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Glaucoma: Symptoms, treatment and prevention

  1. Types
  2. Who Is At Risk?
  3. Symptoms
An elderly man receiving an eye exam

Glaucoma is often called the "silent thief of sight," because most of its types typically cause no pain and produce no symptoms until noticeable vision loss occurs.

For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged.

What is glaucoma?

Glaucoma is a group of related eye disorders that cause damage to the optic nerve that carries information from the eye to the brain.

In most cases, glaucoma is associated with higher-than-normal pressure inside the eye — a condition called ocular hypertension. But it can also occur when intraocular pressure (IOP) is normal. If untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness.

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In most types of glaucoma, optic nerve damage and vision loss occurs because the pressure inside the eye (IOP) is too high.

Glaucoma is the second-leading cause of blindness worldwide (behind cataracts).

Types of glaucoma

The two major categories of glaucoma are open-angle glaucoma and narrow angle glaucoma. The "angle" in both cases refers to the drainage angle inside the eye that controls the outflow of the watery fluid (aqueous) which is continually being produced inside the eye.

If the aqueous can access the drainage angle, the glaucoma is known as open angle glaucoma. If the drainage angle is blocked and the aqueous cannot reach it, the glaucoma is known as narrow angle glaucoma.

Glaucoma symptoms

Most types of glaucoma typically cause no pain and produce no symptoms until noticeable vision loss occurs, but with acute angle-closure glaucoma, one experiences sudden symptoms like blurry vision, halos around lights, intense eye pain, nausea and vomiting.

If you have these symptoms, see an eye doctor so steps can be taken to prevent permanent vision loss.

Diagnosis, screening and tests for glaucoma

During routine eye exams, a tonometer is used to measure your intraocular pressure, or IOP. Your eye typically is numbed with eye drops, and a small probe gently rests against your eye's surface. Other tonometers send a puff of air onto your eye's surface.

An abnormally high IOP reading indicates a problem with the amount of fluid (aqueous humor) in the eye. Either the eye is producing too much fluid, or it's not draining properly.

Normally, IOP should be below 21 mmHg (millimeters of mercury) — a unit of measurement based on how much force is exerted within a certain defined area.

If your IOP is higher than 30 mmHg, your risk of vision loss from glaucoma is 40 times greater than someone with intraocular pressure of 15 mmHg or lower. This is why glaucoma treatments such as eye drops are designed to keep IOP low.

Other methods of monitoring glaucoma involve the use of sophisticated imaging technology to create baseline images and measurements of the eye's optic nerve and internal structures.

Then, at specified intervals, additional images and measurements are taken to make sure no changes have occurred that might indicate progressive glaucoma damage.

Glaucoma treatments

Treatment for glaucoma can involve surgery, laser treatment or medication, depending on the severity. Eye drops with medication aimed at lowering IOP are usually tried first to control glaucoma.

Because glaucoma is often painless, people may become careless about strict use of eye drops that can control eye pressure and help to prevent permanent eye damage.

In fact, not complying to prescribed glaucoma medication program one of the major reasons for blindness caused by glaucoma.

If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your eye doctor about a possible alternative therapy.

Exercise may cut glaucoma risk

Can you reduce the glaucoma risk? According to a recent European study, exercise lessens the chance that some people will develop glaucoma because it helps improve blood flow in your body and your eyes.

In addition to regular exercise and an active lifestyle, you also can reduce your risk for glaucoma by not smoking, maintaining a healthy weight, and eating a varied and healthy diet.

Open-angle glaucoma in Filipino and white Americans: a comparative study. Journal of Glaucoma. April/May 2014.

Ophthalmology seeks revised government assessment of glaucoma screenings and treatment. Press release issued by American Academy of Ophthalmology in November 2011.

Physical activity and ocular perfusion pressure: The EPIC-Norfolk Eye Study. Investigative Ophthalmology & Visual Science. October 2011.

Physical fitness could have a positive effect on eye health: new study links active lifestyle to reduced risk of glaucoma. Press release issued by Association for Research in Vision and Ophthalmology (ARVO) in October 2011.

Glaucoma is second leading cause of blindness globally. World Health Organization bulletin. November 2004.

Ophthalmology. 2nd edition. 2004.

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