Glaucoma is an eye condition that damages the optic nerve. This damage can lead to vision loss or blindness. The optic nerve sends visual information from your eye to the brain and is vital for good vision. Damage to the optic nerve is often related to high pressure in the eye. But glaucoma can happen even with typical eye pressure.
Glaucoma can happen at any age but is more common in older adults. It is one of the leading causes of blindness for people over the age of 60.
Many forms of glaucoma have no warning signs. The effect is so gradual that you may not notice a change in vision until the condition is in its later stages.
It's important to have regular eye exams that include measurements of your eye pressure. If glaucoma is found early, vision loss can be slowed or prevented. If you have glaucoma, you'll need treatment or monitoring for the rest of your life.
The symptoms of glaucoma depend on the type and stage of the condition.
If you have symptoms that come on suddenly, you may have acute angle-closure glaucoma. Symptoms include bad headache and severe eye pain. You need treatment as soon as possible. Go to an emergency room or call an eye doctor, called an ophthalmologist, immediately.
Glaucoma develops when the optic nerve becomes damaged. As this nerve gradually gets worse, blind spots develop in your vision. For reasons that eye doctors don't fully understand, this nerve damage is usually related to increased pressure in the eye.
Raised eye pressure happens as the result of a buildup of fluid that flows throughout the inside of the eye. This fluid, called the aqueous humor, usually drains through a tissue located at the angle where the iris and cornea meet. This tissue is called the trabecular meshwork. The cornea is important to vision because it lets light into the eye. When the eye makes too much fluid or the drainage system doesn't work properly, eye pressure may increase.
This is the most common form of glaucoma. The drainage angle formed by the iris and cornea remains open. But other parts of the drainage system don't drain properly. This may lead to a slow, gradual increase in eye pressure.
This form of glaucoma happens when the iris bulges. The bulging iris partially or completely blocks the drainage angle. As a result, fluid can't circulate through the eye and pressure increases. Angle-closure glaucoma may happen suddenly or gradually.
No one knows the exact reason why the optic nerve becomes damaged when eye pressure is healthy. The optic nerve may be sensitive or experience less blood flow. This limited blood flow may be caused by the buildup of fatty deposits in the arteries or other conditions that damage circulation. The buildup of fatty deposits in the arteries also is known as atherosclerosis.
A child may be born with glaucoma or develop it in the first few years of life. Blocked drainage, injury or an underlying medical condition may cause optic nerve damage.
In pigmentary glaucoma, small pigment granules flake off from the iris and block or slow fluid drainage from the eye. Activities such as jogging sometimes stir up the pigment granules. That leads to a deposit of pigment granules on tissue located at the angle where the iris and cornea meet. The granule deposits cause an increase in pressure.
Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage.
Glaucoma can damage vision before you notice any symptoms. So be aware of these risk factors:
Some people have narrow drainage angles, putting them at increased risk of angle-closure glaucoma.
These steps may help find and manage glaucoma in its early stages. That may help to prevent vision loss or slow its progress.
Get regular eye exams. Regular eye exams can help find glaucoma in its early stages, before a lot of damage occurs. As a general rule, the American Academy of Ophthalmology recommends a comprehensive eye exam every 5 to 10 years if you're under 40 years old; every 2 to 4 years if you're 40 to 54 years old; every 1 to 3 years if you're 55 to 64 years old; and every 1 to 2 years if you're older than 65.
If you're at risk of glaucoma, you'll need screening more often. Ask a healthcare professional to recommend the right screening schedule for you.
An eye care professional will review your medical history and do a comprehensive eye exam. Several tests may be done, including:
The damage caused by glaucoma can't be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if the disease is found in its early stages.
Treatment of glaucoma aims to lower intraocular pressure. Treatment options include prescription eye drops, oral medicines, laser treatment, surgery or a combination of approaches.
Glaucoma treatment often starts with prescription eye drops. Some may decrease eye pressure by improving how fluid drains from the eye. Others decrease the amount of fluid the eye makes. Depending on how low the eye pressure needs to be, more than one eye drop may be prescribed.
Prescription eye drop medicines include:
Prostaglandins. These increase the outflow of the fluid in the eye, helping to reduce eye pressure. Medicines in this category include latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan) and latanoprostene bunod (Vyzulta).
Possible side effects include mild reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or eyelid skin, and blurred vision. This class of medicine is prescribed for once-a-day use.
Beta blockers. These reduce the production of fluid in the eye, helping to lower eye pressure. Examples include timolol (Betimol, Istalol, Timoptic) and betaxolol (Betoptic S).
Possible side effects include difficulty breathing, slowed heart rate, lower blood pressure, impotence and fatigue. This class of medicine can be prescribed for once- or twice-daily use depending on your condition.
Alpha-adrenergic agonists. These reduce the production of the fluid that flows throughout the inside of the eye. They also increase the outflow of fluid in the eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan P, Qoliana).
Possible side effects include irregular heart rate; high blood pressure; fatigue; red, itchy or swollen eyes; and dry mouth. This class of medicine is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.
Because some of the eye drop medicine is absorbed into the bloodstream, you may experience some side effects unrelated to your eyes. To minimize this absorption, close your eyes for 1 to 2 minutes after putting the drops in. You also may press lightly at the corner of your eyes near your nose to close the tear duct for 1 to 2 minutes. Wipe off any unused drops from your eyelid.
You may be prescribed multiple eye drops or need to use artificial tears. Make sure you wait at least five minutes in between using different drops.
Eye drops alone may not bring eye pressure down to the desired level. So an eye doctor also may prescribe oral medicine. This medicine is usually a carbonic anhydrase inhibitor. Possible side effects include frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney stones.
Other treatment options include laser therapy and surgery. The following techniques may help to drain fluid within the eye and lower eye pressure:
After your procedure, you'll need to see your eye doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise or other changes happen in your eye.
Acute angle-closure glaucoma is a medical emergency. If you're diagnosed with this condition, you'll need urgent treatment to reduce the pressure in your eye. This generally will require treatment with medicine and a laser or surgical procedures.
You may have a procedure called a laser peripheral iridotomy. The doctor creates a small hole in your iris using a laser. The hole allows fluid to flow through the iris. This helps to open the drainage angle of the eye and relieves eye pressure.
These tips may help control high eye pressure or promote eye health.
Some alternative medicine approaches may help overall health, but none is an effective glaucoma remedy. Talk with an eye doctor about the possible benefits and risks.
When you receive a diagnosis of glaucoma, you're potentially facing lifelong treatment, regular checkups and the possibility of progressive vision loss.
Meeting and talking with other people with glaucoma can be very helpful, and many support groups exist. Check with hospitals and eye care centers in your area to find local groups and meeting times. Look for online resources, including support groups.
You may start by seeing your primary healthcare professional. Or you may be referred immediately to an eye specialist, also called an ophthalmologist.
Here's some information to help you get ready for your appointment.
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:
Take a family or friend along, if possible, to help you remember the information you're given.
For glaucoma, some basic questions to ask include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you several questions, such as:
Avoid doing anything that seems to worsen your symptoms.
