Glaucoma living patient overview

Overview

Glaucoma is a group of eye conditions that damage the optic nerve, the part of the eye that sends signals to your brain. The damage is often caused by fluid building up in the front of the eye, which increases pressure inside the eye. This can lead to vision loss if not treated.

Glaucoma is fairly common, especially in people over 60. It affects about 2% of people over age 40 and becomes more common with age.

Glaucoma can affect anyone, but it is more common in older adults, people of African, Asian, or Hispanic heritage, and those with a family history of glaucoma. It also affects people with certain medical conditions like diabetes or high blood pressure.

Symptoms

Common symptoms

• Often no symptoms in early stages
• Gradual loss of peripheral (side) vision, usually in both eyes
• Blurred vision or seeing halos around lights
• Tunnel vision in advanced stages

Symptoms in children

• Unusually large or cloudy cornea (front part of the eye)
• Sensitivity to light
• Excessive tearing
• Eyelid spasms

Symptoms in older adults

• Gradual loss of side vision, often unnoticed at first
• Trouble adjusting to dark rooms
• Difficulty focusing on near objects

Causes

Main causes

• Increased pressure inside the eye due to fluid buildup
• Poor drainage of the fluid inside the eye (aqueous humor)
• Damage to the optic nerve from other causes, even with normal eye pressure

Risk factors

• Being over 60 years old
• Family history of glaucoma
• Being of African, Asian, or Hispanic descent
• High or very low blood pressure
• Eye injury or surgery in the past
• Long-term use of corticosteroid medications (e.g., eye drops, pills)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe eye pain or sudden vision loss, seek emergency care immediately.

Book a routine appointment if:

• If you are over 40 and have not had an eye exam in the past 2 years, schedule one.
• If you have a family history of glaucoma, get a comprehensive eye exam every 1-2 years.

Diagnosis

Glaucoma is diagnosed through a comprehensive eye exam. Your eye doctor will measure your eye pressure, examine your optic nerve, and test your visual fields (side vision).

Tests that may be done

• Tonometry (eye pressure test)
• Ophthalmoscopy (examining the optic nerve)
• Perimetry (visual field test)
• Gonioscopy (checking the drainage angle of the eye)
• Pachymetry (measuring corneal thickness)

What to expect at your appointment

The tests are painless and usually take about an hour. You may have your eyes dilated with drops, which can cause blurry vision for a few hours. Your doctor will explain the results and any next steps.

Treatment

Glaucoma cannot be cured, but treatment can slow or stop vision loss. Treatment usually starts with prescription eye drops that reduce fluid production or improve drainage. Other options include laser treatment or surgery to improve fluid outflow. Regular checkups are important to monitor eye pressure and nerve health.

Self-care at home

• Take your eye drops exactly as prescribed—never skip a dose.
• Tell your doctor about any side effects you experience.
• Keep all follow-up appointments with your eye specialist.
• Wear protective eyewear to avoid eye injuries.

Medical treatments

Treatment typically begins with prescription eye drops that lower eye pressure. These drops work by either reducing the amount of fluid the eye makes or helping it drain better. If drops are not enough, your doctor may recommend oral medications or laser treatment to open the drainage channels. Never share your eye drops with anyone.

When is surgery considered?

Surgery may be considered if eye pressure remains high despite medications and laser treatment. There are several types of surgery that create a new drainage channel for fluid to exit the eye. Your eye doctor will discuss the risks and benefits with you.

Living with this condition

Living with glaucoma means managing your eye pressure and protecting your vision. Use your eye drops consistently and keep a schedule to avoid missing doses. You may need to adapt to changes in side vision, such as being more cautious when walking or driving. Your doctor can recommend low-vision aids if needed.

Lifestyle tips

• Avoid activities that increase eye pressure, such as heavy lifting or exercises that involve holding your breath.
• Protect your eyes from injury with safety glasses during sports or yard work.
• Quit smoking, as it can worsen glaucoma.

Diet and exercise

A healthy diet rich in leafy greens, fruits, and omega-3 fatty acids may support eye health. Moderate exercise, like walking or swimming, can help lower eye pressure. Always check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

A diagnosis of glaucoma can be stressful and may cause anxiety about vision loss. It is normal to feel worried or sad. Talk to your doctor or a mental health professional if these feelings affect your daily life.

Prevention

There is no proven way to prevent glaucoma, but early detection through regular eye exams can prevent vision loss. If you have risk factors, talk to your doctor about how often you need eye exams.

Screening programmes

Routine eye exams are the best screening tool. The UK National Health Service recommends an eye test every 2 years for adults over 40, or more often if you have risk factors.

Complications

If left untreated

• Permanent vision loss, starting with peripheral (side) vision
• Tunnel vision (only seeing straight ahead)
• Complete blindness in some cases

Long-term outlook

While glaucoma is a serious condition, most people who follow their treatment plan can preserve their sight for life. Regular checkups and sticking with your eye drops are the keys to protecting your vision. New treatments continue to improve outcomes.

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