Primary open-angle glaucoma (POAG) is the most common form of glaucoma in the United States. It is a chronic, progressive optic neuropathy in which the angle of the anterior chamber is open, there is loss of optic nerve tissues, also called cupping, and there are no other explanations for the nerve damage, such as trauma, uveitis, chronic steroid use, etc. It is often bilateral but can be asymmetric.

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

Management involves lowering IOP to slow disease progression and prevent vision loss, most commonly by pharmacotherapy, laser therapy, or surgery.