Primary open-angle glaucoma (POAG) is a chronic, progressive, usually bilateral disease of the eye with an insidious onset.
It is most often characterized by optic nerve damage, defects in the retinal fiber layer and subsequent visual field loss in the absence of underlying ocular disease or congenital abnormalities.
It is generally asymptomatic until it has caused a significant loss of visual field.
Occasionally, patients with very high intraocular pressure may complain of nonspecific headache, discomfort, intermittent blurring of vision or even halos caused by corneal edema.
Inform and involve patients about the status of their condition, the goals and plans for managing their disease, as well as the risks and benefits involved in such interventions
Form a therapeutic alliance with patient and family, and stress that glaucoma is a chronic disease where treatment and follow-up is life-long
Educate patients on how to recognize significant changes in their condition so physicians may be alerted
Provide emotional support and encouragement to help patients deal with possible issues concerning employment, relationships, diminished functional capacities (eg driving, reading, performance of everyday tasks, sports-related activities)
Patients may be referred to support groups or provided counseling
Patients should be taught how to perform nasolacrimal occlusion or eyelid closure when applying topical medications to reduce systemic absorption
Punctual occlusion and eyelid closure for at least 3 minutes
If ≥2 drops are to be instilled, wait at least 5 minutes between drops
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.