While you can expect some changes in your vision as the years go by, some deviations may be a sign of open-angle glaucoma. Potential signs of the condition include blurry vision or an inability to see from the side (peripheral vision). (Learn More)

The symptoms of open-angle glaucoma are only noticeable once the damage is irreversible, and that is why prevention and early detection are key. (Learn More) Monitoring your eyesight, maintaining a healthy diet, and wearing protective glasses, if you are an athlete, can help you prevent and treat open-angle glaucoma. (Learn More)

Open-Angle Glaucoma: An Overview

 Glaucoma is the number one cause of vision loss around the world, and it affects an estimated 70 million people internationally. The majority of glaucoma patients have open-angle glaucoma.

Your eye is composed of a fluid-filled area called the aqueous humor. The fluid in the aqueous humor nourishes the eye and maintains its shape. It needs to be filled and drained consistently to prevent blockages or excess pressure.

Two parts make sure the aqueous humor has proper fluid levels:

  • The uveoscleral outflow
  • Trabecular meshwork

Damage to the trabecular network causes open-angle glaucoma. The condition gets its name from the position of your eye during blockages, which increase pressure that damages the optic nerve. It means your iris is in the correct spot and the uveoscleral canals are fine, but the trabecular meshwork is blocked.

Narrow-Angle Glaucoma

Narrow-angle glaucoma makes up an estimated 20 percent of cases. The condition is also called acute-angle glaucoma or angle-closure glaucoma. It is usually caused by damage to the iris.

In this form of glaucoma, both the uveoscleral canals and trabecular network are blocked, leading to increased pressure in the eye.

Symptoms & Diagnosis                      Tunnel Vision

Eye exams are the best way to prevent or screen for glaucoma.

Acute cases of glaucoma may produce symptoms. Talk to your doctor if you identify these symptoms:

  • Tunnel vision: This occurs when your peripheral vision gets so bad you cannot see well or at all from the sides, even if your general wide-angle vision is fine.
  • Cloudy or patchy peripheral vision: Your peripheral vision is beginning to be restricted.
  • Unresponsive pupils: Your dilated pupil may not change even in different light conditions.
  • Redness: Red areas in the white part of the eye can be a sign of glaucoma.

These symptoms are most common to narrow (or acute) angle glaucoma, but they can appear with open-angle glaucoma as well. Glaucoma can also be free of symptoms.

If these symptoms appear or persist, your doctor will give the following tests to detect and diagnose open-angle glaucoma:

  • Visual field test (perimetry)
  • Checking the eye’s drainage angle (gonioscopy)
  • Optic nerve evaluation (ophthalmoscopy)
  • Eye pressure measurements (tonometry)

Risk factors for the development of glaucoma include:

  • A family history of the condition.
  • Being Hispanic, Asian, or African Americans
  • Diabetes
  • A history of cardiovascular disease.

Again, the symptoms of open-angle glaucoma often do not present until damage has been done. Even when symptoms begin to appear, they come on so gradually that patients often do not notice. First symptoms may include a minor loss of peripheral vision.

The best way to diagnose glaucoma is with regular eye exams. If treated early, vision loss can be seriously mitigated.

Will I Go Blind?

A study shows that people who were diagnosed with glaucoma between 1981 and 2000 fared better than patients diagnosed between 1965 and 1980. Some theories on why those diagnosed in more recent years fare better include:

  • Increased knowledge about the progression of glaucoma and its risk factors.
  • Medical and surgical innovations that enable patients to get better treatment.
  • Development of new procedures that are effective in managing glaucoma.
  • Changes in criteria for diagnosis that allow for earlier detection.

Glaucoma can still cause blindness or severe vision loss if untreated, but your odds of becoming blind are low if you are diagnosed early.

Scientists are still researching the progression of glaucoma, and timetables vary from one person to the next. It’s important to be under the care of an ophthalmologist who can give you a more specific timeline of what to expect for your case.

woman getting an eye exam done

Treatment & Prognosis

 If glaucoma is detected early, you can prevent or lessen serious symptoms, such as vision loss.

Damage caused by glaucoma is irreparable. Treatment only helps to control the condition and prevent further damage.

