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In the early stages of primary open-angle glaucoma, there are no symptoms. Because of the silent nature of primary open-angle glaucoma, people do not usually have any visual complaints until late in the course of the disease (see When to Seek Medical Care). By the time you would notice vision loss, significant amounts of optic nerve damage and vision loss have already occurred. The optic nerve damage and vision loss are permanent.

Some people’s first sign of disease from elevated intraocular pressure can be sudden vision loss due to the vein in the central part of the retina becoming blocked, called a central retinal vein occlusion. Elevated intraocular pressure is the second most common risk factor for a central retinal vein occlusion after high blood pressure (hypertension). This central retinal vein occlusion can cause vision loss separately from primary open-angle glaucoma.

Risk factors identified with primary open-angle glaucoma include the following:

• History of elevated intraocular pressure
  
  
• Family history of glaucoma
  
  
• Race (People of African American descent are at an increased risk.)
  
  
• Age older than 40 years (The risk of glaucoma increases with age.)
  
  
• Nearsightedness (myopia)

Of these risk factors, elevated intraocular pressure is the main risk factor for glaucoma that must be immediately and continuously treated. For this reason, regular eye examinations with an ophthalmologist are very important to rule out any damage to the optic nerve due to high pressure.

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