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Glaucoma 

Glaucoma is a group of eye diseases that damage the optic nerve, usually due to increased pressure inside the eye. Over time, this damage can lead to permanent vision loss or blindness. 

Many people with glaucoma do not notice symptoms early. Because the disease develops slowly, regular eye exams are the best way to detect glaucoma before vision loss occurs. 

There is no cure for glaucoma, but early diagnosis and treatment can slow or stop the disease from getting worse.

What is glaucoma?

Glaucoma is an eye disease that damages the optic nerve of the eye. This nerve sends the images you see to your brain. Glaucoma usually affects both eyes, but it may affect one eye more than the other.

Your eyes produce a clear fluid called aqueous humor that nourishes the eye and maintains its shape. This fluid normally drains through a structure called the drainage angle.   

If the fluid doesn’t drain properly, pressure builds up inside the eye (called intraocular pressure). Over time, increased eye pressure can damage the optic nerve and lead to vision loss. 

Why glaucoma is called the “silent thief of sight” 

Glaucoma often develops slowly and without noticeable symptoms at first. Vision loss usually begins with peripheral (side) vision, which many people do not notice right away. 

Because damage happens gradually, many people do not realize they have glaucoma until the disease is advanced. Regular eye exams are the best way to detect glaucoma early.  

Types of glaucoma

Glaucoma is a common age-related eye problem and is the second most common cause of vision loss or blindness in the U.S. 

The four main types of glaucoma are:

Open-angle glaucoma (also called chronic glaucoma)

Open-angle glaucoma is the most common type of glaucoma, affecting up to 90% of Americans with glaucoma. It happens when the drainage angle is open but does not work correctly, causing pressure to build up.

Nicknamed “the silent thief of sight,” this glaucoma develops slowly, is painless and causes no vision changes at first. Many people with this type of glaucoma don’t know they need care until damage to the optic nerve has already happened.

Closed-angle glaucoma (also called angle-closure or narrow-angle glaucoma)

Closed-angle glaucoma is a rare type that requires urgent medical treatment.

It happens when the drainage angle in the eye narrows or is suddenly blocked, and fluid can’t flow out of the eye. This blockage causes a quick rise in eye pressure, which can cause sudden pain and vision loss.

Normal-tension glaucoma (also called low-tension glaucoma)

People with normal-tension glaucoma have eye pressure within a normal range but still show signs of glaucoma. 

The exact cause of this type of glaucoma is not fully understood, but certain medical conditions may increase your risk. These include autoimmune diseases like rheumatoid arthritis, lupus, migraines, Raynaud’s phenomenon and high blood pressure (hypertension). 

Childhood glaucoma (also called congenital, pediatric or juvenile glaucoma)

Some children are born with glaucoma. It is caused when the eye does not develop normally. Childhood glaucoma may also happen because of an eye disorder, eye injury or other disease.

Am I at risk for glaucoma?

People at higher risk for glaucoma include those who: 

  • Are over age 40 
  • Have a family history of glaucoma 
  • Are of Black, Hispanic, Asian or Native American heritage 
  • Have diabetes or high blood pressure 
  • Have thin corneas or elevated eye pressure 
  • Have had eye injuries 
  • Take corticosteroid medications for long periods 

Can glaucoma be prevented? 

Glaucoma cannot always be prevented, but early detection can help protect your vision. 

Steps that may reduce your risk of vision loss include: 

  • Getting regular comprehensive eye exams 
  • Following your provider’s treatment plan 
  • Using prescribed eye drops as directed 
  • Managing conditions such as diabetes or high blood pressure 
  • Protecting your eyes from injury 

Regular eye exams are especially important if you have risk factors for glaucoma.

What are the symptoms of glaucoma

Early-stage glaucoma often has no symptoms. Vision loss usually happens gradually and begins with side vision. 