Care for glaucoma may consist of medications, laser treatments, or traditional surgery.

  • Medication: Eye drops are the most common way glaucoma can be treated. Some of these eye drops decrease intraocular pressure by ensuring fluid can drain out properly. Others decrease the amount of aqueous fluid your eye makes.Eye drops can cause side effects, such as itching, stinging, redness in or around the eyes, dry mouth, eyelash growth, or blurry vision. Tell your doctor about any medications you currently take, and do not stop using your eye drops without consulting with your doctor first.
  • Laser eye surgery: This is typically performed in an outpatient center or ophthalmologist’s practice. Individuals with open-angle glaucoma usually get a trabeculoplasty. This procedure uses a laser to help the trabecular mesh better drain itself to decrease eye pressure.
  • Traditional or operating room surgery: Surgical procedures are conducted in an operating room. There two procedures that can help patients with glaucoma.
    • Glaucoma drainage services: A small tube is implanted in the eye to divert fluid and send it to a reservoir, or collection area. Your surgeon will create this collection area behind the thin layer covering the white part of the eye and the inside your eyelids, or conjunctiva. This will ensure blood vessels absorb excess fluid back into your body.
    • Trabeculectomy: In this procedure, your surgeon cuts a minuscule flap in the white of the eye, or sclera. Next, a pocket called a filtration bleb is created in the conjunctiva. This bleb is typically beneath the upper part of your eyelid. Aqueous humor can drain out of the eye and into the bleb via the flap to relieve pressure.

If you have already been diagnosed, prescribed a medication, or had surgery, it is vital that you follow directions for medication and aftercare. This will prevent symptoms from becoming worse. 

People with a confirmed diagnosis of glaucoma can expect to visit their ophthalmologist every three to six months. The length of time between visits varies, depending on your needs. If your open-angle glaucoma worsens, your doctor may change your treatment regime or recommend surgery.

Make sure to get regular eye exams,  know your family’s eye health history, and wear protective gear to ensure good overall eye health.

Frequently Asked Questions

woman reading book indoors

What is open-angle glaucoma?

Your eye needs to drain its aqueous fluid correctly, so you do not feel any pressure. It does so by using the trabecular meshwork and outflow from the uveoscleral coat. Open-angle glaucoma results from a blockage to the trabecular meshwork that increases pressure and begins to damage your optic nerve. Left untreated, this increased pressure could cause vision loss, eventually progressing to blindness. 

How is open-angle glaucoma detected and diagnosed?

Regular eye exams can help your eye doctor notice any changes to your vision. An ophthalmologist can screen for glaucoma and order additional tests if symptoms are present. You will be asked to share your medical history, as glaucoma is more likely in patients with a family history of the condition.

Four types of tests can detect and diagnose open-angle glaucoma: visual field screening, pressure measurements, evaluation of the optic nerve, and an examination of the drainage angle. 

What types of treatment can I expect?

Eye drops are the most common medication used to control glaucoma and relieve eye pressure.

Laser eye surgery is another alternative. A laser is used to help the trabecular mesh drain your eye to relieve intraocular pressure.

Traditional surgery is another option for patients with open-angle glaucoma. This is usually the last resort after less invasive treatment options prove ineffective.

Follow directions from your doctor, and use your medications as prescribed. Depending on the severity of symptoms, you may need more than one type of treatment. It is normal to see your ophthalmologist more often after surgery to ensure your treatment is effective.

References

Symptoms of Open-Angle Glaucoma. (October 2017). Glaucoma Research Foundation.

Glaucoma Overview. See International.

Glaucoma. (July 2019). National Eye Institute.

Glaucoma Treatment (August 2019). American Academy of Ophthalmology.

Glaucoma. Kellogg Eye Center, University of Michigan.

What Are Symptoms of Glaucoma? (May 2019). American Academy of Ophthalmology.

Vision Changes as We Age: What’s Normal? What’s Not? (September 2016). University of Utah.

Incidence and Probability of Progression to Blindness Due to Open-Angle Glaucoma Decreases Dramatically. (May 2014). Mayo Clinic.