primary%20open-angle%20glaucoma
PRIMARY OPEN-ANGLE GLAUCOMA
Treatment Guideline Chart
Primary open-angle glaucoma (POAG) is a chronic, progressive, irreversible, 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.

Primary Open-Angle Glaucoma References

  1. Canadian Ophthalmological Society Glaucoma Clinical Practice Guideline Expert Committee; Canadian Ophthalmological Society. Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol. 2009;44(Suppl Suppl 1):S7-S93. doi: 10.3129/cjo44s1. Accessed 19 Sep 2019. PMID: 19492005
  2. Broan AM, Garcger CP, Sirbat D, et al. Comparison of two fixed beta-blocker-pilocarpine combinations. The Carteolol-Pilocarpine Study Group. Eur J Ophthalmol. 1997;7(4):351-356. http://www.ncbi.nlm.nih.gov/pubmed/. Accessed 10 Feb 2012. PMID: 9457458
  3. Demailly P, Allaire C, Bron V, Trinquand C. Effectiveness and tolerance of beta blocker/pilocarpine combination eye drops in primary open-angle glaucoma and high intraocular pressure. J Glaucoma. 1995 Aug;4(4):235-241. http://www.ncbi.nlm.nih.gov/pubmed/. Accessed 10 Feb 2012. PMID: 19920680
  4. European Glaucoma Society. Terminology and guidelines in glaucoma. 3rd. Italy: European Glaucoma Society; 2008.
  5. South East Asia Interest Group. Asia Pacific glaucoma guidelines. 2nd ed. Sydney, Australia: SEAGIG; 2008
  6. Henderson P, Labbe T, Kass MA. Ocular hypertension. In: Yanoff M, Duker JS, Augsburger JJ, et al. Yanoff & Duker: Ophthalmology. 3rd ed. Maryland Heights, MO: Mosby, Inc; 2008
  7. Japan Glaucoma Society. Guidelines for glaucoma. 2nd ed. Japan Glaucoma Society. http://ryokunaisho.jp/. Sep 2006. Accessed 31 Aug 2012.
  8. National Collaborating Centre for Acute Care. Glaucoma: Diagnosis and management of chronic open angle glaucoma and ocular hypertension. National Institute for Health and Care Excellence. http://www.nice.org.uk/. Apr 2009. Accessed 03 Feb 2012.
  9. American Academy of Ophthalmology Glaucoma Panel. Preferred Practice Guidelines. Primary open-angle glaucoma. San Francisco, CA: American Academy of Ophthalmology. http://one.aao.org/. Oct 2013.
  10. American Optometric Association Original Consensus Panel on Care of the Patient with Open-Angle Glaucoma. Optometric clinical practice guideline care of the patient with open-angle glaucoma. American Optometric Association. http://www.aoa.org/. 2010. Accessed 03 Feb 2012.
  11. International Council of Ophthalmology. Primary open-angle glaucoma: initial evaluation. International Council of Ophthalmology. http://www.icoph.org/. 2010. Accessed 04 Feb 2012.
  12. International Council of Ophthalmology. Primary open-angle glaucoma: follow-up evaluation. International Council of Ophthalmology. http://www.icoph.org. 2010. Accessed 04 Feb 2012.
  13. International Council of Ophthalmology. Primary open-angle glaucoma suspect: initial evaluation and follow-up. International Council of Ophthalmology. http://www.icoph.org/. 2010. Accessed 06 Feb 2012.
  14. Jacobs DS. Open-angle glaucoma: epidemiology, clinical presentation, and diagnosis. UpToDate. https://www.uptodate.com. 04 Aug 2020. Accessed 19 Sep 2019.
  15. Jacobs DS. Open-angle glaucoma: treatment. UpToDate. https://www.uptodate.com. 16 Nov 2021. Accessed 19 Sep 2019.
  16. European Glaucoma Society (EGS). Terminology and guidelines for glaucoma. 4th ed. EGS. http://www.eugs.org/. Jun 2014. Accessed 13 Oct 2015.
  17. Asian Pacific Glaucoma Society. Asia Pacific glaucoma guidelines. APGS. 3rd ed. Amsterdam: Kugler Publications; 2016.
