Primary open-angle glaucoma (POAG): diagnosis and treatment
The latent and gradual deterioration of visual function remains one of the main challenges in modern ophthalmology. Patients often go years without noticing internal changes, attributing mild eye fatigue to simple eye strain. Without timely medical intervention, this process inevitably leads to serious consequences, so it is crucial to understand the mechanisms of development and the specific features of this disease.
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Why is open-angle glaucoma dangerous and why is it important not to wait for symptoms?
Open-angle glaucoma develops over years and, in its early stages, shows no symptoms. The patient experiences no pain, burning, or obvious discomfort that would prompt them to seek medical attention.
Why does the disease often cause no complaints for so long?
The asymptomatic course is explained by the structural features of our visual analyzer. With this form of the disease, the angle of the anterior chamber, where the drainage systems are located, remains open, but the filtration network itself gradually loses its capacity. Fluid is retained slowly, causing intraocular pressure to rise gradually. The eye has time to adapt to these changes, and the person does not experience the sharp pain.
Symptoms and signs to look out for
Sometimes patients report a periodic appearance of a slight blurring of vision that quickly resolves. A feeling of heaviness in the brow ridges or a dull ache in the temples may also occur.
Decreased peripheral vision
A person initially loses the ability to clearly see objects to the sides.
Gradually, the field of vision narrows on the nasal side, and then this process spreads to other areas.
When noticeable changes occur
Noticeable changes occur when atrophy has affected more than half of the fibers that make up the optic nerve. By this point, the disease usually progresses to stage three. The patient begins to suddenly bump into objects in the room, fails to notice objects on the side while walking, or experiences severe difficulties with spatial orientation.
Causes and risk factors
The exact causes of primary open-angle glaucoma remain the subject of active scientific debate in the global ophthalmology community.
The main factor is an imbalance between the production and outflow of aqueous humor within the eye.
Who especially needs to see an ophthalmologist?
Glaucoma screening is recommended for patients:
- Over 40–45 years of age, as the risk of developing the disease increases proportionally with age.
- Those with close relatives with a similar diagnosis.
- Those with concomitant systemic diseases, such as diabetes, arterial hypertension or hypotension, cervical osteochondrosis, and atherosclerosis.
- Those with a high degree of myopia or hyperopia.
- Those who are required to take hormonal medications for a long time.
How we diagnose open-angle glaucoma
We never make a diagnosis based on a single test. To get a complete picture, our specialists use high-tech, expert-grade equipment.
Measuring intraocular pressure
Ophthalmotonometry is a procedure in which a doctor determines the pressure inside the eyeball. We use both non-contact methods, which use a directed air stream to measure pressure, and classic contact methods such as Maklakov's or Goldman's.
Perimetry and visual field testing
The next crucial step is computer perimetry. This test allows us to determine the boundaries of vision and identify hidden focal defects called scotomas.
Based on the data obtained, the device creates a detailed map, which the ophthalmologist can use to assess the degree of visual function preservation.
Optic nerve examination, OCT and gonioscopy
To assess the condition of the internal structures of the eye, a comprehensive hardware diagnostic is performed:
- OCT. This method allows for contactless scanning and obtains a layered image of the organ with an accuracy of several microns.
- Gonioscopy. The examination is performed using a special lens, which the doctor gently applies to the patient's eye after preliminary anesthesia.
- Fundus examination (ophthalmoscopy). The doctor carefully examines the condition of the retina and evaluates the optic disc, paying attention to its color, the clarity of its borders, and the degree of excavation—the depression that enlarges as nerve cells die.
General information
What's included in the initial consultation
The first visit to our medical center is the foundation upon which all subsequent interactions and treatment selection are built.
Complaints collection and risk factor assessment
The specialist determines whether you have complaints of intermittent blurred vision, headaches, or eye discomfort. A detailed medical history is also reviewed, including information about chronic illnesses, medications taken, and any history of blindness or glaucoma in family members.
Selection of necessary tests
Based on the consultation, the ophthalmologist creates an individualized examination plan. If risk factors are detected, the patient is immediately referred to an advanced diagnostic unit.
Explanation of results and action plan
If glaucoma is detected, the specialist clearly shows the damaged areas on OCT images and explains the steps to take immediately. The patient receives an official report and a clear step-by-step action plan.
Comparison of disease forms
| Symptom | Open-angle glaucoma | Closure-angle glaucoma |
|---|---|---|
| Symptoms | Long-term absence, narrowing of the visual field | Sharp pain, halos, nausea |
| Pace of progression | Slow, imperceptible | Sudden exacerbation possible |
| Presence of pain | Usually absent | Sharp eye pain, headache |
| Diagnostic tactics | Planned, comprehensive | Urgent, with gonioscopy |
| Urgency of treatment | Planned, but without delay | Emergency |
FAQ
What is primary open-angle glaucoma?
How can I tell if I have open-angle glaucoma?
Is it possible to stop the progression of glaucoma?
What tests are needed if glaucoma is suspected?
Conclusion / call to action
"When treating glaucoma, we focus on more than just the patient's complaints. It's important to assess intraocular pressure, visual field, and optic nerve health. A comprehensive diagnosis allows us to detect problems early and adjust treatment," notes our ophthalmologist.
Don't put off taking care of your health or wait until the disease manifests itself with the first irreversible symptoms. The only way to protect yourself and preserve your vision is with regular preventive examinations.
Call our medical center now or fill out the contact form on the K+31 clinic website to schedule a comprehensive examination at a time convenient for you.
Category of clinical guidelines of the Ministry of Health of the Russian Federation — https://cr.minzdrav.gov.ru/
NMIC MNTK "Eye Microsurgery" named after Academician S. N. Fedorov — https://www.mntk.ru/
NMIC of Eye Diseases named after Helmholtz - https://www.helmholtzeyeinstitute.ru/
eLIBRARY.RU - https://elibrary.ru/
CyberLeninka - https://cyberleninka.ru/
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What is primary open-angle glaucoma?
Primary open-angle glaucoma, often referred to as POAG in medical practice, is a chronic, progressive disease of the eye. This pathology involves gradual and irreversible damage to the specific structures that allow a person to see the world around them. This process is caused by impaired drainage of intraocular fluid through the natural drainage channels of the eye. Fluid begins to accumulate, resulting in increased or unstable intraocular pressure.
The increased pressure within the eyeball begins to exert constant mechanical stress on the posterior segment of the eye, where the optic nerve head is located. Prolonged compression and associated circulatory impairment lead to nerve fiber atrophy.