What Are the Causes, Symptoms, and Best Treatment Options for Glaucoma?

Glaucoma refers to a group of eye conditions that can lead to vision loss and optic nerve damage if left untreated. In this article, we’ll explore the main causes, symptoms, and treatments for glaucoma, along with ways to prevent it.

What Is Glaucoma?

Glaucoma, also known as ocular hypertension or blue water in the eye, is a general term used to describe a group of eye disorders that damage the optic nerve—the most common cause of irreversible vision loss.

In most cases, fluid builds up in the front part of the eye, putting pressure on the eye (known as intraocular pressure). This pressure gradually damages the optic nerve. Glaucoma typically affects both eyes, although it might progress faster in one eye than the other at first.

Types of Glaucoma

There are several types of glaucoma, including:

Open-Angle Glaucoma

Also known as chronic glaucoma, this is the most common form. It develops slowly and often without noticeable symptoms in the early stages, even when some vision loss has already occurred. Because of this, many people don’t seek medical help until permanent damage has already taken place.

Angle-Closure Glaucoma

Also known as acute angle-closure glaucoma, this type can occur suddenly with eye pain and rapid vision loss. Since symptoms are more noticeable, patients often seek medical attention quickly, allowing for faster treatment and a better chance of preserving vision.

Normal-Tension Glaucoma

This rare form of glaucoma occurs even when intraocular pressure is within the normal range. The exact cause is unclear, but reduced blood flow to the optic nerve may play a role.

Pigmentary Glaucoma

This form of open-angle glaucoma usually develops in early or middle adulthood. It results from pigment cells from the iris (the colored part of the eye) spreading and blocking drainage channels, raising intraocular pressure.

Glaucoma in Children

Although rare, glaucoma can affect children due to genetic factors. Treatments such as medications and surgery can help prevent vision loss. Common signs in children include:

• Unusually large eyes
   
• Excessive tearing
   
• Cloudy corneas
   
• Light sensitivity

What Are the Causes of Glaucoma?

The exact cause of glaucoma is still unknown, but several health conditions can increase the risk, such as:

• Tumors
   
• Diabetes
   
• Thyroid dysfunction
   
• Advanced cataracts
   
• Eye inflammation
   

Major Risk Factors Include:

• People over 60 years old (especially Caucasians)
   
• Latinos and African Americans over 40
   
• Having diabetes or other chronic illnesses
   
• Family history of glaucoma
   
• Eye injury or previous eye surgery
   
• Severe nearsightedness
   
• Long-term use of corticosteroids, especially eye drops
   
• High blood pressure
   
• Genetic factors (especially in childhood cases)

What Are the Symptoms of Glaucoma?

Symptoms vary depending on the type of glaucoma:

Open-Angle Glaucoma Symptoms

Most people experience no symptoms early on. When symptoms appear, they are usually advanced. It’s often called the "silent thief of sight" because peripheral vision loss is usually the first sign.

Angle-Closure Glaucoma Symptoms

This type presents quickly and more severely, including:

• Seeing halos around lights
   
• Vision loss
   
• Redness in the eye
   
• Cloudy cornea, especially in infants
   
• Nausea or vomiting
   
• Eye pain
   
• Severe headache
   

Pigmentary Glaucoma Symptoms

• Halos around lights
   
• Blurred vision during physical activity
   
• Gradual peripheral vision loss
   
• Light sensitivity
   

Normal-Tension Glaucoma Symptoms

There are usually no symptoms early on. Over time, blurry vision and peripheral vision loss may occur.

Secondary Glaucoma Symptoms

Symptoms often depend on the underlying cause and may resemble those of open-angle or angle-closure glaucoma.

Congenital Glaucoma Symptoms

Symptoms often appear in infants within a few months of birth, such as:

• Cloudiness in the eye
   
• Enlargement of one or both eyes
   
• Redness in parts of the eye
   
• Light sensitivity
   
• Visual disturbances

How Is Glaucoma Diagnosed?

A comprehensive eye exam is the only way to diagnose glaucoma. Common tests include:

• Measuring intraocular pressure (tonometry)
   
• Using a special lens to examine the eye's drainage angle (gonioscopy)
   
• Laser scans or photographs of the optic nerve
   
• Imaging of the drainage angle
   
• Retinal examination
   
• Checking pupil reaction to light
   
• Slit-lamp examination
   
• Visual acuity test
   
• Visual field test

What Are the Treatments for Glaucoma?

Treatment typically involves medications, laser therapy, or surgery:

Glaucoma Medications

Prescription eye drops are often the first line of treatment. They reduce fluid buildup and improve drainage to lower eye pressure. Because glaucoma is a chronic condition, drops may need to be used daily for life. One common medication is Bimatoprost.

Laser Treatment for Glaucoma

Laser therapy can improve fluid drainage or serve as an alternative or supplement to drops. The effects may last for years in some cases.

Glaucoma Surgery

Surgery is another effective option, especially for older adults or when drops/lasers are insufficient. Surgery can lower eye pressure more quickly and help prevent further vision loss, although it cannot restore lost vision. There are various surgical procedures, and the ophthalmologist will choose the best option based on the case.

What Are the Complications of Glaucoma?

Blindness is a rare complication when glaucoma is detected early. However, because it's a chronic disease, some degree of vision loss is common over time. The earlier it's diagnosed and treated, the better the outcome.

Studies show that proper treatment can slow disease progression and protect the optic nerve. If you're at risk, regular eye exams are crucial.

What’s the Difference Between Cataracts and Glaucoma?

Cataracts occur when the eye's lens becomes cloudy, leading to blurred vision and progressive sight loss. Glaucoma, on the other hand, is a condition that causes damage to the optic nerve due to increased eye pressure, starting with peripheral vision loss and potentially leading to permanent blindness if untreated.

FAQs

Can Glaucoma Cause Blindness?
Yes, but it is rare if diagnosed and treated early. Neglecting treatment can lead to permanent vision loss.

Is Glaucoma Curable?
There is no complete cure for glaucoma, but its symptoms and progression can be managed effectively with ongoing treatment to preserve vision and protect the optic nerve.