Primary open-angle glaucoma (POAG) is a progressive, chronic, irreversible ocular disease that leads to loss of visual field. In the United States, its prevalence is expected to more than double from 2011 to 2050. POAG is three times more common among Black people than White people. More than half of patients with POAG are asymptomatic. Management focuses on decreasing intraocular pressure. Prostaglandin analogue eye drops can preserve visual field and are the first-line therapy. There currently is no evidence to support universal screening for POAG in adults. Physicians should recognize patients at high risk and provide early referral to an ophthalmologist. They also should encourage patients with POAG to adhere to treatment and follow up with their ophthalmologist. Cataract is a progressive condition caused by opacification of the lens of the eye. It affects 24.4 million Americans and is expected to affect 50 million Americans by 2050. Patients with cataracts present with visual impairment, glare, decreased color and contrast sensitivity, and poor adaptation to darkness. Management consists of surgical removal of the lens via small-incision phacoemulsification with placement of a foldable intraocular lens. After surgery, patients may develop posterior capsular opacification, which can be managed with laser capsulotomy.

Case 2. JM is a 51-year-old man with a history of hypertension, diet-controlled diabetes, and mild obesity. He comes to your office for an annual health maintenance examination. On review of systems, he reports that during the past few months he has experienced blurry vision, occasional headaches, halos around lights, and episodic redness of the eyes. JM was referred to an ophthalmologist for an eye examination at his last physical 1 year ago, but has not yet scheduled the visit.