Glaucoma

Glaucoma does not usually cause any symptoms to begin with. This is one of the reasons that the NHS recommends regular eye tests, particularly as you get older or where there is a history of other medical conditions such as diabetes.

Glaucoma tends to develop slowly over many years and affects the edges of your vision (peripheral vision) first, so you may not become aware of it until it has progressed.

For this reason, many people do not realise they have glaucoma, and it’s often only picked up during a routine eye test.

If you do notice any symptoms, they might include blurred vision, or seeing rainbow-coloured circles around bright lights.

Both eyes are usually affected, although it may be worse in one eye.

Very occasionally, glaucoma can develop suddenly and cause:

• intense eye pain
• nausea and vomiting
• a red eye
• a headache
• tenderness around the eyes
• seeing rings around lights
• blurred vision

There are several types of glaucoma:

• Primary open angle glaucoma – This is the most common type of glaucoma and develops very slowly. It’s caused by the drainage channels in the eye becoming gradually clogged over time.
• Angle closure glaucoma – This is rare and can occur slowly (chronic) or may develop rapidly (acute) with a sudden, painful build-up of pressure in the eye.
• Normal tension glaucoma – This is when eye pressure is within the normal range (less than 21mmHg) but still causes damage to the optic nerve. It’s not entirely clear why some people’s optic nerve becomes damaged even though their eye pressure is at a normal level, but normal tension glaucoma is treated in the same way as open angle glaucoma – by lowering the eye pressure.
• Secondary glaucoma –This occurs as a result of an eye injury or another eye condition, such as inflammation of the eye (uveitis).
• Developmental glaucoma (congenital glaucoma) -This is rare but can be serious. It is usually present at birth or develops shortly after birth. It is caused by an abnormality of the eye.

Among white Europeans, about 1 in 50 people over 40 years of age and 1 in 10 people over 75 years of age have chronic open-angle glaucoma.

You are also at increased risk of developing open-angle glaucoma if you are of black-African or black-Caribbean origin.

The other types of glaucoma, such as acute angle-closure glaucoma, are much less common. However, people of Asian origin are more at risk of getting this type of glaucoma compared with those from other ethnic groups.

Glaucoma can occur for several reasons. Most cases are caused by a build-up of pressure in the eye when fluid is unable to drain properly (ocular hypertension or OHT).

This increase in pressure then damages the nerve that connects the eye to the brain (optic nerve).

It’s often unclear why this happens, although certain things can increase the risk, including:

• your age – glaucoma becomes more common as you get older.
• your ethnicity – people of African, Caribbean or Asian origin are at a higher risk.
• your family history – you’re more likely to develop glaucoma if you have a parent or sibling with the condition.
• other medical conditions – such as short-sightedness, long-sightedness and diabetes.

It’s not clear whether you can do anything to prevent glaucoma but having regular eye tests should pick it up as early as possible.

Glaucoma is usually picked up during a routine eye test by an optician/optometrist, often before it causes any noticeable symptoms.

This may be because of the appearances of the optic disc when the back of the eye is viewed directly or through measurement of the intraocular pressure (fluid pressure within the eyeball).

Other tests are usually needed afterwards to diagnose and monitor the condition, for further details of what may be involved click here.

It’s important to have regular eye tests so problems such as glaucoma can be diagnosed and treated as early as possible. Early treatment can help stop your vision becoming severely affected.

You should have an eye test at least every 2 years. If you’re at a higher risk of glaucoma – for example, if you have a close relative with it – you may be advised to have more frequent tests.

You can get an eye test at a local opticians, and the tests are carried out by an optometrist. Find an optician near you.

Some people can receive free eye tests on the NHS. Find out if you’re entitled to free NHS eye tests.

If you have any concerns about your vision you should consult with an optician.

If you have glaucoma, early diagnosis and treatment can help stop your vision getting worse and without treatment, glaucoma can eventually lead to blindness.

If your optician suspects glaucoma they can refer you to see a specialist (this does not normally need to be done through your GP).

Without treatment, glaucoma can eventually lead to blindness.

If you develop visual symptoms suddenly (including those of glaucoma outlined above) then you should go to your nearest eye casualty unit or A&E as soon as possible as this is a medical emergency that may require immediate treatment.

It’s not possible to reverse any loss of vision that occurred before glaucoma was diagnosed, but treatment can help stop your vision getting worse.

The treatment recommended for you will depend on the type of glaucoma you have, but the options are:

• eyedrops – to reduce the pressure in your eyes.
• laser treatment – to open the blocked drainage tubes or reduce the production of fluid in your eyes.
• surgery – to improve the drainage of fluid (trabeculectomy).

You’ll also probably need regular specialist appointments to monitor your condition and check that the treatment is working.

For more details about the treatments listed above click here.

• Understanding Glaucoma – Royal National Institute for the Blind (RNIB)
• Glaucoma – A Guide – Glaucoma UK
• Glaucoma – Moorfields Eye Hospital website
• Glaucoma UK – a UK registered charity providing help, information & support to anyone living with glaucoma
• Primary open angle glaucoma – Glaucoma UK patient information leaflet
• Primary angle closure glaucoma – Glaucoma UK patient information leaflet
• Secondary Glaucomas – Glaucoma UK patient information leaflet (.pdf)
• Eye examinations – Royal National Institute for the Blind (RNIB) website
• Eye Drops & Dispensing Aids – Glaucoma UK patient information leaflet
• Glaucoma – vision & driving FAQ’s – Moorfields Eye Hospital patient information leaflet
• Glaucoma in Babies & Children – Glaucoma UK patient information leaflet
• Glaucoma surgery: 8-12 years – Moorfields Eye Hospital patient information leaflet
• Glaucoma surgery: teens/parents – Moorfields Eye Hospital patient information leaflet

What is Glaucoma | Speak Health

Published: 17 Feb 2017

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