What is glaucoma?

Glaucoma is the name for a group of eye diseases that damage the optic nerve. This nerve carries information from the eye to the brain. When the nerve is damaged, you can lose your vision.

Glaucoma is one of the most common causes of legal blindness in the world. At first, people with glaucoma may have very mild symptoms. But if the disease isn't treated, vision loss may get worse. It can lead to total blindness over time.

There are different types of glaucoma.

• Open-angle glaucoma usually affects both eyes at the same time. Your vision gradually gets worse. But it gets worse so slowly that you may not notice it.
• Closed-angle glaucoma usually affects one eye at a time. It can happen suddenly and be a medical emergency.
• Childhood glaucoma is a rare form of glaucoma that may be present at birth or may develop in the first few years life.

If you have open-angle glaucoma, you likely won't have any symptoms at first. You may have vision loss, but you may not notice it until the disease has become very serious. Any vision loss is most often side (peripheral) vision loss.

Symptoms of closed-angle glaucoma, such as blurred vision, can be mild. But they are often severe and happen suddenly. You may have pain and redness in your eye and see colored halos around lights. Other symptoms include vision loss, feeling sick to your stomach, and vomiting.

In congenital and infantile glaucoma, signs can include watery eyes and being sensitive to light. Your baby's eyes may look cloudy or larger than normal. Your baby may rub their eyes, squint, or keep their eyes closed much of the time.

When checking for possible glaucoma, your doctor will ask about your past health and do a physical exam. If your doctor thinks you may have glaucoma, he or she will refer you to an eye specialist (ophthalmologist). The specialist will check your eyes to help find out if you have the disease and how severe it is. He or she will look for certain signs of damage in the eye by checking things like:

Eye structure.

Ophthalmoscopy, gonioscopy, slit lamp exam, and optic coherence tomography all check the structures of the eye.

Eye pressure.

Tonometry measures the pressure in the eye (intraocular pressure, or IOP).

Vision.

Vision tests include tests to check for visual acuity and loss of side and central vision (perimetry testing).

Cornea thickness.

Tests such as ultrasound pachymetry measure the thickness of the clear front surface of the eye (cornea). Cornea thickness, along with intraocular pressure, helps determine your risk for glaucoma.

Most treatment for glaucoma is done to lower the pressure in the eyes. Treatment depends on the type of glaucoma.

• Open-angle glaucoma. Treatment for this usually starts with medicines to lower the pressure inside the eye. Most likely, eyedrops will be used. If medicines don't work, you may need laser treatment or surgery. Sometimes laser treatment or surgery will be tried before medicine.
• Closed-angle glaucoma. The first treatment for this is most often a procedure called laser iridotomy. You may also need medicine to help you stay at your target eye pressure. Usually eyedrops are used.
• Acute closed-angle glaucoma. Laser treatment is needed right away for this problem. Medicines may be needed if laser treatment is delayed.
• Childhood glaucoma. This almost always requires surgery. Medicine may sometimes be used. But it usually doesn't work as well.

If you have glaucoma, you will need regular eye exams and treatment for glaucoma for the rest of your life.

If you have vision loss, you can do things to help keep your quality of life. You can use vision aids, such as large-print items and special video systems. Support groups can also help you deal with vision loss. Take your medicines as directed. Make sure to go to all of your doctor appointments.