The first sign of glaucoma is often a loss of peripheral (side) vision, which may not be noticeable at first. This is why glaucoma is often called the “silent thief of sight.” As the condition progresses, people may experience tunnel vision, where they only see what’s directly in front of them. Other symptoms may include eye pain, blurred vision, halos around lights, and headaches. However, it’s important to note that not everyone with glaucoma experiences symptoms, which is why regular eye exams are crucial for early detection and treatment.

Overview of Glaucoma

Glaucoma is a group of eye conditions that can cause damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain. The most common type of glaucoma is open-angle glaucoma, but there are other types as well, including angle-closure glaucoma, normal-tension glaucoma, and pigmentary glaucoma.

In most cases, glaucoma is caused by increased pressure inside the eye, which is known as intraocular pressure (IOP). However, in some cases, glaucoma can occur even when IOP is within the normal range.

Glaucoma often has no early warning signs, which is why regular eye exams are essential for early detection and treatment. If left untreated, glaucoma can cause irreversible damage to the optic nerve, leading to vision loss and eventually blindness.

Treatment for glaucoma typically involves lowering IOP to prevent further damage to the optic nerve. This can be done through the use of eye drops, oral medications, laser therapy, or surgery. The specific treatment plan will depend on the type and severity of the glaucoma.

What are the first symptoms or signs of open angle glaucoma?

Open-angle glaucoma, the most common form of glaucoma, often develops slowly and without noticeable symptoms in its early stages. However, as the disease progresses, the first symptoms of open-angle glaucoma may include:

Loss of peripheral (side) vision

The loss of peripheral vision is often the first sign of open-angle glaucoma. It may be difficult to notice at first, but as the condition progresses, it can become more noticeable and may eventually lead to tunnel vision.

Patchy blind spots

Open-angle glaucoma can also cause patchy blind spots in your side or central vision. These spots can worsen over time and may eventually lead to complete vision loss.

Difficulty adjusting to low light

People with open-angle glaucoma may have difficulty adjusting to low light, such as when entering a dimly lit room. This is because the condition can affect the eyes’ ability to adjust to changes in light.

Blurred vision

Blurred vision is a less common symptom of open-angle glaucoma but can occur in some cases. It can also be a sign of other eye conditions, so it’s important to see an eye doctor for a proper diagnosis.

It’s important to note that open-angle glaucoma may not cause symptoms until the condition has advanced, which is why regular eye exams are essential for early detection and treatment.

What are the first symptoms of Acute angle-closure glaucoma?

Acute angle-closure glaucoma is a medical emergency that requires immediate attention. The first symptoms of acute angle-closure glaucoma may include:

Severe eye pain

The most common symptom of acute angle-closure glaucoma is sudden, severe eye pain. The pain may be described as a deep ache or a sharp stabbing sensation.

Headache

Acute angle-closure glaucoma can cause a severe headache, which is often described as being on one side of the head.

Blurred vision

Blurred vision is a common symptom of acute angle-closure glaucoma. It may be accompanied by halos around lights, colored rings around lights, or a foggy appearance to the vision.

Eye redness

The affected eye may appear red or bloodshot.

Nausea and vomiting

Some people with acute angle-closure glaucoma may experience nausea and vomiting, which can be a sign of severe eye pain.

Dilated pupils

The affected eye may have a dilated pupil that does not react to light.

If you experience these symptoms, seek immediate medical attention as acute angle-closure glaucoma can cause permanent vision loss if left untreated.

The first sign of Normal-tension glaucoma 

Normal-tension glaucoma (NTG) is a type of glaucoma that occurs when there is damage to the optic nerve without high eye pressure. The first sign of normal-tension glaucoma may be a subtle loss of vision, which can be difficult to detect in the early stages. Other possible signs and symptoms may include:

Difficulty seeing in low light conditions

People with normal-tension glaucoma may have trouble seeing in dimly lit environments, such as at night.

Gradual loss of peripheral vision

As the condition progresses, people with normal-tension glaucoma may experience a gradual loss of peripheral vision, which can eventually lead to tunnel vision.

Eye pain or discomfort

Some people with normal-tension glaucoma may experience eye pain or discomfort, especially after prolonged periods of reading or doing other close work.

Blurred or hazy vision

Normal-tension glaucoma can cause blurred or hazy vision, which may be more noticeable in one eye than the other.

Seeing halos around lights

Some people with normal-tension glaucoma may see halos or rainbows around lights, especially at night.

It’s important to note that not everyone with normal-tension glaucoma experiences symptoms, which is why regular eye exams are essential for early detection and treatment.

What are the first signs of glaucoma in children?

Glaucoma in children is relatively rare but can be very serious if left untreated. The first signs of glaucoma in children may include:

Enlarged eye(s)

One or both eyes may appear larger than normal, which is known as buphthalmos or megalocornea.

Cloudy or hazy eyes

The cornea (the clear, front part of the eye) may appear cloudy or hazy.

Excessive tearing

The child’s eye may produce an excessive amount of tears or have a constant watery discharge.

Sensitivity to light

The child may be sensitive to light (photophobia) or squint frequently in bright light.

Redness in the eye(s)

One or both eyes may appear red or bloodshot.

