Management of open-angle glaucoma

Open-angle glaucoma is a non-curable, blinding disease which has its best prognosis when management begins at its earliest onset. Recent studies, such as those demonstrating axonal loss before functional or physical changes occur, will have an effect on the current standard of management. This includes indications for initiating treatment as well as what constitutes controlled intraocular pressure. Pharmacological management is often difficult due to drug tolerance and compliance problems. Some types of secondary open angle glaucomas respond very poorly to treatment. Hence, an accurate diagnosis is imperative to proper management. Principles underlying pharmacological management are discussed. When pharmacological management fails, laser and/or surgical intervention is required to prevent further vision loss.