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Overview

What Is Glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve, which carries visual information from the eye to the brain. This damage can cause glaucoma vision loss that develops gradually and may become permanent. Anyone can be affected, although the risk increases with age, family history, certain medical conditions, and some eye characteristics. The main forms include open-angle glaucoma and angle-closure glaucoma.

Symptoms

Glaucoma Symptoms

Open-angle glaucoma often causes no noticeable symptoms in its early stages. Peripheral vision may be lost slowly, sometimes before a person notices changes in central vision. Because early signs of glaucoma can be difficult to detect, routine eye examinations are important even when vision seems normal.

  • Gradual loss of peripheral vision may make it harder to notice objects to the side.
  • Blurred or hazy vision can occur as glaucoma progresses.
  • Severe eye pain or headache may signal acute angle-closure glaucoma.
  • Eye redness or halos around lights can occur during a sudden rise in eye pressure.
  • Nausea or vomiting with sudden vision changes requires immediate medical evaluation.

Seek urgent care

Sudden symptoms need immediate evaluation

Sudden severe eye pain, a red eye, headache, halos around lights, nausea or vomiting, or rapidly changing vision may indicate acute angle-closure glaucoma. Seek emergency medical care immediately because prompt treatment may help protect vision.

Causes

What Causes Glaucoma?

The eye continuously makes a clear fluid called aqueous humor, which normally circulates and drains through a drainage angle. If fluid drainage is reduced, pressure can build inside the eye and place stress on the optic nerve. However, some people develop glaucoma with normal measured eye pressure because the optic nerve is more vulnerable to damage.

How the main forms develop

In open-angle glaucoma, the drainage angle remains open but does not remove fluid efficiently, so damage usually develops gradually. In angle-closure glaucoma, the drainage angle becomes narrowed or blocked, and pressure can rise quickly in an acute glaucoma attack. Injury, steroid medicines, inflammation, or other eye conditions can also contribute to secondary glaucoma.

Risk Factors

Glaucoma Risk Factors

CANNOT CHANGE

Age, a family history of glaucoma, certain ancestries, and some eye-anatomy features can increase risk.

DISCUSS WITH A CLINICIAN

Steroid exposure, diabetes, blood pressure problems, smoking, eye injury, and other eye conditions may require medical management or closer monitoring.

Having a risk factor does not mean that you will develop glaucoma, but it can make regular comprehensive eye examinations especially important. Tell your eye-care clinician about family history, medical conditions, medicines, and previous eye injuries.

Complications

Glaucoma Complications

  • Progressive peripheral vision loss can reduce awareness of objects and movement at the sides.
  • Reduced central vision may develop in advanced glaucoma.
  • Difficulty with reading, mobility, driving, or other daily activities can occur as vision declines.
  • Permanent blindness can occur if optic-nerve damage becomes severe.

Diagnosis

How Glaucoma Is Diagnosed

Diagnosing glaucoma requires a comprehensive eye examination rather than a single measurement. A person can have glaucoma with normal eye pressure, while high eye pressure does not always mean that glaucoma is present. Clinicians combine pressure measurements, optic-nerve findings, visual-field results, and other tests.

  • Tonometry measures pressure inside the eye.
  • A dilated eye examination lets the clinician inspect the optic nerve.
  • Visual-field testing checks for areas of missing peripheral vision.
  • Gonioscopy examines whether the drainage angle is open or narrowed.
  • Optical coherence tomography or other imaging measures retinal and optic-nerve changes.

Treatment & Management

Glaucoma Treatment and Management

Glaucoma treatment is individualized and generally aims to lower eye pressure or reduce stress on the optic nerve. The goal is to preserve existing vision and prevent progression, not to restore vision already lost. Treatment may involve medicines, laser procedures, surgery, or a combination of approaches.

ApproachPurpose or typical use
Prescription eye drops or medicinesLower eye pressure or reduce fluid production.
Laser treatmentImprove fluid drainage or reduce fluid production, depending on glaucoma type.
SurgeryCreate or improve an alternative drainage pathway when other treatment is insufficient.

Outlook and Prognosis

Glaucoma Outlook and Prognosis

Glaucoma usually cannot be cured, and established optic-nerve damage cannot generally be reversed. However, early diagnosis and consistent glaucoma treatment can preserve useful vision for many people and reduce the risk of further loss.

What influences the outlook?

The outlook depends on the type of glaucoma, the amount of damage at diagnosis, how well eye pressure is controlled, treatment adherence, and regular monitoring. Report changes in vision and keep lifelong follow-up appointments, even when you feel well, because glaucoma may progress without obvious symptoms.

When Should You See a Doctor

When Should You See a Doctor for Glaucoma?

  • Arrange a comprehensive eye examination if you have glaucoma risk factors or are overdue for routine care.
  • Make an appointment for new or worsening peripheral vision loss or blurred vision.
  • Contact your eye-care clinician if medicines cause side effects or are difficult to use.

Emergency symptoms

Get immediate medical care

Seek emergency care immediately for sudden severe eye pain, a red eye, halos around lights, headache, nausea or vomiting, or rapid vision loss. These symptoms may indicate acute angle-closure glaucoma, which requires urgent treatment.

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