Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first-line treatment for open-angle glaucoma?

1. Laser surgery

2. Beta-blockers

3. Prostaglandin analogs

4. Carbonic anhydrase inhibitors

The correct answer is: Prostaglandin analogs

Prostaglandin analogs are widely recognized as the first-line treatment for open-angle glaucoma due to their efficacy in reducing intraocular pressure (IOP). These medications work by increasing the outflow of aqueous humor through the uveoscleral pathway, which effectively lowers IOP. This is particularly important in managing open-angle glaucoma, where elevated IOP can lead to progressive damage to the optic nerve and subsequent vision loss. Prostaglandin analogs also have the advantage of being dosed once daily, which improves patient compliance compared to some other treatment options that may require more frequent dosing. Common examples include latanoprost, bimatoprost, and travoprost, which are often chosen for their strong IOP-lowering effects and favorable side effect profiles. Other treatments exist for glaucoma management, and while beta-blockers, laser surgery, and carbonic anhydrase inhibitors are also effective, they are typically considered second-line or adjunctive therapies in the treatment hierarchy for open-angle glaucoma.