Low-Tension Glaucoma

Low-Tension Glaucoma

What is open-angle glaucoma? — Glaucoma is a disease that damages the main nerve in the eye, called the optic nerve. It causes vision loss and can even lead to blindness. There are different types of glaucoma. The most common type in the United States is called "chronic open-angle glaucoma."
What are the symptoms of open-angle glaucoma? — At first, open-angle glaucoma does not usually cause symptoms. When it does cause vision loss, it starts by affecting the edges of what you see (picture 1). In other words, the center of what you look at often looks clear. But things that are off to the side do not. This is sometimes called "tunnel vision." As the disease gets worse, even your central vision can be affected.
Is there a test for open-angle glaucoma? — Yes. To check for open-angle glaucoma, doctors can use a few different tests. They can:
Look into the back of your eye with a lighted magnifying tool and see if there are signs of nerve damage
Check how well you see things in the center of your vision and how well you see things that are off to the side
Check the pressure inside your eye by pushing or blowing on your eye with a special tool (people with open-angle glaucoma often have too much pressure inside the eye)
Everyone age 40 and older should be tested for open-angle glaucoma at least once. You might need more frequent tests if you have a parent, brother, or sister who has glaucoma. Testing helps doctors find and treat the disease early, before it causes symptoms. That's important, because treatment for open-angle glaucoma can prevent or slow down vision loss. But it cannot undo damage that has already been done.
How is open-angle glaucoma treated? — Effective treatments for open-angle glaucoma all work by lowering the pressure inside the eye. There are 3 ways to lower eye pressure: eye drops, laser therapy, or surgery.
Eye drop medicines – There are 2 main types of glaucoma eye drops:
•Prostaglandins
•Beta blockers
Laser therapy – Laser therapy improves the way fluid drains from the eye.
Surgery – Surgery involves making a small opening or inserting a tiny tube in the eye so that fluid can drain better.
Which treatment should I have? — Experts usually recommend starting with either eye drops or laser therapy. Your doctor can talk to you about your options and help you decide. People who want to avoid a procedure might choose eye drops. People who would have trouble putting in the eye drops every day might choose laser therapy.
If your doctor prescribes eye drops, it's very important that you use them every day, as directed. These medicines can keep you from losing your vision. But they only work if you follow the instructions on how to use them. There are now eye drops that you can use just once a day. Some people need to add a second eye drop medicine. Some people who choose laser therapy also need eye drops.
Whether you get eye drops or laser therapy, you will need to see your doctor or nurse regularly. They will check your eyes to see how well the treatment is working. If your eye pressure is still too high, you might need to switch to a different treatment. If you have tried both eye drops and laser therapy, your doctor might suggest surgery.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15845 Version 14.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.