Understanding Glaucoma: Spot It, Treat It, Prevent It

A top cause of vision loss, glaucoma strikes without warning. But the more you know, the better you’ll be able to protect your vision.

family reading about glaucoma

Pop quiz: Define and describe glaucoma. 

Stumped? You’re not alone. In a Prevent Blindness America survey, 50% of respondents had heard of the eye disease but weren’t sure what it was. Another 30% had never heard of glaucoma. And of the 20% who did know a little bit about glaucoma, most of them were tripped up by the specifics of the condition.  

For the record: Glaucoma is a neurodegenerative disease that strikes at the bundle of retinal nerves that carry information about what you’re looking at from your eyes to your brain. 

The condition often—but not always—occurs when fluid doesn’t drain properly through a tiny drainage area in the eye. When too much fluid builds up, it puts pressure on the eye and causes the optic nerve to deteriorate.  

“Without treatment, glaucoma can lead to vision loss and permanent blindness,” says Thomas Brunner, president and chief executive officer of the Glaucoma Research Foundation, a nonprofit organization based in San Francisco that’s dedicated to finding a cure for the disease. 

About half of the estimated 3 million Americans who have glaucoma don’t know that their vision is in jeopardy. That’s because glaucoma is like a sleight-of-hand magician—now you see, now you don’t.

“Glaucoma often has no symptoms in the early stages,” explains Brunner. “By the time someone notices something is wrong with their vision, nothing can be done to regain that lost sight.”

The best way to protect your vision is to brush up on the basics of the condition, become familiar with your own risks, and keep up with your regular eye exams. A great place to start is right here. 

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SPOT IT: Recognize glaucoma’s clues and risk factors

The most common type of glaucoma, open angle, develops bit by bit as fluid and pressure build up inside the eye. It’s responsible for 90% of glaucoma cases and causes little pain or early symptoms, which explains its nickname: the sneak thief of sight.

Inside your eye, though, blind spots are forming along your side (or peripheral) view. You’ve likely heard the term “tunnel vision”—that’s what open-angle glaucoma is leading up to, and it’s easy to miss.

“A person with open-angle glaucoma may lose as much as 40% of their vision without realizing it,” says Brunner.

A different form of glaucoma, closed angle, tends to come on suddenly due to a rapid increase of eye pressure. Symptoms may include severe eye pain, blurred vision, headaches, nausea, and the appearance of rainbow-colored rings or halos around lights. 

The onset of closed-angle glaucoma is a true emergency that requires immediate medical attention. 

Anyone, and at any age, can get glaucoma. But it usually strikes in midlife. That’s why most adults are encouraged to see their eye doctor for a baseline eye disease screening starting at age 40, according to the International Glaucoma Association.

Eye tests to check for glaucoma include tonometry and ophthalmoscopy. Tonometry measures pressure in the eye. Ophthalmoscopy scans the optic nerve for damage caused by glaucoma. Your eye doctor may do additional tests if results suggest a potential problem.

If you get the all clear, you’ll repeat the glaucoma check every two to three years until age 60, when screenings should take place once a year. You may need earlier or more frequent testing if you have certain risk factors that up your chances of developing the condition, including the following: 

Age. Your chances of developing glaucoma go up slightly with each passing year. People age 60 and older are most likely to develop glaucoma. “As many as 15% of people may have glaucoma by the time they are 85,” Brunner says.

Race. African Americans are more likely to develop glaucoma starting as early as age 40. Asians, Hispanics, and Native Alaskans have a higher risk of experiencing closed-angle glaucoma. People of Japanese descent are more prone to low-tension glaucoma, a form of the disease that causes eye damage without an increase in eye pressure. 

Family history. You are four to nine times more likely to develop glaucoma when a parent or sibling has it. “There are more than 150 genes involved in the development of adult glaucoma, but researchers have only identified specific genes associated with childhood, or congenital, glaucoma,” says Brunner.

Eye problems and injuries. Being hit in the eye or experiencing another type of eye trauma can inflame the eye or damage the drainage system. Surgeries to treat chronic eye conditions can also change the anatomy of the drainage system.

Eye anatomy. People who are highly nearsighted are more prone to developing glaucoma. Thin corneas are another risk factor.

Medical conditions. Having diabetes, high blood pressure, or heart disease can affect blood circulation and make you more prone to glaucoma. Chronic migraine sufferers also have a higher risk.

Steroid use. The lengthy use of corticosteroids (such as cortisone, hydrocortisone, and prednisone) to treat certain types of arthritis, lupus, and other inflammatory conditions can increase eye pressure and lead to glaucoma.

TREAT IT: Manage glaucoma to save your eyesight

There isn’t a cure just yet for glaucoma, but certain treatments can relieve eye pressure and help slow down the disease, so you can hold on to the vision you still have. Among them:

Medicated eyedrops. Used daily, prescription eyedrops can decrease fluid buildup and associated eye pressure by limiting fluid production or increasing fluid discharge. Certain oral medications also can help.

Laser surgery. With selective laser trabeculoplasty, or SLT, your eye doctor uses low-level laser light to stimulate the repair of the drainage tissue in the eye and improve fluid outflow. “One treatment can lower eye pressure for months or up to many years,” says Brunner. Your doctor may recommend SLT as an initial treatment instead of eyedrops or as an additional treatment if eyedrops don’t adequately lower eye pressure.

Conventional surgery. A trabeculectomy is a surgical procedure that creates a tiny new drainage flap in the white of the eye. Excess fluid goes into the flap and then drains into the body’s veins and arteries (the vascular system).

Drainage implants. Your eye surgeon implants a tiny drainage tube in the eye. The tube sends fluid into a surgically created reservoir. The fluid is then absorbed into nearby blood vessels.

PREVENT IT: Cut your chances of vision loss

As you now know, glaucoma doesn’t discriminate—we’re all at risk. We also share the same defense strategy: Routine eye exams.

“Some risk factors can be managed,” says Brunner. “But the best thing for everyone to do is keep up with your eye exams and have open and honest conversations with your eye doctor.”

That means speaking up if anything seems off with your vision, your health history has changed, or if a close relative develops glaucoma.

“The earlier glaucoma is detected and treated,” he says, “the better your chances of keeping your vision.”