Glaucoma is a group of eye problems that can damage the optic nerve and lead to progressive or abrupt vision loss.
It’s the second-leading cause of blindness in the world, according to the World Health Organization.
Fluid buildup in the eye increases pressure and leads to gradual or quick nerve damage. This sometimes results from irregularities in the eye’s drainage system and depends on the type of disease. When left untreated, glaucoma can lead to permanent vision loss.
Although there’s no cure for glaucoma, early treatment can slow vision loss and protect against further damage. It’s important to see a doctor right away if you’re experiencing eye pain, poor vision, or severe headaches.
It’s also important to take routine, thorough eye exams; early signs of the most common type of glaucoma are often hard to spot.
If you’re at risk of developing this disease, you may ask: “What is glaucoma?”
Here, we’ll break down the causes, risk factors, and treatment options for glaucoma to help you make informed decisions and protect your vision.
Types and Causes of Glaucoma
Glaucoma is often associated with a buildup of fluid that puts pressure on the eye (or eyes) and damages its optic nerve. However, experts are still not sure exactly what causes many types of glaucoma, according to the National Eye Institute.
As the damaged optic nerve worsens over time, a person with glaucoma starts to develop blind spots and blurry vision. Eventually, if left untreated, this can lead to permanent vision loss.
An estimated 3 million Americans have glaucoma, according to the Glaucoma Research Foundation, but only about half realize it. Early symptoms are often hard to spot. With early diagnosis and treatment, complete blindness is rare (but still possible).
The types of glaucoma are:
- Primary open-angle glaucoma: The most common type of glaucoma usually involves slow, painless damage to the optic nerve. Some believe this to result from problems in the eye’s drainage system that arise over time. Those with this type of glaucoma can lose a significant portion of their eyesight before noticing vision problems. When left untreated, it often takes open-angle glaucoma several years to progress to complete blindness.
- Angle-closure glaucoma: Sometimes called closed-angle glaucoma, this type of the disease is less common. However, it is also a medical emergency that can cause vision loss within a day. The drainage angle is the spot where the iris and sclera meet and inner-eye fluid drains. People with a narrow drainage angle may experience this type of glaucoma. The eye’s drainage angle closes or becomes blocked, causing fluid buildup in the eye. Angle-closure glaucoma can progress gradually or appear suddenly.
- Secondary glaucoma: A result of an injury or another eye disease, this can result from medical conditions, medications, physical injuries, or eye abnormalities.
- Normal-tension or low-tension glaucoma: This is when a person’s eye pressure is in the “normal” range but the optic nerve is still damaged for unknown reasons. It’s possible people with this type of glaucoma have a sensitive optic nerve or have a lower blood supply to the optic nerve due to other issues.
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Risk Factors For Glaucoma
Anyone can develop glaucoma at any age, but certain people are at a higher risk.
Risk factors for developing glaucoma include:
- Age: Those who are 60 years old or older are more likely to get glaucoma with each passing year.
- Ethnicity: African Americans are at a significantly higher risk of getting open-angle glaucoma, especially after age 40. They are also more likely to have permanent vision loss. Asian Americans are more likely to get angle-closure glaucoma, with Japanese Americans in particular more likely to get low-tension glaucoma.
- Family history: If you have a family history of glaucoma, you’re more likely to get the disease.
- Certain conditions: Some studies suggest that high blood pressure, diabetes, and heart disease may increase the risk of developing glaucoma. Conditions like retinal detachment and eye tumors can make that risk greater, too.
- Physical injuries: Physical trauma to the eye can cause chronic and/or acute secondary glaucoma that may require immediate treatment. An injury or complicated eye surgery can both lead to secondary glaucoma.
- Eye anatomy: Thinner corneas and/or optic nerve sensitivity may increase the risk of developing certain types of glaucoma.
What Are the Signs and Symptoms?
The most common type of glaucoma, primary open-angle glaucoma, tends to show very few noticeable symptoms in its early stages.
It usually comes along slowly and painlessly, and peripheral vision loss is often the first to go. You may notice your peripheral vision getting worse if you’re turning your head more often to look off to the side.
As the disease progresses, potential symptoms include:
- Blind spots.
- Blurred vision.
- Eye pain, pressure, and/or redness.
- Halos or colored rings around lights.
- Nausea or vomiting.
- Severe headache.
- Tunnel vision.
- Vision problems.
For those with angle-closure glaucoma, the symptoms are more dramatic and can include blurred vision, halos or colored rings around lights, and pain and/ or redness in the eye.
Should I Get Screened for Glaucoma?
Regular eye exams are the only way to catch glaucoma early and stop significant vision loss.
Early detection is key, so anyone with high-risk factors for glaucoma should get tested every one to three years.
The American Academy of Ophthalmology recommends those at risk for glaucoma take complete eye exams:
- Every one to three years from ages 40 to 54.
- Every one to two years from ages 55 to 64.
- Every six to 12 months for ages 65 and older.
Everyone should have a baseline eye screening by age 40 to spot early signs; a complete eye exam includes common tests to detect glaucoma, such as:
- Corneal thickness measurements.
- Dilated eye exam.
- Eye angle exam.
- Eye pressure check.
- Optic nerve imaging and retina evaluation.
- Visual field tests.
What Are My Treatment Options?
There are a number of treatment options for glaucoma depending on the type and status of the disease.
Proper treatment can stop vision loss from worsening. Treatment options include:
- Medicine: Your doctor may prescribe medicine like eyedrops to lower the pressure in your eye and prevent any further damage to your optic nerve.
- Laser treatment: Many doctors can use lasers to help drain the fluid from your eye with a simple in-office procedure. One laser treatment, trabeculoplasty, treats open-angle glaucoma. Other laser treatments are available to address other types of glaucoma.
- Surgery: If medicine and laser treatment have not been effective, your doctor may recommend surgical options. These can help the fluid drain out of your eye and reduce pressure. They can include a trabeculectomy, glaucoma implant surgery, or minimally invasive glaucoma surgery.
Talk to your doctor about the benefits and risks of glaucoma treatment options and decide what’s right for you.
What Can I Do to Prevent Glaucoma?
The best way to prevent glaucoma is to take routine comprehensive eye exams and talk to an eye doctor about your risk factors to catch the disease early.
Though preventing glaucoma isn’t always possible, early treatment can prevent significant vision loss. Talk to your doctor often about risks and treatments and encourage family members to get screened for glaucoma if you’re diagnosed.
Generally, eating a nutritious diet rich in vitamins like vitamin A and getting regular moderate exercise may keep your eyes healthy for longer. Protecting your eyes from injury during sports, work, and home improvement projects can protect you from secondary glaucoma, too. Wear protective eyewear whenever neccesary.
Remember: The best prevention is early detection.
About UPMC Vision Institute
The UPMC Vision Institute is a national leader in the treatment of eye diseases and disorders. We seek to improve and restore your vision to help your quality of life, diagnosing and treating a wide range of conditions in both children and adults. Our treatments include both surgical and nonsurgical options. We also offer routine eye screenings and have full-scale optical shops. Find an eye expert close to you.