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Glaucoma is a complicated disease in which damage to the optic nerve results in vision loss.
There are several forms of glaucoma; the two most common forms are primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG). Open-angle glaucoma is often called "the sneak thief of sight" because it has no symptoms until significant vision loss has occurred.
There are typically no early warning signs or symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years.
Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease.
By the time a patient is aware of vision loss, the disease is usually quite advanced. Vision loss from glaucoma is not reversible with treatment, even with surgery.
Because open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventative treatment to help protect your vision.
In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve. It is the most common type of glaucoma, affecting about four million Americans, many of whom do not know they have the disease.
You are at increased risk of glaucoma if your parents or siblings have the disease, if you are African-American or Latino, and possibly if you are diabetic or have cardiovascular disease. The risk of glaucoma also increases with age.
In angle-closure glaucoma (also called narrow angle glaucoma), the angle is closed in many or most areas, causing increased eye pressure, which leads to optic nerve damage, and possible vision loss. This rise in eye pressure may occur suddenly (an acute attack of angle closure) or gradually. There are also early stages of the disease in which the angle is closed but the eye pressure may or may not be high and the optic nerve is not affected yet.
Symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly. If you experience any of these symptoms, seek immediate care from an ophthalmologist.
If you are diagnosed with glaucoma, it is important to set a regular schedule of examinations with your eye doctor to monitor your condition and make sure that your prescribed treatment is effectively maintaining a safe eye pressure.
Article by Doreen Fazio, MD. Dr. Fazio completed her ophthalmology residency and glaucoma fellowship at Jules Stein Eye Institute, UCLA. She currently practices as an ophthalmologist at Valley Eye Center in Van Nuys, California.
Last reviewed on September 18, 2019