Traditionally, ophthalmologists have been taught that older patients living with primary open-angle glaucoma don’t need to be treated as aggressively as younger patients, who have more years ahead of them. But this philosophy is being challenged by Leon Herndon, Jr., M.D., an ophthalmologist, professor of ophthalmology, and chief of the glaucoma division at Duke University Eye Center.

What Is Primary Open-Angle Glaucoma?

As described by the Glaucoma Research Foundation, primary open-angle glaucoma (POAG) happens when the eye’s natural drainage system becomes blocked and fluid pressure builds inside the eye, called intraocular pressure. Like a clogged drainpipe, the blockage in POAG typically happens further inside the drainage canals.

While POAG is the most common type of glaucoma in the U.S., with roughly three million people affected each year, many people show no symptoms. If not diagnosed and treated early, loss of vision can occur over time. If treated early, however, patients usually respond well.

How Should a Patient’s Age Affect POAG Treatment?

Dr. Herndon explains that older people are more susceptible to developing glaucoma and that the U.S. population is aging. While we can’t know exactly how much longer a person will live, data shows that a 90-year-old will live another 4-5 years. 

• Extensive research using the Duke Glaucoma Registry shows that older POAG patients tend to experience faster erosion of optic-nerve tissue (from increased eye pressure) than younger patients.
• Yet, ophthalmologists are taught that younger POAG patients should be treated more aggressively than older patients because they will live longer.

“We need to revisit that,” states Herndon. “These older patients will live longer, and they may continue to lose vision if we don’t pay attention to their intraocular pressures.”

*AJMC staff. (2021, November 14). Dr. Leon Herndon Explains the Role of Age in Primary Open-Angle Glaucoma [Video]. AJMC. https://www.ajmc.com/view/dr-leon-herndon-explains-the-role-of-age-in-primary-open-angle-glaucoma