A nurse is collecting data from a client who has open-angle glaucoma. Which of the following findings should the nurse expect?

Choice B rationale Open-angle glaucoma is a chronic, progressive condition characterized by increased intraocular pressure due to reduced aqueous humor outflow through the trabecular meshwork. Normal intraocular pressure is 10 to 21 mmHg. This pressure causes damage to the optic nerve fibers, which initially manifests as a gradual loss of peripheral vision, often called tunnel vision. Because the central vision is preserved until late stages, the patient may not notice the deficit until substantial damage has occurred. Choice A rationale Seeing halos around lights is a classic symptom of acute angle-closure glaucoma, not open-angle glaucoma. In acute closure, the intraocular pressure rises rapidly, causing corneal edema. This edema scatters light as it enters the eye, creating the appearance of rainbows or halos. Open-angle glaucoma is typically asymptomatic in its early stages and does not cause the rapid corneal changes required to produce this specific visual phenomenon during the majority of its progression. Choice C rationale Open-angle glaucoma is often referred to as the silent thief of sight because it rarely causes pain or discomfort. The increase in intraocular pressure happens very slowly over years, allowing the eye to adapt without stimulating pain receptors. If a patient experiences significant eye discomfort, the nurse should investigate other causes such as infection, trauma, or acute angle-closure glaucoma, which is a medical emergency characterized by sudden, severe pain and a very high pressure. Choice D rationale Headaches are not a standard clinical finding for open-angle glaucoma. While a very high and sudden spike in pressure in acute angle-closure glaucoma can cause a severe brow ache or headache, the gradual pressure elevation in the open-angle variety does not usually trigger cephalalgia. If a patient with open-angle glaucoma reports headaches, it is likely unrelated to the glaucoma itself unless the pressure has reached extremely high levels not typical of the chronic form.