SeminarGlaucoma
Section snippets
Definition and diagnosis
POAG has an adult onset, is usually bilateral, and has no noticeable symptoms in most patients until the later stages of the disease when patients lose their central vision.11, 12 In the USA, POAG has an age-adjusted prevalence of 1·55%.13 Although POAG has conventionally been characterised as a disease of raised eye pressures, it is currently defined as a group of ocular diseases that may cause characteristic, progressive changes in the optic nerve head, visual field loss, or both.11 These
Diagnosis and epidemiology
Patients with PACG may present with acute raised eye pressures, a mid-dilated pupil, a red eye, or nausea and vomiting, whereas in other cases they may have no complaints or may complain of a non-specific headache, eye pain, or halos around lights.67 The diagnosis of PACG requires an assessment of the anterior chamber angle to find out if the trabecular meshwork is blocked by the peripheral iris. If a skilled observer, slit-lamp, and gonioscopy lens are not available, a presumptive diagnosis of
Conclusion
If current trends prevail, the worldwide prevalences of POAG and PACG will continue to increase. Attempts to reduce substantially the visual impairment and blindness associated with glaucoma will need more aggressive detection, so that more people with glaucoma are aware that they have this disease. Also needed is more careful management of POAG and PACG that incorporates lessons learned from current research. Because of the health, social, and economic consequences of blindness, the burden of
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