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How Do I Know If I Have Glaucoma?

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How Do I Know If I Have Glaucoma?

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Glaucoma is a prolonged deterioration of the optic nerve function affecting the vision and caused by various factors, one of which is the pressure of our eye.

Medically reviewed by

Dr. K. Shobana

Published At July 17, 2018
Reviewed AtOctober 5, 2023

What Is Glaucoma?

Glaucoma is a chronic progressive degenerative disease of the optic nerve. In a broad sense, in glaucoma, the optic nerve undergoes a process of slow death due to its nerve fibers getting squeezed by the eye's pressure. This nerve degeneration often goes unnoticed by patients as it is a painless and asymptomatic process.

Why Is It Important to Screen Asymptomatic People for Glaucoma?

The global burden of the disease is estimated to be 1 to 2 % of the world's population. It is in vogue to screen everyone above 40 years of age for glaucoma in many countries. The screening process is more important for certain high-risk groups, including people from certain races and women, as they carry a higher risk of the development of glaucoma.

The crux of the matter, as pointed out, is not only the absolute asymptomatic nature of glaucoma but also the fact that the nerve damage and hence the visual field loss is irreversible. This translates into visual impairment, leading to an economic setback for the individual, their family, and society. This makes the burden of the disease quite significant in terms of years of productive life lost, a loss that could have easily been prevented or occasionally avoided altogether.

Hence, screening for this disease in the average population is essential.

What Are the Risk Factors for Glaucoma?

  1. Age above 40 years.

  2. A family history of glaucoma.

  3. Certain races or ancestry.

  4. Hypertension.

  5. High cholesterol.

  6. Hypermetropia.

  7. Smoking.

What Are the Types of Glaucoma?

There are two main types of glaucoma:

  • Open-Angle Glaucoma:

In open-angle glaucoma, there are no symptoms, and the disease follows the classical course of nerve damage over a long protracted period.

  • Acute Angle-Closure Glaucoma:

In angle closure, however, the picture is different. The patient develops symptoms of pain, redness, and blurred vision with the feeling of seeing haloes around light. The nerve damage process is accelerated, especially in acute attacks where the patient may lose sight in a matter of hours.

  • Pigmentary Glaucoma:

This type of glaucoma occurs due to the build-up of pigmentary granules in the drainage tract, thereby stopping fluid drainage. As a result, there is a rise in intermittent pressure resulting in glaucoma. Jogging can also increase the chances of pigmentary granule deposition on the trabecular meshwork.

  • Glaucoma in Children:

Any underlying medical condition or blockage in the drainage tracts can bring about an optic nerve damage leading to glaucoma in children. It can be present either congenitally or can develop over the years.

  • Normal-Tension Glaucoma:

There is damage to the optic nerve in normal-tension glaucoma even when the ocular pressure is normal. The exact cause is not known in these cases. An overly sensitive optic nerve or atherosclerosis in the blood vessels supplying the optic nerve have been the attributed causes.

What Are the Symptoms of Glaucoma?

  1. Open-angle Glaucoma - Most open-angle glaucomas are asymptomatic and would only be picked up on screening. Symptoms that can present here can be

    1. Frequent changes in the glass prescription.

    2. Headaches that aggravate in dark environments.

    3. Patchy blind spots can be seen. It can be either in the central vision or peripheral vision.

    4. In severe cases, there can be the formation of tunnel vision.

  2. Acute Angle-Closure Glaucoma - Angle-closure glaucoma can present as:

    1. Red, watery, and painful eyes.

    2. Patients can have blurred vision with the symptom of seeing colored haloes around lights.

    3. Nausea and vomiting.

    4. Severe headaches.

When Should One Get Tested?

One needs to be tested for glaucomatous disease if they have any glaucoma symptoms or any of the above-mentioned risk factors of glaucoma. In general, it is recommended that if above 40 years of age, one should undergo glaucoma testing.

What Tests Are Available for Diagnosis of Glaucoma?

The significant tests whose outcomes determine the progression of glaucoma and the treatment decisions are:

1. Intraocular pressure.

2. Optic nerve head morphology.

3. Visual field analysis.

The adjunctive tests having a corroboratory impact are:

1. Optical coherence tomography (OCT).


3. Corneal thickness/pachymetry.

4. HRT (Heidelberg retinal tomography).

What Are the Treatment Options Available?

Glaucoma can be treated by various options, including eye drops, lasers, and surgery. The treatment decision depends on the severity of the disease and a few patient factors.

Glaucoma is thus a progressive disease, and a quick visit to an ophthalmologist in case of symptoms or patients having risk factors can prevent irreversible nerve damage.

The following are the available treatment modalities:

1. Medical Treatment:

a. Eye Drops - These help lower eye pressure by promoting the outflow of eye fluid (aqueous humor), reducing its production, and decreasing the activity of the rho kinase enzyme responsible for increasing the eye fluid. Prescription eye drops containing any of the below medications are used in the treatment of glaucoma:

i. Prostaglandins like Latanoprost, Latanoprostene bunod, Tafluprost, Travoprost, and Bimatoprost.

ii. Alpha-adrenergic agonists like Brimonidine and Apraclonidine.

iii. Rho-kinase inhibitors like Netarsudil.

iv. Beta-blockers like Betaxolol and Timolol.

v. Cholinergic drugs like Pilocarpine.

vi. Carbonic anhydrase inhibitors like Brinzolamide and Dorzolamide.

b. Oral Tablets - In some cases, oral medications like carbonic anhydrase inhibitors can be prescribed to reduce eye pressure.

2. Surgical and Other Treatment Methods:

a. Drainage Tubes - In individuals where there is eye pressure can be reduced by removing the excess fluid by placing a drainage tube.

b. Trabeculectomy - In the whites (sclera) of the eye, an opening is created, and the trabecular meshwork is removed by the trabeculectomy procedure. Drainage of fluid helps reduce eye pressure.

c. Laser Therapy - A laser therapy called laser trabeculoplasty is done in individuals with open-angle glaucoma. The clog in the drainage tracts is removed with the help of a laser. An essential drawback of this procedure is that it takes around a few weeks to be effective.

d. Minimally Invasive Glaucoma Surgery- It is the most recommended procedure owing to the fewer associated risks and postoperative care needed for this procedure. In the majority of cases, it is carried out together with cataract surgery.

How Can We Prevent Glaucoma?

  • Regular Eye Check-Ups:

Dilated eye examinations must be done periodically to help detect glaucoma at its early stages. The American academy of ophthalmology recommends the following in terms of regular eye check-ups:

  1. Individuals below the age of 40 years - every five to ten years.

  2. Individuals between the ages of 41 to 54 - every two to four years.

  3. Individuals between the ages of 55 to 64 - every one to three years.

  4. Individuals above the age of 65 years - every one to two years.

  • Avoid Strenuous Exercises:

Doing exercises that are mild and moderate can help prevent glaucoma.

  • History of Glaucoma:

In patients with a family history of glaucoma, screening should be done much more frequently for early detection of glaucoma.

  • Use Prescription Eye Drops:

Regular use of prescription eye drops, even in the absence of symptoms, reduces the risk of glaucoma by decreasing the ocular pressure.

  • Protect the Eyes:

Injury can aggravate the risk of developing glaucoma. Therefore, while working with high-speed racket sports and power tools, it is vital to wear eye-protective devices.

  • Reduce Caffeine Intake:

Caffeine intake increases the risk of raising eye pressure.

  • Use Pillow:

Keeping the head elevated at about 20 degrees while sleeping with the help of a wedge pillow reduces intraocular pressure.

  • Moderate Fluid Consumption:

Increased liquid intake rapidly can increase intraocular pressure; therefore, it is advisable to drink moderate amounts of fluids periodically.


Glaucoma is characterized by optic nerve damage due to increased intraocular pressure. Taking proper preventive measures reduces the risk of developing glaucoma. Also, when you are at an increased risk of developing glaucoma, getting adequate screening helps in early diagnosis and prompt treatment.

Frequently Asked Questions


What Are the Early Warning Signs Associated With Glaucoma?

Blurred vision, severe headache, and loss of side vision are early warning signs of glaucoma. Glaucoma is a common eye disease that affects and damages the optic nerve. The optic nerve is responsible for sending images to the brain.


