What is primary open-angle glaucoma?
Primary open-angle glaucoma (POAG) is a condition where there is damage to the sensitive nerves at the back of the eye. Everyone has fluid called aqueous humour inside their eye which circulates inside the eyeball to nourish the inner structures. Aqueous humour normally drains away at a consistent rate and pressure, without causing any problems. For people with glaucoma, however, this fluid doesn’t drain at a normal rate, meaning the pressure can become raised and subsequently damages the optic nerve fibres, which can lead to loss of vision.
POAG is just one of the many forms of glaucoma, you can learn about all the different types by going to our glaucoma guide.
Treatments for primary open-angle glaucoma
Treatment for POAG generally aims to reduce the pressure of fluid inside the eye, and therefore limit the damage to nerves and vision. There are a number of treatments available, your specialist eye doctor will discuss which one is best for you.
There is a range of different eye drops available to treat glaucoma, your ophthalmologist will detail which will work for you depending on how progressive your glaucoma could be. However, you can learn more about the different types of eye drops for glaucoma treatment here.
Eye drops for POAG work to reduce the production of fluid, or by improving the drainage of fluid from the eye, or both. If your specialist advises that eye drops are the best option for you, it’s important that you take them as instructed, as continued use of them can avoid any further damage to your eye. Usually, this treatment will continue over an extended period of time, so remember to keep at it.
If you find taking eye drops difficult, there’s no need to panic about your treatment. You can ask for your optometrist or even your pharmacist for advice.
Some people can find they have side effects from the eye drops. The most common of these are stinging and irritation, with some drops potentially causing blurred vision too. These side effects are completely normal, but, usually, you can minimise side effects by using the right dosage, and by getting advice on the best way to apply eye drops if you are worried.
Laser treatment is a relatively simple surgery. A laser is used to create tiny holes in the meshwork through which the fluid normally drains out of the eye — improving drainage and reducing the pressure inside the eye.
This treatment can mean that you no longer need to use eye drops, but it is still important that the pressure inside your eye and your vision is monitored. Some people may still need to use eye drops after laser treatment, depending on how their glaucoma has progressed. The treatment has few side effects, but after a number of years may become less effective2, so ongoing regular eye exams are still important even following successful laser treatment.
Your ophthalmologist may also discuss more traditional forms of surgery with you. This may be considered if eye drops or laser treatment don’t work, but it can also be the treatment of choice for some people, such as those who might struggle with eye drops.
During surgery, a tiny drainage hole is made in the white part of the eye which allows fluid to drain out and lower the pressure inside the eye. This surgery can be done under local anaesthetic which can be an advantage if you have other health problems.
It’s often done as day surgery, too, so you probably won’t need to stay anywhere overnight. Your eye may be red and somewhat uncomfortable after treatment, but this will subside within a few weeks.
As with the other types of treatment, you will still need to attend appointments for regular monitoring of your vision, your visual fields and the pressure inside your eye.
New insights on treatment
Research is continuing into new ways to treat primary open-angle glaucoma. There is growing evidence that there are other factors at play for people who continue to lose sight even when the pressure in their eye is reduced. There are also studies which indicate a link between Alzheimer’s disease, Parkinson’s and POAG. Treatments are being tested which could, in the future, potentially protect nerve function for people with glaucoma as well as these other conditions3.
To learn more about the link between the brain and glaucoma, you can discover some dedicated content here on glaucoma as a neurodegenerative disease.
If you have concerns about glaucoma treatment, you can find similar informative content here. You can also find more information regarding glaucoma causes and glaucoma diagnosis in our dedicated glaucoma resource. Remember, too, to discuss your concerns with your specialist eye doctor who can provide advice based on your particular circumstances.
2. The Glaucoma Laser Trial (GLT) and Glaucoma Laser Trial Follow-Up Study: 7. Results. Glaucoma Laser Trial Research Group. Am J Ophthalmol. 1995 Dec.
3. Beidoe G, Mousa SA. Current primary open-angle glaucoma treatments and future directions. Clin Ophthalmol. 2012;6:1699–1707. doi:10.2147/OPTH.S32933