Critical
See Signs in 9.1, PRIMARY OPEN-ANGLE GLAUCOMA, except IOP is consistently below 22 mm Hg. There is a greater likelihood of optic disc hemorrhages. Visual field defects are denser, more localized, and closer to fixation. A dense nasal paracentral defect is typical.
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If optic nerve changes and atrophy are unrelated to IOP, it is imperative to investigate potential etiologies of an optic neuropathy other than glaucoma. |
Controversial. Most investigators believe that IOP plays an important role in low-tension POAG. Other IOP-independent proposed etiologies include vascular dysregulation (e.g., systemic or nocturnal hypotension, vasospasm, or loss of autoregulation), microischemic disease, accelerated apoptosis, and autoimmune disease.
See Workup in 9.1, PRIMARY OPEN-ANGLE GLAUCOMA. Also consider: