Glaucoma, Open Angle, Primary

Background and History: 

The disease we call glaucoma has been known since antiquity, at least since Hippocrates described it in about 400 BC.  The word comes from the description of the eye which appeared cloudy.  Of course, we now know that there are other causes of a cloudy looking eye and the most common form of glaucoma as we know it does not lead to a cloudy cornea.  Unfortunately, glaucoma has many forms and is the most common cause of new blindness in this country in people over the age of 50.

Clinical Correlations: 

The type of glaucoma described here is called open angle glaucoma and is by far the most common.  It usually does not cause symptoms until extensive damage to vision has occurred.  Therefore, the only way to detect the disease early and to get treatment is through regular eye examinations.  Untreated, glaucoma causes blindness.  No blood test or other body changes provide any clues to the presence of glaucoma.  Often, but not always, the pressure inside the eye is elevated but usually not sufficiently to cause pain or discomfort.

Genetics: 

There is no individual gene mutation that causes primary open angle glaucoma.  However, many genes seem to confer susceptibility to the development of glaucoma.  We know that the disease is heritable since people with first degree relatives (parents, sibs) who have glaucoma have a greater risk of developing the disease.  There is also a higher risk for this type of glaucoma among African Americans, Native Americans, and Hispanics.  Other risk factors such as obesity, smoking, diabetes, alcohol abuse, cardiovascular disease and stress have also been reported.

A number of diseases of the eye and of the body, many of them hereditary may be associated with glaucoma but these are usually considered secondary to the underlying condition.

Diagnosis and Prognosis: 

This type of glaucoma can only be diagnosed by your eye doctor via a complete eye examination.  If he or she finds the pressure in the eye to be elevated, medications can be used to lower it.  These by themselves can be effective but in some patients surgery is required for adequate control of the pressure.  There is no cure and once diagnosed, it is important that regular checkups be done throughout life to monitor control and change therapy if necessary.

Additional Information