Review of The Stages of Glaucoma

Stages of Glaucoma

Table of Contents

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A series of eye disorders known as glaucoma harm the optic nerve. For clear vision, the optic nerve, which transmits visual data from the eye to the brain, is essential. High pressure in your eye is frequently associated with damage to the optic nerve. Yet, glaucoma can develop with normal pressure in the eye as well. 

Although it can affect anyone, older persons are more likely to develop glaucoma. For those over 60, it is one of the main causes of blindness. 

Numerous glaucoma types show no symptoms at all. You might not notice a change in vision until the problem is advanced since the effect is so gradual. 

Comprehensive eye exams that include measuring your eye pressure are crucial. Early glaucoma diagnosis allows for possible prevention or slowing of vision loss. For the remainder of your life, glaucoma patients will require treatment or monitoring.

Stages of Glaucoma

Stages of Glaucoma

Glaucoma progresses and worsens in stages, just like other diseases. Even in the most difficult situations, making the shift as simple as possible can be achieved by being aware of how these stages operate and the symptoms that define them. Learn about the different glaucoma stages, the best management and treatment strategies for each, and how to improve your health and quality of life as you proceed. It’s important to understand that each person’s precise glaucoma stage progression is unique, making it imperative to have a working relationship with your doctor and eye care provider as your diagnosis changes.

The course of the condition and the level of optic nerve damage determine the stages of glaucoma. 

Angle-closure glaucoma and open-angle glaucoma are the two primary varieties. The most typical kind of glaucoma, open-angle glaucoma, gradually worsens over time. A quick onset of angle-closure glaucoma might result in a rapid loss of vision. 

Glaucoma progression typically occurs in four stages: 

Stage 1

Little optic nerve damage and little vision loss describe early-stage glaucoma. Regular eye exams are essential to diagnose glaucoma early since people with early-stage glaucoma may not exhibit any symptoms. 

Stage 2

Moderate-stage glaucoma is characterized by mild to moderate vision loss and more extensive optic nerve damage. A person’s vision may start to change as their glaucoma progresses, such as becoming fuzzy or developing blind patches. 

Stage 3

Advanced optic nerve damage and considerable vision loss are features of severe-stage glaucoma. Individuals who have advanced glaucoma may find it challenging to do simple tasks like read or driving. 

Stage 4

Complete or nearly complete vision loss is a sign of end-stage glaucoma. End-stage glaucoma patients may have no vision at all or very little peripheral vision. 

It is significant to emphasize that the course of glaucoma varies from person to person, and some people, even with severe optic nerve damage, may never develop serious visual loss. Early detection and routine eye exams are essential for controlling and reducing the progression of glaucoma.

Diagnostic tests used to determine each stage 

Diagnostic tests - Stages of Glaucoma

A number of different tests that assess the health of the optic nerve, visual field, and eye pressure are used to define the phases of glaucoma. 

Stage 1

Early-stage glaucoma is often identified if specific risk indicators are present, such as high eye pressure, a thin cornea, and a family history of glaucoma. Early-stage glaucoma can be identified with eye tests such as visual field tests, dilated eye exams, and tonometry (measuring eye pressure). 

Stage 2

The evidence of optic nerve damage, which can be found by an eye doctor during a dilated eye exam, is typically used to diagnose moderate-stage glaucoma. Fundus photos and  testing the visual field are methods for determining the degree of vision loss. 

Stage 3

Severe-stage glaucoma is identified based on more severe visual field loss and considerable optic nerve damage using the same tests. Furthermore, eye pressure may be higher than usual, hopefully, the condition has been diagnosed prior to this stage and the pressure is being treated.

Stage 4

Extensive optic nerve degeneration and nearly total vision loss are used to diagnose end-stage glaucoma. Visual field tests will reveal a limited field of vision or total blindness. 

OCT, which measures the optic nerve’s thickness, and pachymetry, which measures the cornea’s thickness, are further examinations that may be used to identify glaucoma and monitor the course of the condition. 

Considering that glaucoma is a progressive condition, regular eye exams are essential to track its progression and modify medication as necessary.

Treatment of Glaucoma in each stage

Treatment of Glaucoma in each stage

Depending on the disease’s stage, many treatments are available for glaucoma. Lowering eye pressure and slowing or halting the progression of optic nerve injury are the two main objectives of treatment. The following are the available glaucoma treatments for each stage: 

Stage 1

Medication eye drops may be used to reduce eye pressure in the early stages of glaucoma. You can use these eye drops every day or as your eye doctor instructs. Also, it’s crucial to regularly check the health of the optic nerve and eye pressure to make sure the disease doesn’t get worse. 

Stage 2

Laser trabeculoplasty, pharmaceutical eye drops, or a combination of the two may be used to treat moderate-stage glaucoma. A laser is used during minimally invasive surgery known as laser trabeculoplasty to enhance fluid outflow and lower eye pressure. 

Stage 3

Treatment for severe glaucoma may include a mix of laser trabeculoplasty, prescription eye drops, and glaucoma surgery. In order to relieve eye pressure, glaucoma surgery is a more invasive technique that adds a new drainage channel to the eye. 

Stage 4

There are few therapy options for end-stage glaucoma, and vision loss is typically irreversible. Palliative care or the use of prescription eye drops to treat symptoms are possible forms of treatment.

