Acute angle-closure glaucoma can be precipitated by the use of dilating eyedrops and is a medical emergency. In contrast, primary open-angle glaucoma is an insidious disease most often discovered during routine examinations. As the disease progresses, deterioration of central visual functions, including acuity, becomes evident. Although no upper limit for normal intraocular pressure has been established, further investigation for treatment is indicated for patients whose pressure exceeds 21 mm Hg. The treatment of glaucoma includes both medical and surgical approaches.
Topical eyedrops are the most common medical treatment of open-angle glaucoma.
Agents either decrease the production of aqueous or increase its outflow and absorption. Although topical beta blockers may be absorbed systemically, resulting in bronchospasm, cardiovascular side effects from these agents are uncommon, as observed in population-based studies. The meiotic pupils, however, interfere with night vision. Surgery for glaucoma is usually reserved for patients in whom target pressures cannot be achieved with medical or laser therapy. Good success rates have been described with argon laser trabeculectomy, but additional surgery is often needed.