Primary Open-Angle Glaucoma (POAG)

What is Primary Open-Angle Glaucoma (POAG)?

Primary open-angle glaucoma is the most common form of glaucoma, and is a disease of the optic nerve in the back of the eye, where “cupping” of the optic disc occurs, caused by increased pressure inside of the eye. Glaucoma is the 2nd leading cause of blindness globally and patients usually do not experience symptoms until more advanced visual field defects are seen. Vision loss due to glaucoma cannot be reversed.1 

Signs & Symptoms

  • Increased pressure in the eye
  • Blindness beginning with outermost vision that tunnels inward


Important Note on POAG

Increased pressure inside the eye puts stress on the optic nerve and causes irreversible blindness. Glaucoma is considered a silently blinding disease because it targets our outermost vision first and then tunnels inward. Therefore, it’s extremely important to maintain comprehensive eye exams and follow-ups as recommended by your primary eye care provider.

“Understanding Glaucoma” by Sharp HealthCare

What causes Primary Open-Angle Glaucoma?

The major risk factors for primary open-angle glaucoma are:

  • Increased age
  • Family history of glaucoma
  • African American race
  • Nearsightedness
  • Systemic conditions (high blood pressure and diabetes)
  • Thinner central corneal thickness (CCT)1, 3

How is Primary Open-Angle Glaucoma diagnosed?

Ophthalmic examination: assessing the appearance of the anterior chamber angle, optic nerve, and surrounding retinal tissue.1

Ocular coherence tomography (OCT): ultrasound through the retina and optic nerve.

Humphrey visual field (HVF): side vision test to map out any vision loss from optic nerve damage.

Tonometry: a measure of the pressure inside the eye.

Gonioscopy: a test to assess the structures inside of the eye, used to verify that the drainage structures in the eye are truly “open”.2

Pachymetry: corneal thickness measurement.

How is Primary Open-Angle Glaucoma treated?

Eye pressure lowering drops : eye drops that work on different tissues of the eye to lower eye pressure.

Systemic medication: oral medication to lower eye pressure.1

Selective laser trabeculoplasty (SLT): laser to the trabecular meshwork of the eye (aqueous drainage structure) to enhance outflow of aqueous and lower eye pressure.

Trabeculectomy: creates an alternative path for aqueous to drain, decreased eye pressure.

Tube shunt procedure: similar to a trabeculectomy, an alternative path is created for aqueous to drain but includes a small tube that is inserted into the eye.3

Minimally invasive glaucoma surgery (MIGS):
micro-stent to help drain aqueous from the eye, can be performed in conjunction with cataract surgery/extraction.4

Living with Primary Open-Angle Glaucoma

If untreated, POAG can lead to irreversible blindness, therefore eye care visits as recommended by your eye care practitioner are essential to monitor and attempt to slow vision loss associated with POAG.1 In cases of more severe vision loss, vision rehabilitation with low vision specialists can assist patients optimize their remaining vision through devices and aids.5

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