Glaucoma

What is glaucoma?

Glaucoma is a health problem where the fluid inside the eye slowly builds up and doesn’t drain correctly. This causes an increase in eye pressure that can damage the optic nerve. The optic nerve is a bundle of nerve fibers that connects the retina with the brain. This damage leads to loss of eyesight.

There are many different types of glaucoma:

• Open-angle glaucoma

• Low-tension or normal-tension glaucoma

• Angle-closure glaucoma

• Childhood glaucoma

• Congenital glaucoma

• Primary glaucoma

• Secondary glaucoma

What causes glaucoma?

Experts don't know what causes glaucoma. Even people with normal eye pressure can lose their eyesight from glaucoma.

Who is at risk for glaucoma?

Anyone can develop glaucoma. But some people are at higher risk than others. The risk factors for glaucoma are:

• Race. Glaucoma is a leading cause of blindness for African Americans, especially those older than age 40.

• Age. People age 60 and older are more at risk for developing glaucoma.

• Family history. People with a family history of glaucoma are more likely to develop the disease.

• High fluid pressure inside the eyes. People with a high fluid pressure inside the eyes are at an increased risk.

Anyone in these risk groups should get an eye exam where the pupils are widened (dilated) at least every 2 years, or as advised by your healthcare provider.

What are the symptoms of glaucoma?

Most people who have glaucoma don't notice any symptoms until they start to gradually lose some of their eyesight. As the optic nerve is damaged by glaucoma, small blind spots may begin to develop. They often affect the side (peripheral) vision. Many people don't notice the blind spots until major optic nerve damage has already happened. If the entire nerve is destroyed, the person becomes blind.

One type of glaucoma, called acute angle-closure glaucoma, does cause noticeable symptoms. This is because there is a quick buildup of pressure in the eye. Symptoms may be a bit different for each person. Symptoms may include:

• Blurred or narrowed field of vision

• Severe eye pain

• Halos or “rainbows” around lights

• Upset stomach (nausea)

• Vomiting

• Headache

The symptoms of acute angle-closure glaucoma may seem like other eye problems. This type of glaucoma is considered a medical emergency. Get medical care right away if you notice these symptoms to prevent blindness.

How is glaucoma diagnosed?

To diagnose glaucoma, your healthcare provider will take your complete health history and examine your eyes. You may also have the following tests:

• Visual acuity test. This common eye chart test measures how well you can see at different distances.

• Pupil dilation. The pupil is widened with eye drops to allow a close-up exam of the retina and optic nerve.

• Visual field. This test measures a person’s side (peripheral) vision. Loss of peripheral vision may mean a person has glaucoma.

• Tonometry. This test checks the fluid pressure inside the eye.

How is glaucoma treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

The symptoms of glaucoma sometimes seem like other conditions or health problems. Always see your healthcare provider for a diagnosis.

Glaucoma can’t be cured. But early treatment can often control it. Treatment may include:

• Medicines. Some medicines cause the eye to make less fluid. Others lower pressure by helping fluid drain from the eye.

• Surgery. The purpose of surgery is to create a new opening for fluid to leave the eye.

• Laser surgery. There are several types of laser surgeries used to treat glaucoma.

• Drainage tube. For this surgery, a flexible plastic tube (shunt) is placed in the eye to help drain fluid.

In some cases, a single surgery isn’t enough to slow down the progress of glaucoma. In those cases, repeat surgery or continued treatment with medicines may be needed.

What are possible complications of glaucoma?

Without treatment, glaucoma can cause lifelong (permanent) blindness.

Living with glaucoma

To help prevent your glaucoma from getting worse, it’s important to follow your healthcare provider’s advice. If you have already lost some of your eyesight, ask your healthcare provider for information on services for people with low vision. There are devices that may help you with your everyday tasks.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, call your healthcare provider right away.

Key points about glaucoma

• Glaucoma is a health problem where the fluid pressure inside the eye slowly builds up and doesn’t drain correctly.

• Even people with normal fluid pressure inside the eye can lose their eyesight from glaucoma.

• Most people don’t notice any symptoms until they start to gradually lose some of their eyesight.

• It can’t be cured. But early treatment can often control it.

• Treatment may include medicines or surgery.

• Without treatment, glaucoma can cause lifelong (permanent) vision loss.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.