Can a Person Check for Glaucoma at Home?

First, both eyes are closed. The tip of both index fingers is kept on the upper eyelids with gentle pressure. Both eyes are compared as a normal eye feels like a tomato which should not be much soft or solid.


At What Age Can a Person Get Glaucoma?

Glaucoma is slow, progressive, chronic in nature, and one of the main causes of blindness in people aged above 60. Old age is the most common factor of glaucoma, as older people are more likely to get affected than younger people. People aged over 40 years are also at risk of glaucoma.


What Is the First Stage of Glaucoma?

The first stage of glaucoma is the onset of intraocular pressure. The stage leads to optic nerve changes with the ability of the eyes to drain fluid from the trabecular meshwork. Glaucoma is a medical condition that damages the optic nerve and can cause permanent blindness over the years.


Can Glaucoma Disappear?

Vision loss related to optic nerve damage cannot be reversed. Vision loss can be slowed with prompt treatment. Regular exercise is important to promote healthy blood flow to prevent vision loss or glaucoma treatment.


Should a Person Be Worried About Glaucoma?

In adults, glaucoma is a common cause of blindness. It is the second leading cause of impaired vision or blindness worldwide. Management of glaucoma involves medical, laser, and surgical modalities.


How to Get Checked for Glaucoma?

Glaucoma can be checked by screening tests. Glaucoma screening is done with tests that observe the changes in pressure of the eye's fluid, changes in the optic nerve, and changes in visual fields. Screening aims to diagnose early glaucoma.


How to Prevent Glaucoma?

Regular eye checkup is essential to prevent any eye-related disease. Family history should be taken into consideration, as glaucoma runs in families. Prescribed eye drops should always be used as the eyes are the body's most sensitive organ.


Can Eyes Itch With Glaucoma?

Itching of the eyes can be seen in some cases of glaucoma. People with thinner cornea are at risk for developing glaucoma. A routine eye examination is important to protect the eyes. Surgical intervention may reduce the risk of vision loss.


Does Drinking Water Help in Treating Glaucoma?

Drinking water does not help in treating glaucoma. Timely treatment of glaucoma can only be done after the proper screening test. Increased community awareness of glaucoma and earlier detection of the disorder will result in fewer glaucoma cases.


What Is Meant by Glaucoma Suspect?

A glaucoma suspect is a person with one or more clinical features that increase the possibility of optic nerve degeneration. High intraocular pressure (IOP) or ocular hypertension are signs of glaucoma suspect. A routine eye examination is important for protecting the eyes.


What Does a Person Having Glaucoma See?

The most common sign of glaucoma is blurry vision. The person often experiences difficulty in having a clear vision. Patients can have blurred vision with the symptom of seeing colored haloes around lights.


How To Cure Glaucoma?

Glaucoma can be cured by medical treatment that involves eyedrops such as prostaglandin derivatives - Latanoprost, Travoprost, and Latanoprostene; beta-blockers, for example, Timolol; alpha-adrenergic agonists, for example, Apraclonidine (Iopidine) and Brimonidine. Oral medication is used when eye drop alone is ineffective in bringing the eye pressure down; carbonic anhydrase is usually prescribed. Surgery includes laser therapy, filtering, drainage tubes, and minimally invasive glaucoma surgery (MIGS). Lifestyle should be modified by eating a healthy diet, exercising regularly, limiting caffeine, and sleeping with the head elevated.


Is It Hard to Diagnose Glaucoma?

Glaucoma screening can be done with tests that observe changes in the pressure of the eye's fluid, changes in the optic nerve, and changes in visual fields. Screening aims to diagnose early glaucoma. The procedure is non-invasive, quick, and painless.


When to Suspect Glaucoma?

Glaucoma suspect is a diagnosis of an individual with glaucoma at present with the characteristic that suggests a high risk of developing the disease. Individuals diagnosed with glaucoma with a positive family history of glaucoma should be documented with visual function status.
Dr. Manjunath Natarajan
Dr. Manjunath Natarajan

Ophthalmology (Eye Care)


eye checkupglaucomaangle closure glaucomaopen angle glaucoma
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