Glaucoma Progression: What You Should Know 

Glaucoma Progression: What You Should Know 

Although there is no set timeframe for when glaucoma will result in blindness, the condition often advances slowly. In a few years, untreated glaucoma can cause blindness. It’s critical to understand that glaucoma-related blindness is quite uncommon. The 2.3 million Americans who are now living with glaucoma advance to blindness at a rate of 5%, according to data from the Glaucoma Research Foundation. 

Regardless of your glaucoma prognosis, it’s crucial to continue working with your doctor to create a proactive plan for treatment and ongoing management. The standard of care you receive is frequently what makes the difference between severe vision impairment and effective control of glaucoma. Learn as much as you can about your disease, including the stage you’re in, the treatments available, and ways to improve your quality of life while managing your glaucoma.

Glaucoma subtypes 

The most prevalent kind of glaucoma, accounting for between 70 and 90% of cases, is open-angle glaucoma. The drainage angle in the eye is open in open-angle glaucoma, but the trabecular meshwork, which drains fluid from the eye, becomes partially obstructed, increasing pressure inside the eye. 

Angle-closure glaucoma

This type of glaucoma causes the drainage angle in the eye between the iris and cornea to close completely or partially, which causes an abrupt rise in eye pressure. Although less prevalent, this form of glaucoma can become an emergency. 

Glaucoma with normal eye pressure that causes optic nerve damage and visual loss is known as normal-tension glaucoma. 

Congenital glaucoma

This uncommon form of glaucoma usually affects infants and young children. It is brought on by congenital defects in the drainage system of the eyes. 

Glaucoma that develops as a result of another eye disorder or disease, such as uveitis, a tumor, or a cataract, is referred to as secondary glaucoma. 

Pigmentary glaucoma

This form of the disease develops when pigment from the iris leaks into the trabecular meshwork, blocking it and raising eye pressure. 

Traumatic glaucoma

Traumatic glaucoma is a condition that develops after an eye injury, such as a piercing or blunt trauma. 

Pseudoexfoliative glaucoma

This form of glaucoma develops when a flaky, white substance accumulates in the eye, obstructing the trabecular meshwork and raising ocular pressure.

The symptoms of glaucoma 

The patient’s level of glaucoma will determine the symptoms they experience. In the majority of situations, a disease has no symptoms in its early stages. The patient may experience a range of symptoms as the illness gets worse. 

Symptoms include weary eyes, bloodshot eyes, headaches, nausea, hazy vision, and patchy blind spots. It will be easier to control the problem and avoid vision loss if you schedule routine eye exams. 

Glaucoma’s causes 

Damage to the optic nerve causes glaucoma. Blind spots start to appear in the patient’s range of vision as the nerve continues to degenerate. Although the exact reason is unclear, increasing eye pressure is frequently linked to nerve injury. Fluid accumulation flowing within the eye is typically the cause of an increase in ocular pressure. 

At the junction of the iris and cornea, this aqueous humor fluid would normally drain out through the trabecular meshwork tissue. Pressure rises when there is an excess of fluid produced or when the drainage system malfunctions.

Low Vision Aids for Different Stages of Glaucoma

Low Vision Aids for Glaucoma

By making the most of their remaining eyesight and enhancing their quality of life, low vision devices can benefit glaucoma patients. There are many different devices and gadgets for people with low vision that can help them read, write, and carry out daily activities. Examples of low vision aids that glaucoma sufferers may find useful include: 


Handheld or mounted on a stand, magnifiers can improve the clarity of small print and details for glaucoma patients. 


Telescopes can improve glaucoma sufferers’ ability to see distant objects clearly. 

Electronic aids

People with glaucoma who have trouble reading text on computer screens or other digital devices can benefit from electronic aids like screen readers and video magnifiers. 


By lowering glare and boosting contrast, filters help glaucoma patients see more clearly under various lighting circumstances. 

Assistive technology can help persons with glaucoma carry out daily duties on their own. Examples include talking clocks and voice-activated assistants. 

Working with a low vision specialist will help you choose the equipment that will be most beneficial for you based on your unique requirements and preferences. People with glaucoma may find low vision aids to be useful tools for preserving their independence and quality of life.

FAQ’s for Stages of Glaucoma

How can the severity of glaucoma be assessed? 

So, it is crucial to examine the visual field and optic disc in order to diagnose glaucoma early and determine the severity of the condition. The most popular technique for determining the extent of glaucomatous damage at the moment is visual field testing with standard automated perimetry (SAP). 

When should glaucoma be treated no longer? 

Glaucoma first impairs peripheral vision before eventually causing blindness if undiagnosed and untreated. It’s too late by the time you begin to experience glaucoma-related visual loss. That vision isn’t recoverable. It isn’t too late for to preserve your remaining vision with treatment though.

What is the typical age of glaucoma patients? 

What is the average age at which glaucoma manifests itself? If you are 40 years of age or older, you are most susceptible to acquiring glaucoma. But that does not mean that glaucoma cannot occur at other times. Everyone can acquire glaucoma, just like anyone else can. 

How rapidly may glaucoma deteriorate? 

Glaucoma is a condition that develops gradually. Untreated glaucoma often progresses from early damage to total blindness over the course of 10 to 15 years. It takes 15 years to advance when the intraocular pressure is between 21 and 25 mmHg, seven years when it is between 25 and 30 mmHg, and three years when it is greater than 30 mmHg.

About the Author:
Dr Shaun Larsen

Dr Shaun Larsen

Dr. Shaun Larsen is an optometrist who specializes in low vision services and enhancing vision with contact lenses. He has a passion for making people's lives better by helping them see well enough to read, write, or drive again. He always keeps up with the latest technology so he can help people regain their independence.


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