Glaucoma, Open-Angle

Open-angle glaucoma is the leading cause of blindness among African Americans and the second leading cause overall in USA.

African American race, advanced age, elevated IOP, myopia, low diastolic perfusion pressures, and family Hx of open-angle glaucoma increase the risk for primary open-angle glaucoma.

Incidence in US: Estimates suggest over 2.25 million Americans over age 40 have open-angle glaucoma.

Vision loss secondary to optic nerve damage from pressure or ischemia

Interactions between ophthalmologic drugs and anesthetics

Increases in IOP

Periop derangements in electrolytes secondary to ophthalmologic drugs

Glaucoma is a degenerative optic neuropathy characterized by optic-nerve cupping that results in progressive vision loss and possibly blindness if not treated. Treatment does not reverse the blindness.

Elevated IOP is often found in glaucoma but is not required for the diagnosis. Nonetheless, treatment for all forms is aimed at maintaining a low-normal IOP.

Onset is gradual, bilateral, and often unnoticed. While juvenile forms exist, it is much more common in those >40 y.