Open-angle glaucoma is best described as which pattern of vision loss?

• A. It presents with severe pain
• B. It causes unilateral vision loss
• C. It causes sudden vision loss
• D. It shows slow, progressive, painless peripheral vision loss

Answer: (D)

Open-angle glaucoma typically damages the optic nerve gradually, producing peripheral vision loss that slowly encroaches on central vision. The process is usually painless, and patients often don’t notice changes until the field constricts significantly, sometimes described as tunnel vision. Loss tends to begin in the mid-peripheral or nasal field and progresses over years, with central vision preserved until late. This contrasts with acute angle-closure glaucoma, which causes sudden, painful eye symptoms and rapid vision loss, or other conditions that cause abrupt unilateral loss. Thus, the pattern most characteristic of open-angle glaucoma is slow, progressive, painless peripheral vision loss.