  18. Gross RL, McMillan BD. Current medical management of glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, Pennsylvania, USA: Saunders, Elsevier; 2019. 1120-1125. :1120-1125.
  19. International Council of Ophthalmology (ICO). ICO guidelines for glaucoma eye care. ICO. http://www.icoph.org. 2015.
  20. Lee DA, Higginbotham EJ. Glaucoma and its treatment: a review. Am J Health Syst Pharm. 2005 Apr;62(7):691-699. doi: 10.1093/ajhp/62.7.691. PMID: 15790795
  21. Lusthaus J, Goldberg I. Current management of glaucoma. Med J Aust. 2019 Mar;210(4):180-187. doi: 10.5694/mja2.50020. PMID: 30767238
  22. MacIver S, MacDonald D, Prokopich CL. Screening, diagnosis, and management of open angle glaucoma: an evidence-based guideline for Canadian optometrists. Can J Optometry. 2017;79(Suppl 1).
  23. Ministry of Health Malaysia. Clinical practice guideline: management of glaucoma (2nd edition). MOH (Malaysia). http://www.acadmed.org.my. Jun 2017. Accessed 19 Sep 2019.
  24. National Health and Medical Research Council. NHMRC guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma 2010. NHMRC. https://www.nhmrc.gov.au. 2010.
  25. National Institute for Health and Care Excellence (NICE). Glaucoma: diagnosis and management. NICE. http://www.nice.org.uk. 01 Nov 2017.
  26. Optometry Australia. Clinical practice guidelines for the diagnosis, treatment and management of glaucoma. https://www.optometry.org.au. Jul 2016.
  27. Wyeth Pharmaceuticals. Phospholine iodide (echothiophate) [prescribing information]. www.dailymed.nlm.nih.gov. Jul 2018.
  28. Prum BE Jr, Lim MC, Mansberger SL, et al. Primary open-angle glaucoma suspect preferred practice pattern guidelines. Ophthalmology. 2016 Jan;123(1):P112-P151. doi: 10.1016/j.ophtha.2015.10.055. PMID: 26581560
  29. Prum BE Jr, Rosenberg LF, Gedde SJ, et al. Primary open-angle glaucoma preferred practice pattern guidelines. Ophthalmology. 2016 Jan;123(1):P41-P111. doi: 10.1016/j.ophtha.2015.10.053. PMID: 26581556
  30. Rupp JD, Kass MA. Ocular hypertension. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, Pennsylvania, USA: Saunders, Elsevier; 2019. 1055-1056. :1055-1056.
  31. Scottish Intercollegiate Guidelines Network (SIGN). Glaucoma referral and safe discharge a national clinical guideline. SIGN. https://www.sign.ac.uk. Mar 2015. Accessed 19 Sep 2019.
  32. Tan JC, Kaufman PL. Primary open-angle glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, Pennsylvania, USA: Saunders, Elsevier; 2019. 1057-1060. Accessed 02 Oct 2019:1057-1060.
  33. ClinicalKey. Open-angle glaucoma. ClinicalKey. http://www.clinicalkey.com. 15 Dec 2020.
  34. European Glaucoma Society. Terminology and guidelines for glaucoma, 5th edition. European Glaucoma Society. https://www.eugs.org. Oct 2020.
  35. Gedde SJ, Vinod K, Wright MM, et al. Primary open-angle glaucoma preferred practice pattern® guidelines. Ophthalmology. 2020 Nov;128(1):PP71-P150. doi: 10.1016/j.ophtha.2020.10.022.
  36. Salmon JF, Kanski JJ. Glaucoma. In: Salmon JF, Kanski JJ, eds.. Kanski's Clinical Ophthalmology: A Systematic Approach. 9th edition. Philadelphia: Elsevier; 2020. Accessed 05 Jul 2021:346-422.
  37. Sun CQ, Chen TA, Deiner MS, et al. Clinical outcomes of micropulse laser trabeculoplasty compared to selective laser trabeculoplasty at one year in open-angle glaucoma. Clin Ophthalmol. 2021 Jan;15:243-251. doi: 10.2147/OPTH.S285136. PMID: 33519186
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