Blurred vision

The child may have difficulty seeing objects clearly or have a decrease in visual acuity.

Abnormal eye movements

The child’s eyes may not move together properly or may shake back and forth (nystagmus).

If you notice any of these signs or symptoms in your child, it’s important to have their eyes checked by an eye doctor as soon as possible. Early diagnosis and treatment are essential for preventing vision loss and preserving your child’s vision.

What are the first signs of pigmentary glaucoma?

Pigmentary glaucoma is a type of open-angle glaucoma that occurs when pigment from the iris (the colored part of the eye) flakes off and clogs the drainage system of the eye. The first signs of pigmentary glaucoma may include:

Blurred vision

Pigmentary glaucoma can cause blurred vision, especially when looking at objects up close.

Glare or halos around lights

People with pigmentary glaucoma may see halos or glare around lights, especially at night.

Eye pain or discomfort

Some people with pigmentary glaucoma may experience eye pain or discomfort, especially after prolonged periods of reading or doing other close work.

Redness in the eye(s)

One or both eyes may appear red or bloodshot.

Sensitivity to light

People with pigmentary glaucoma may be sensitive to light (photophobia) or squint frequently in bright light.

Loss of peripheral (side) vision

Pigmentary glaucoma can cause a gradual loss of peripheral vision, which can eventually lead to tunnel vision.

It’s important to note that pigmentary glaucoma may not cause symptoms in its early stages, which is why regular eye exams are essential for early detection and treatment. If you have any concerns about your eye health or notice any changes in your vision, it’s important to see an eye doctor for a proper diagnosis.

How is glaucoma diagnosed?

Glaucoma is diagnosed through a comprehensive eye exam that includes several tests to measure the pressure inside the eye, examine the optic nerve, and evaluate the visual field. Here are some common diagnostic tests for glaucoma:

Tonometry

This test measures the pressure inside the eye (intraocular pressure or IOP). It may involve using a tonometer that blows a puff of air onto the eye, or it may involve using a device that lightly touches the surface of the eye.

Ophthalmoscopy

This test allows the eye doctor to examine the optic nerve at the back of the eye. The doctor may use a special instrument called an ophthalmoscope to look through the pupil and evaluate the appearance of the optic nerve.

Perimetry

This test measures the visual field or the area of vision that can be seen when looking straight ahead. The doctor may use a machine called a perimeter to test different areas of the visual field.

Gonioscopy

This test is used to evaluate the drainage angle of the eye, which is where fluid drains out of the eye. The doctor uses a special lens to examine the drainage angle and determine if it is open or closed.

Optical coherence tomography (OCT)

This test uses light waves to create a detailed image of the optic nerve and retina. It can help the doctor to detect early signs of damage to the optic nerve.

Pachymetry

This test measures the thickness of the cornea, which can affect the accuracy of IOP measurements.

Depending on the results of these tests, the eye doctor may diagnose glaucoma and recommend a treatment plan. It’s important to have regular eye exams, especially if you have risk factors for glaucoma such as age, family history, high eye pressure, or certain medical conditions. Early detection and treatment can help to prevent vision loss and preserve your eye health.

Glaucoma Treatment

The goal of glaucoma treatment is to lower intraocular pressure (IOP) to prevent further damage to the optic nerve. There are several treatment options available, depending on the type and severity of the glaucoma. Here are some common treatment options:

Eye drops

These are the most common form of treatment for glaucoma. Eye drops work by reducing the amount of fluid produced in the eye or increasing the drainage of fluid from the eye, which helps to lower IOP.

Oral medications

In some cases, oral medications may be prescribed to help lower IOP.

Laser therapy

Laser trabeculoplasty is a type of laser therapy that can be used to help open up the drainage channels in the eye, allowing fluid to flow out more easily and reducing IOP.

Surgery

If eye drops or laser therapy are not effective in lowering IOP, surgery may be recommended. There are several types of surgery that can be used to treat glaucoma, including trabeculectomy, in which a new drainage channel is created in the eye, and tube shunt surgery, in which a tiny tube is implanted in the eye to help drain fluid.

Microinvasive glaucoma surgery (MIGS)

This is a newer type of surgery that uses small incisions and tiny devices to help lower IOP. MIGS is less invasive than traditional glaucoma surgery and can often be done on an outpatient basis.

The specific treatment plan will depend on the type and severity of the glaucoma, as well as other factors such as age, overall health, and medical history. It’s important to follow the treatment plan recommended by your eye doctor and have regular follow-up appointments to monitor your eye health and adjust your treatment as needed. With proper treatment, it’s often possible to slow or stop the progression of glaucoma and preserve your vision.

Conclusion

Glaucoma comes on slowly and you could potentially have it for some time before ever experiencing symptoms. It is crucial to have regular eye exams to detect subtle changes that may be occurring within your eyes and vision.

FAQ’s

How rapidly does glaucoma develop? 

Glaucoma is a condition that develops gradually. Untreated glaucoma often progresses from early damage to complete 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. 

Can early-stage glaucoma be stopped? 

Although there is currently no treatment for glaucoma, if it is detected early on, visual loss can be avoided. 

What is the typical age of onset of glaucoma? 

Although it may strike anybody, older persons are more likely to develop glaucoma. For those over 60, it is one of the main causes of blindness.