As glaucoma progresses, symptoms may include: 

  • Gradual loss of peripheral (side) vision 
  • Tunnel vision in later stages 
  • Blurred vision 
  • Seeing halos around lights 

Symptoms of acute angle-closure glaucoma 

Angle-closure glaucoma is a medical emergency. Symptoms may include: 

  • Sudden severe eye pain 
  • Headache 
  • Nausea or vomiting 
  • Blurred vision 
  • Red eyes 
  • Seeing rainbow-colored halos around lights 

Seek immediate medical care if these symptoms occur. 

How is glaucoma detected?

Left untreated, glaucoma can cause permanent vision loss. The good news is that you can slow or stop it from getting worse with regular eye exams. Check-ups by an eye care specialist (an ophthalmologist or optometrist) can help catch glaucoma and many other eye problems. 

During the exam, they will: 

  • Measure your eye pressure (tonometry) 
  • Look at your optic nerve for damage (ophthalmoscopy)
  • Check your central and peripheral vision (visual field testing)
  • Examine your eye’s drainage angle (gonioscopy)
  • Measure the thickness of your cornea (pachymetry)

What treatment is available for glaucoma?

Although there is no cure for glaucoma, the main goal of treatment is to reduce pressure in the eye to stop damage to the optic nerve. If glaucoma is found early enough, proper care and treatment can slow or prevent further vision loss, but it cannot restore lost vision. 

Treatment focuses on lowering eye pressure to prevent further damage to the optic nerve. The right treatment depends on the type of glaucoma, how advanced it is and your overall health.

Treatment can vary from person to person but may include the following:

  • Eye drops: Used every day, prescription eye drops can treat glaucoma. Some decrease fluids or increase drainage to improve eye pressure. 
  • Laser therapy: Your eye care specialist can use a laser to help improve fluid drainage in your eye. The two main types of laser surgery are trabeculoplasty (for open-angle glaucoma) and iridotomy (for closed-angle glaucoma).
  • Conventional surgery: If laser surgery and eye drops do not help, your provider may recommend traditional surgery. There are two main types:
    • Trabeculectomy: This surgery creates a tiny opening in the eye to allow fluid to drain, reducing pressure in the eye and preventing damage to the optic nerve.
    • Tube shunt surgery: A small tube (shunt) is placed in the eye to drain fluid out of the eye and lower pressure. 
  • Minimally invasive glaucoma surgery (MIGS): This new procedure reduces the risks related to traditional glaucoma surgery. MIGS uses microscopic implants, precision lasers and tiny cuts in the eye, which can lead to more rapid healing and even some vision recovery.

The best treatment for glaucoma depends on your specific needs and the stage of your disease. Your health care provider will work with you to develop the right treatment plan. 

What is the outlook for people who have glaucoma?

Many people with glaucoma can maintain good vision with early detection and proper care. Regular check-ups with your eye care specialist play an important role in keeping your eyes healthy. It’s important to stay on top of your eye care to give yourself the best chance of maintaining good vision. 

Frequently asked questions about glaucoma 

Can glaucoma cause blindness? 

Yes. If left untreated, glaucoma can cause permanent vision loss and blindness. Early detection and treatment can help slow or stop the disease. 

Does glaucoma run in families? 

Yes. Having a family history of glaucoma increases your risk. If a close relative has glaucoma, regular eye exams are especially important. 

At what age does glaucoma start? 

Glaucoma is more common after age 40, but it can develop earlier, especially in people with risk factors. 

Can glaucoma be cured? 

There is no cure for glaucoma. However, treatment can slow or stop vision loss in many people. 

Expert glaucoma care at Banner Health 

Early detection is key to protecting your vision. Banner Health eye specialists provide comprehensive eye exams, advanced glaucoma testing and treatment options tailored to your needs. 

From prescription eye drops to minimally invasive surgery, we work with you to preserve your vision and manage glaucoma at every stage. 

Schedule an appointment with a Banner Health eye specialist to get started.