👁️ OphthalmologyEyeStudentInternResident

Chronic Open-Angle Glaucoma

Also known as: primary open-angle glaucoma · POAG

A chronic, usually painless optic neuropathy with progressive loss of peripheral vision, commonly (but not always) with raised intraocular pressure — a leading cause of irreversible blindness. It is silent until advanced, so early detection matters.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Older adults, a family history, African ethnicity, raised intraocular pressure, myopia and diabetes.

Red flags — escalate / refer

Advanced field loss, very high pressure, or rapid progression → prompt ophthalmology; distinguish from acute angle-closure (painful, acute).

Work-up / diagnosis

1Ophthalmic assessment — intraocular pressure, optic-disc examination (cupping) and visual fields.
2Gonioscopy (an open angle) and OCT of the nerve; screen at-risk groups because it is asymptomatic early.

Management — overview

Lower the intraocular pressure to slow progression — first-line is usually topical medication (a prostaglandin analogue, then a beta-blocker/others) or laser trabeculoplasty.
Surgery (trabeculectomy) for uncontrolled disease.
Lifelong monitoring and adherence; screen first-degree relatives.

In-depthFull dosing & advanced protocol

Drug dosing

Topical IOP-lowering drops

Slow progression

Adult dose: Prostaglandin analogue first-line ± beta-blocker/others, per protocol
Route: Topical (ocular)

Caution: Adherence to drops is a major issue; treatment slows but doesn't reverse damage.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Silent until advanced — screen and treat early

It is usually asymptomatic until significant field loss — screening saves sight.
Treatment slows progression but cannot reverse damage; adherence is key.
Distinguish it from acute angle-closure glaucoma (painful emergency).

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Red EyeA common presentation ranging from benign conjunctivitis to sight-threatening emergencies. The key skill is spotting the dangerous red eye.Acute Angle-Closure GlaucomaA sudden rise in intraocular pressure from blockage of aqueous drainage — a painful red eye with blurred vision, haloes around lights, headache and nausea/vomiting, with a fixed mid-dilated pupil. A sight-threatening emergency.CataractClouding of the lens causing gradual, painless blurring of vision, glare and faded colours — the leading cause of reversible blindness worldwide, and cured by surgery.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical IOP-lowering drops

📈 Silent until advanced — screen and treat early

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical IOP-lowering drops

📈 Silent until advanced — screen and treat early

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Silent until advanced — screen and treat early

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Silent until advanced — screen and treat early

References