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Identifying patients at risk from glaucoma

You will identify the majority of patients who are at risk from chronic open angle glaucoma during a routine eye examination. They are principally patients with one or more of the following: 
  1. optic disc features suggestive of glaucoma
  2. loss of peripheral vision
  3. high IOP.
Even in the absence of the signs or symptoms in the paragraph above, patients at greater than average risk of primary open angle glaucoma include those:103
  1. in certain ethnic groups, for example African-Caribbean people
  2. with first degree relatives with glaucoma
  3. over the age of 40. The risk increases with every decade of life thereafter
  4. with thinner corneas
  5. with myopia (myopia >6D is associated with an increased risk)
  6. with diabetes
  7. with systemic hypertension
  8. taking topical or systemic steroids, as they may develop steroid-induced glaucoma.
The signs of asymptomatic chronic angle closure glaucoma are almost identical to those of chronic open angle glaucoma with the exception that the anterior chamber angle is capable of intermittent closure or being obstructed.
The prevalence of angle closure glaucoma is greater than that of chronic open angle glaucoma (COAG) in people of South or East Asian descent.