Glaucoma is a leading cause of irreversible vision loss, often asymptomatic until advanced stages. The review by Weinreb, Aung, and Medeiros provides an overview of the pathophysiology, diagnosis, and treatment of open-angle and angle-closure glaucoma. Key points include: 1. **Pathophysiology**: Intraocular pressure (IOP) is a critical factor in glaucoma, causing mechanical stress on the optic nerve and retinal ganglion cells. Other factors like mitochondrial dysfunction and microcirculation issues also play roles. 2. **Genetics**: Several genes, such as MYOC, OPTN, and WD repeat domain 36, are associated with glaucoma, though they account for less than 10% of cases. Genome-wide association studies have identified new loci for angle closure glaucoma. 3. **Clinical Presentation and Diagnosis**: Early diagnosis is crucial due to the asymptomatic nature of the disease. Ophthalmoscopic examination and visual field testing are essential for detection. Advanced imaging techniques like optical coherence tomography (OCT) have improved early detection and monitoring of disease progression. 4. **Treatment**: Reducing IOP is the primary treatment goal. Medications, laser trabeculoplasty, and surgery (trabeculectomy) are used to lower IOP and slow disease progression. Primary care physicians can play a vital role in early diagnosis and referral for comprehensive ophthalmologic examination. 5. **Angle-Closure Glaucoma**: This form is characterized by an anatomically closed angle, often causing acute symptoms like severe pain, blurred vision, and nausea. Management includes laser peripheral iridotomy to prevent pupillary block and surgical interventions for advanced cases. The review emphasizes the importance of early intervention and the role of primary care physicians in managing glaucoma to prevent vision loss.Glaucoma is a leading cause of irreversible vision loss, often asymptomatic until advanced stages. The review by Weinreb, Aung, and Medeiros provides an overview of the pathophysiology, diagnosis, and treatment of open-angle and angle-closure glaucoma. Key points include: 1. **Pathophysiology**: Intraocular pressure (IOP) is a critical factor in glaucoma, causing mechanical stress on the optic nerve and retinal ganglion cells. Other factors like mitochondrial dysfunction and microcirculation issues also play roles. 2. **Genetics**: Several genes, such as MYOC, OPTN, and WD repeat domain 36, are associated with glaucoma, though they account for less than 10% of cases. Genome-wide association studies have identified new loci for angle closure glaucoma. 3. **Clinical Presentation and Diagnosis**: Early diagnosis is crucial due to the asymptomatic nature of the disease. Ophthalmoscopic examination and visual field testing are essential for detection. Advanced imaging techniques like optical coherence tomography (OCT) have improved early detection and monitoring of disease progression. 4. **Treatment**: Reducing IOP is the primary treatment goal. Medications, laser trabeculoplasty, and surgery (trabeculectomy) are used to lower IOP and slow disease progression. Primary care physicians can play a vital role in early diagnosis and referral for comprehensive ophthalmologic examination. 5. **Angle-Closure Glaucoma**: This form is characterized by an anatomically closed angle, often causing acute symptoms like severe pain, blurred vision, and nausea. Management includes laser peripheral iridotomy to prevent pupillary block and surgical interventions for advanced cases. The review emphasizes the importance of early intervention and the role of primary care physicians in managing glaucoma to prevent vision loss.