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
Otros factores de diagnóstico
- corneal hysteresis
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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- tonometry
- gonioscopy
- direct ophthalmoscopy
- indirect ophthalmoscopy
- slit-lamp biomicroscopy
- visual field testing
- optical coherence tomography scanning
Pruebas diagnósticas que deben considerarse
- digital imaging
- pachymetry
- nerve fiber layer analysis
Pruebas emergentes
- corneal hysteresis
Algoritmo de tratamiento
eye drops preferred or laser trabeculoplasty contraindicated/failed
laser trabeculoplasty preferred or eye drops contraindicated /failed
eye drops contraindicated /failed and rapidly progressive disease
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
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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