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Open-angle glaucoma.

Abstract

Glaucoma is the second most common cause of legal blindness in the United States. Open-angle glaucoma is an asymptomatic, progressive optic neuropathy characterized by enlarging optic disc cupping and visual field loss. Patients at increased risk for open-angle glaucoma include blacks older than 40 years, whites older than 65 years, and persons with a family history of glaucoma or a personal history of diabetes or severe myopia. Elevated intraocular pressure is a strong, modifiable risk factor for open-angle glaucoma, but it is not diagnostic. Some patients with glaucoma have normal intraocular pressure (i.e., normal-pressure glaucoma), and many patients with elevated intraocular pressure do not have glaucoma (i.e., glaucoma suspects). Routine measurement of intraocular pressure by primary care physicians to screen patients for glaucoma is not recommended. Open-angle glaucoma usually is discovered during an adult eye evaluation performed for other indications. Final diagnosis and treatment occur in collaboration with ophthalmologists and optometrists. Formal visual field testing (perimetry) is a mainstay of glaucoma diagnosis and management. Eye drops, commonly nonspecific beta-blocker or prostaglandin analog drops, generally are the first-line treatment to reduce intraocular pressure. Laser treatment and surgery usually are reserved for patients in whom medical treatment has failed. Without treatment, open-angle glaucoma can end in irreversible vision loss.

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  • Authors+Show Affiliations

    ,

    Milliman Care Guidelines, Division of Milliman, Seattle, Washington 98104, USA. jim.distelhorst@milliman.com

    Source

    American family physician 67:9 2003 May 01 pg 1937-44

    MeSH

    Adrenergic alpha-Agonists
    Adrenergic beta-Antagonists
    Blindness
    Glaucoma, Open-Angle
    Humans
    Mass Screening
    Ophthalmic Solutions

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    12751655

    Citation

    Distelhorst, James S., and Grady M. Hughes. "Open-angle Glaucoma." American Family Physician, vol. 67, no. 9, 2003, pp. 1937-44.
    Distelhorst JS, Hughes GM. Open-angle glaucoma. Am Fam Physician. 2003;67(9):1937-44.
    Distelhorst, J. S., & Hughes, G. M. (2003). Open-angle glaucoma. American Family Physician, 67(9), pp. 1937-44.
    Distelhorst JS, Hughes GM. Open-angle Glaucoma. Am Fam Physician. 2003 May 1;67(9):1937-44. PubMed PMID: 12751655.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Open-angle glaucoma. AU - Distelhorst,James S, AU - Hughes,Grady M, PY - 2003/5/20/pubmed PY - 2003/6/18/medline PY - 2003/5/20/entrez SP - 1937 EP - 44 JF - American family physician JO - Am Fam Physician VL - 67 IS - 9 N2 - Glaucoma is the second most common cause of legal blindness in the United States. Open-angle glaucoma is an asymptomatic, progressive optic neuropathy characterized by enlarging optic disc cupping and visual field loss. Patients at increased risk for open-angle glaucoma include blacks older than 40 years, whites older than 65 years, and persons with a family history of glaucoma or a personal history of diabetes or severe myopia. Elevated intraocular pressure is a strong, modifiable risk factor for open-angle glaucoma, but it is not diagnostic. Some patients with glaucoma have normal intraocular pressure (i.e., normal-pressure glaucoma), and many patients with elevated intraocular pressure do not have glaucoma (i.e., glaucoma suspects). Routine measurement of intraocular pressure by primary care physicians to screen patients for glaucoma is not recommended. Open-angle glaucoma usually is discovered during an adult eye evaluation performed for other indications. Final diagnosis and treatment occur in collaboration with ophthalmologists and optometrists. Formal visual field testing (perimetry) is a mainstay of glaucoma diagnosis and management. Eye drops, commonly nonspecific beta-blocker or prostaglandin analog drops, generally are the first-line treatment to reduce intraocular pressure. Laser treatment and surgery usually are reserved for patients in whom medical treatment has failed. Without treatment, open-angle glaucoma can end in irreversible vision loss. SN - 0002-838X UR - https://www.unboundmedicine.com/medline/citation/12751655/full_citation L2 - http://www.aafp.org/link_out?pmid=12751655 DB - PRIME DP - Unbound Medicine ER -