Open-Angle Glaucoma: Causes, Symptoms, and Treatment

A silent thief like glaucoma steals sight without warning. Open angle glaucoma creeps in unnoticed, damaging vision bit by bit. 

What is Open-Angle Glaucoma?

Maintaining a delicate balance of fluid production and drainage is essential for eye health. When disrupted, pressure builds up inside, leading to open angle glaucoma. This condition develops slowly, often without obvious warning signs.

Unlike acute angle-closure glaucoma, open angle glaucoma does not cause sudden pain or redness. Instead, in this condition, the peripheral vision starts to fade over time. The loss is so gradual that many people remain unaware until damage has occurred. 

Experts classify open angle glaucoma as a chronic disease. It progresses over the years. It affects both eyes, though not always at the same rate. While anyone can develop open angle glaucoma, some people face higher risks. Age, family history, nearsightedness, and certain health conditions increase the likelihood of developing the condition.

Causes of Open-Angle Glaucoma

The eye constantly produces a fluid called aqueous humor. This fluid flows out through a drainage system, keeping pressure stable. In open angle glaucoma, this drainage slows down, causing fluid build-up. The optic nerve suffers damage as pressure rises. This leads to gradual vision loss.

Age is a major factor. Open angle glaucoma is more common in people over 60, though the risk starts increasing after 40. Genetics also plays a role. Yes, having a close family member with glaucoma increases the chances of developing the condition.

Certain health conditions make the risk higher. Diabetes and high myopia (severe nearsightedness) can contribute to optic nerve damage. The role of hypertension is complex, as both high and low blood pressure can affect optic nerve health. Prolonged use of steroid medications, often prescribed for asthma or arthritis, may also increase susceptibility.

In some patients, eye injuries trigger changes in fluid drainage, raising the risk. Even if pressure levels appear normal, optic nerve damage can still occur. That’s why routine eye check-ups are essential. Open angle glaucoma may not show early open angle glaucoma symptoms, but spotting the condition in time helps preserve vision. 

Symptoms of Open-Angle Glaucoma

Vision loss in open angle glaucoma happens so slowly that most people don’t notice at first. There’s no pain, no redness, and no sudden changes. The earliest sign is usually a subtle loss of peripheral vision. Straight-ahead sight remains clear, making it easy to miss the problem.

As the condition progresses, blind spots develop. These gaps in vision grow larger, affecting both eyes. Reading, driving, and recognising faces may become difficult. Eventually, without treatment, open angle glaucoma can lead to complete blindness.

Since symptoms appear late, early detection is key. Regular eye exams can catch the condition before significant damage occurs. Advanced tests measure eye pressure, examine the optic nerve, and map out vision loss.

Timely open angle glaucoma treatment can slow the progression and protect eyesight for years to come. 

How is Open-Angle Glaucoma Diagnosed?

Detecting open angle glaucoma early is the best way to prevent vision loss. Since open-angle glaucoma symptoms develop slowly, routine eye check-ups are essential. Specialists use advanced tests to examine eye pressure, nerve health, and visual function.

• A tonometry test measures intraocular pressure. While high pressure is a key risk factor, some people with normal pressure still develop open angle glaucoma. That’s why additional tests are needed.
• An ophthalmoscopy allows doctors to inspect the optic nerve for signs of damage. If changes are detected, a visual field test checks for blind spots. This helps assess how much vision loss has already occurred.
• A gonioscopy examines the drainage angle inside the eye. This test confirms whether the fluid outflow is restricted, which is common in open angle glaucoma. 
• Optical coherence tomography (OCT) provides a detailed image of the optic nerve, tracking damage over time.

Treatment Options for Open-Angle Glaucoma

Open angle glaucoma cannot be reversed, but treatment can slow the condition’s progress and protect vision. The goal is to reduce eye pressure, preventing further damage to the optic nerve. Doctors choose treatments based on severity, lifestyle, and overall eye health. Common open angle glaucoma treatment options include the following.

1. Prescription eye drops: These lower eye pressure by either reducing fluid production or improving drainage. They are the first line of treatment for most patients.
2. Oral medications: Sometimes, doctors prescribe pills to decrease fluid build-up when eye drops alone aren’t enough.
3. Laser therapy: A painless procedure that improves fluid drainage, helping to lower eye pressure. Selective Laser Trabeculoplasty (SLT) is commonly used as a first-line treatment, but its effects may diminish over time, requiring repeat procedures.
4. Surgical procedures: In advanced cases, trabeculectomy creates a new drainage channel, while Minimally Invasive Glaucoma Surgery (MIGS) enhances the eye’s existing drainage system.

Is Open-Angle Glaucoma Preventable?

There is no guaranteed way to prevent open angle glaucoma, but steps can reduce the risk and slow progression. Since early-stage glaucoma has no symptoms, regular eye check-ups are essential, especially for those at higher risk.

Maintaining healthy eye pressure is key. While pressure naturally varies, excessive build-up damages the optic nerve over time. Routine eye exams can catch changes early, allowing doctors to start treatment before significant vision loss occurs.

A few lifestyle habits may help.

• Exercise regularly: Moderate aerobic activities like walking or cycling may help lower eye pressure. However, activities that involve straining, such as heavy weightlifting or prolonged head-down yoga poses, should be done cautiously.
• Protect your eyes: Injuries can increase glaucoma risk, so wear protective eyewear when needed.
• Follow medication plans: If prescribed eye drops, use them as directed to maintain stable eye pressure.