonly known as narrow-angle glaucoma, is caused by complete blockage of drainage canals in the eye. The blockage results in a sudden rise in pressure in the eye (intraocular pressure). Narrow-angle closure glaucoma is more rare. It can develop quickly and requires immediate medical treatment.

Can open-angle glaucoma be cured?

Open-angle glaucoma usually occurs in both eyes and worsens with time. There is no cure for it; however, if detected early, the progression of the disease can be slowed or delayed.

What is the treatment for open-angle glaucoma?

Damage to the optic nerve caused by glaucoma is irreversible. The best way to prevent vision loss is regular eye checkups. With regular check-ups, your doctor can start treating high intraocular pressure before you have any symptoms.

Depending on the progression of the disease, your treatment options may include any of the following: 

  • Eyedrops: The treatment of glaucoma often begins with eye drops. These are used to reduce eye pressure and help in improving the fluid drainage in your eye by decreasing fluid production. The medications may include: 
    • Beta-blockers, e.g. timolol (these medications decrease the production of fluid in your eye)
    • Carbonic anhydrase inhibitors e.g. dorzolamide, brinzolamide (these medications decrease the production of fluid in your eye)
    • Alpha-adrenergic agonist e.g. brimonidine (these medications reduce the production of aqueous humor and increase the outflow of the fluid in your eye)
    • Rho-kinase inhibitors e.g. netarsudil (these medications decrease the eye pressure by inhibiting rho kinase enzymes, which is responsible for an increase in fluid)
    • Prostaglandins e.g. latanoprost, travoprost ( these medications increase the outflow of the fluid in your eye, which helps in reducing the eye pressure) 
    • Cholinergic agents e.g. pilocarpine (these medications increase the outflow of the fluid from your eye)
  • Oral medications e.g. acetazolamide (these agents reduce eye pressure in emergency situations when eye drops cannot be used)
  • Surgeries (various laser therapy and surgical procedures intended to improve the drainage of eye fluid and reduces eye pressure are used when medications fail to do so)

Depending on your condition and eye pressure, one or more treatment options may be prescribed.

What are the early warning signs of open-angle glaucoma?

The early stages of open-angle glaucoma usually do not show any symptoms. Damage to the optic nerve often occurs before you become aware of it. However, symptoms may appear that includes: 

  • Nausea 
  • Redness in the eye (white part)
  • Decrease vision 
  • Loss of peripheral vision (tunnel vision)
  • Swollen cornea 
  • Pupil dilation to a medium size that does not change with an increase or decrease light exposure

What medications should be avoided with open-angle glaucoma?

The most well-known medications that increase eye pressure are steroids, which should be avoided in open-angle glaucoma. They can cause permanent blockage of the eye’s drainage system. If you have been diagnosed with glaucoma, check with your doctor or pharmacist before taking steroid medication.

A variety of other medications can affect glaucoma and put you at risk of worsening your vision. Hence, before taking any other medications, you should always consult your doctor or pharmacist.

How serious is open-angle glaucoma?

Open-angle glaucoma is a slow progressive disease due to an increase in eye pressure, which causes damage to the optic nerve. If left untreated, open-angle glaucoma may eventually cause blindness.

Will you go blind with open-angle glaucoma?

Most people with open-angle glaucoma do not completely lose their vision in their lifetime. However, it is possible, especially if it is left untreated over a long period of time. The best way to prevent losing your sight is to have regular eye check-ups and follow your treatment plan to delay disease progression. 

How fast does open-angle glaucoma progress?

Open-angle glaucoma is a slow degenerative disorder of the eye, which causes damage to the eye gradually. How fast the disease progresses varies from person to person. In one study, about 1 in 3 patients progressed to advanced glaucoma after 10 years.

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