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Open-angle glaucoma

Última revisión: 1 Feb 2026
Última actualización: 12 Jun 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • cup-to-disk ratio >0.5
  • notching of optic nerve cup
  • symptomatic peripheral vision loss
  • increased intraocular pressure
  • scotomas
  • loss of nerve fiber layer
  • optic disk hemorrhage
Todos los datos

Otros factores de diagnóstico

  • corneal hysteresis
Todos los datos

Factores de riesgo

  • intraocular pressure >21 mmHg
  • age >50 years
  • family history of glaucoma
  • genetic abnormalities
  • black ethnicity or Hispanic ethnicity
  • myopia
  • diabetes mellitus
  • hypertension
  • low ocular perfusion pressure
  • thin central corneal thickness
  • corneal hysteresis
  • calcium-channel blockers
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • tonometry
  • gonioscopy
  • direct ophthalmoscopy
  • indirect ophthalmoscopy
  • slit-lamp biomicroscopy
  • visual field testing
  • optical coherence tomography scanning
Todos los datos

Pruebas diagnósticas que deben considerarse

  • digital imaging
  • pachymetry
  • nerve fiber layer analysis
Todos los datos

Pruebas emergentes

  • corneal hysteresis

Algoritmo de tratamiento

Agudo

eye drops preferred or laser trabeculoplasty contraindicated/failed

laser trabeculoplasty preferred or eye drops contraindicated /failed

eye drops contraindicated /failed and rapidly progressive disease

En curso

treatment failure

Colaboradores

Autores

Nishani Amerasinghe, MBBS, BSc(Hons), FRCOphth

Consultant Ophthalmic Surgeon

Glaucoma Specialist

University Hospital Southampton NHS Trust

Southampton

UK

Divulgaciones

NA is president-elect of the UK and Éire Glaucoma Society and has acted as an unpaid advisor to NICE and The Royal College of Ophthalmologists. NA has served on an advisory panel for Santen and has received travel honoraria and speaker's fees from Thea Pharmaceuticals, Santen, and Allergan. NA has received research funding from AbbVie Pharmaceuticals.

Irena Serov-Volach, MD

Senior Glaucoma and Cataract Fellow

Ophthalmology department

Eye Unit

Epsom and St Helier University Hospitals NHS Trust

London

UK

Divulgaciones

ISV has received consultancy/travel fees from Glaukos.

Agradecimientos

Dr Nishani Amerasinghe and Dr Irena Serov-Volach would like to gratefully acknowledge Dr Robert B. Avery and Dr Michael N. Wiggins, the previous contributors to this topic.

Divulgaciones

RBA and MNW declare that they have no competing interests.

Revisores por pares

Andrew Chen, MD

Assistant Professor

University of Washington

Seattle

WA

Divulgaciones

AC declares that he has received research funding from Janssen LLC.

Sheila Sanders, MD

Professor of Ophthalmology

University of Kentucky

South Limestone

Lexington

KY

Divulgaciones

SS declares that she has no competing interests.

Mohamed Khodeiry, MD

Glaucoma Fellow

University of Kentucky

South Limestone

Lexington

KY

Divulgaciones

MK declares that he has no competing interests.

Roshini Sanders, FRCS, FRCOphth

Consultant Ophthalmologist

Queen Margaret Hospital

Dunfermline

Fife

UK

Divulgaciones

RS declares that she has no competing interests.

Agradecimiento de los revisores por pares

Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.

Divulgaciones

Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Weinreb RN, Leung CK, Crowston JG, et al. Primary open-angle glaucoma. Nat Rev Dis Primers. 2016 Sep 22;2:16067. Resumen

International Council of Ophthalmology. ICO guidelines for glaucoma eye care. Feb 2016 [internet publication].Texto completo

American Academy of Ophthalmology. Primary open-angle glaucoma preferred practice pattern. Nov 2020 [internet publication].Texto completo

American Academy of Ophthalmology. Primary open-angle glaucoma suspect preferred practice pattern. Nov 2020 [internet publication].Texto completo

National Institute for Health and Care Excellence. Glaucoma: diagnosis and management. Jan 2022 [internet publication].Texto completo

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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  • Guidelines

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    • Trabeculectomy with a biodegradable collagen matrix implant for glaucoma
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  • Patient information

    Glaucoma

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