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

Choice A rationale Open-angle glaucoma is often referred to as the silent thief of sight because it typically does not cause any physical discomfort or pain in the early to middle stages. The increase in intraocular pressure happens gradually over many years, allowing the eye to adapt without triggering the pain receptors. This lack of symptoms is why regular eye examinations are critical; by the time a patient feels actual discomfort, the disease has usually progressed to a very advanced stage. Choice B rationale Seeing halos around lights is a classic symptom associated with angle-closure glaucoma, which is an acute medical emergency. In that condition, the rapid rise in pressure causes corneal edema, which refracts light in a way that creates rainbow-like halos. In chronic open-angle glaucoma, the pressure rise is so slow and subtle that the cornea usually remains clear, meaning halos are not a standard finding that a nurse should expect during a routine data collection. Choice C rationale General headaches are not a common clinical finding for clients with primary open-angle glaucoma. Similar to the lack of eye pain, the slow progression of pressure does not usually result in the systemic or localized neurological symptoms that cause headaches. Intense headaches accompanied by nausea and vomiting are more indicative of acute angle-closure glaucoma, where the intraocular pressure spikes suddenly to very high levels, often exceeding 50 mmHg, necessitating immediate intervention to prevent permanent blindness. Choice D rationale The hallmark of open-angle glaucoma is the progressive, painless loss of peripheral vision, often described as tunnel vision. This occurs because the increased intraocular pressure damages the nerve fibers of the optic disc, starting with those that provide vision for the outer edges of the visual field. Normal intraocular pressure ranges from 10 to 21 mmHg. In open-angle glaucoma, this pressure is elevated, leading to permanent optic nerve atrophy and the characteristic narrowing of the patient's sight.