Primary open-angle glaucoma - External and Internal Eye
Alerts and Notices
Synopsis

Typically asymptomatic, it is classically characterized by painless, gradual peripheral visual field loss followed by central visual field loss and eventually irreversible blindness, often with elevated intraocular pressure (IOP). However, 40% of cases are associated with normal IOP (see also normal tension glaucoma).
In the United States, POAG is the leading cause of blindness in black individuals, and there is a threefold-higher incidence in black patients as compared to non-Hispanic white patients; Hispanic patients have a comparable high prevalence rate to black patients.
Risk factors for development of POAG include:
- Elevated IOP
- Age over 50 years
- Family history of glaucoma, especially in first-degree relative
- African descent or Latin / Hispanic ethnicity
- Thinner central cornea
- Diabetes mellitus type 2
- Myopia (nearsightedness)
- Disc hemorrhage
- Increased cup-to-disc ratio
- Changes on peripheral visual fields
Codes
ICD10CM:H40.1190 – Primary open-angle glaucoma, unspecified eye, stage unspecified
SNOMEDCT:
77075001 – Primary open angle glaucoma
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Differential Diagnosis & Pitfalls
Other diseases associated with optic disc damage or visual field abnormalities should be considered prior to accepting the diagnosis of glaucoma. These include:Optic disc abnormalities:
- Anterior ischemic optic neuropathies
- Optic nerve drusen
- Myopic tilted optic nerves
- Toxic optic neuropathies
- Congenital pit
- Congenital disc anomalies (eg, coloboma, periventricular leukomalacia, morning glory syndrome)
- Leber hereditary optic neuropathy and dominant optic atrophy
- Optic neuritis
- Age-related macular degeneration
- Panretinal photocoagulation
- Retinitis pigmentosa
- Retinal arterial and venous occlusions
- Compressive optic neuropathy
- Demyelination from multiple sclerosis
- Nutritional optic neuropathy
- Dominant optic atrophy
Secondary causes of glaucoma:
- Pigment dispersion syndrome
- Pseudoexfoliation syndrome
- Congenital anomalies
- Traumatic glaucoma
- Neovascular glaucoma
- Uveitic glaucoma
- Steroid response glaucoma
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References
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Last Reviewed:07/04/2017
Last Updated:02/09/2021
Last Updated:02/09/2021