Autonomic nervous system, circadian rhythms, and primary open-angle glaucoma

Doina Gherghel, Sarah L. Hosking, Selim Orgül

Research output: Contribution to journalArticlepeer-review


The etiology of primary open-angle glaucoma (POAG) remains the subject of continuing investigation. Despite the many known risk factors and mechanism of damage, the principal treatment objectives in POAG still consist of reduction of intraocular pressure, which although straightforward in many cases, often leaves the clinician with the question of how far to pursue a sufficiently low pressure to prevent further damage. Other risk factors such as hemodynamic insufficiency due to vascular dysregulation and abnormal blood pressure are often overlooked in the day-to-day practice; their harmful effects for glaucoma are, it seems, more potent at night while the patient sleeps and when clinical investigation is most difficult. Although the status of autonomic nervous system is an important determinant of the systemic hemodynamic parameters, this issue is usually ignored by the clinician in the process of glaucoma diagnosis. Consequently, there is a lack of alternative therapies tailored to address associated systemic risk factors for POAG on a case and chronological basis; this approach could be more effective in preventing the progression and visual loss in selected glaucoma cases. © 2004 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)491-508
Number of pages18
JournalSurvey of ophthalmology
Issue number5
Early online date20 Aug 2004
Publication statusPublished - Sept 2004


  • autonomic nervous system
  • blood flow
  • primary open-angle glaucoma


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