What You Should Know About Glaucoma

Glaucoma is the second most common cause of blindness worldwide. People with glaucoma develop damage to their optic nerve — the connection between the eye and the brain. 

Glaucoma is actually a group of diseases that damage the optic nerve in different ways. But all types of glaucoma can lead to permanent vision loss. Most people don’t even know they have glaucoma until they start experiencing symptoms, by which point glaucoma has already damaged the eye. 

But the good news is that there are treatments for glaucoma that can help keep your vision safe. If you’ve been diagnosed with glaucoma, here’s what you need to know to take care of your eyes. 

What are the types of glaucoma?

There are many types of glaucoma. The different types describe how changes develop in the eye and cause optic nerve damage. The types also classify whether the injury happened all of a sudden or recently (acute), gradually (subacute), or has been long standing (chronic). Some people can have more than one type of glaucoma (mixed-mechanism glaucoma). 

These divisions may seem confusing. But they help ophthalmologists (eye doctors) understand how glaucoma develops in a person’s eye and their best treatment options. 

Here are some common types of glaucoma.

Open-angle glaucoma

This is the most common type of glaucoma. It’s what most people think of when they hear the word “glaucoma.” People with open-angle glaucoma can have high pressure inside their eye. This pressure damages the optic nerve and causes a loss of peripheral vision. 

Normal-tension glaucoma

People with normal-tension glaucoma have a normal pressure inside their eye but develop optic nerve damage anyway. Normal tension glaucoma tends to run in families.

Angle-closure glaucoma

This type of glaucoma develops when fluid builds up in the eye because the drainage system is blocked. This causes increased pressure in the eye, which damages the optic nerve. Angle-closure glaucoma is a medical emergency and can cause blindness in as little as a few days without treatment. Other names for it are “closed-angle glaucoma” or “narrow-angle glaucoma.”

Neovascular glaucoma

Neovascular glaucoma develops when blood vessels clog the drainage pathway inside the eye. This causes a rise in pressure inside the eye. Neovascular glaucoma develops when certain medical conditions, like diabetes or high blood pressure, aren’t well controlled. 

Uveitic glaucoma

Uveitic glaucoma can develop after someone experiences an episode of anterior uveitis. It can also develop during treatment for uveitis. People with certain inflammatory conditions — like rheumatoid arthritis, sarcoidosis, and lupus — are more likely to develop uveitis and uveitic glaucoma.

Congenital glaucoma

Some infants are born with glaucoma. Congenital glaucoma develops because the drainage pathway for fluid in the eye doesn’t develop completely. This leads to increased pressure in the eye and optic nerve damage.

Who is at risk of developing open-angle glaucoma?

Primary open-angle glaucoma is the most common type of glaucoma. Things that can increase your risk of developing this type of glaucoma include:

• Age: The risk of developing glaucoma goes up as you get older. Your chance of developing open-angle glaucoma doubles between the ages of 65 and 80 years old. 

• Increased eye pressure: The relationship between eye pressure and glaucoma isn’t always clear cut. Some people with glaucoma have normal eye pressure, and some people with above average eye pressure don’t have glaucoma. But most experts agree that having higher eye pressure puts you at risk for developing open-angle glaucoma.

• Family history: Having family members with glaucoma increases your chances of developing glaucoma, especially if your siblings or parents have glaucoma. 

• Medical conditions: Some medical conditions — like heart disease, hypothyroidism, diabetes, and hypertension — can increase your risk of developing glaucoma. 

• Myopia: There’s some research that myopia can increase the risk of developing glaucoma. 

What are the symptoms of glaucoma?

Most people don’t have any symptoms from glaucoma. Many times people only find out they have glaucoma when an eye exam finds it. Other times, people don’t find out they have glaucoma until they notice changes in their vision. Glaucoma causes a loss of peripheral vision first and then starts to affect central vision. 

One exception is angle-closure glaucoma. People who have angle-closure glaucoma will experience a sudden start of symptoms, including:

• Headache

• Eye pain

• Nausea

• Blurred vision

How do you diagnose glaucoma?

Your eye doctor can diagnose glaucoma during your regular eye exam. Your eye doctor will:

• Look at the front and back of your eye using a slit lamp

• Check your eye pressure

• Test your peripheral vision

Catching glaucoma early can save your vision. Since most people don’t have symptoms, a change in vision is the first time they notice something is wrong. By that time, the glaucoma has already progressed, and those vision losses may be permanent.

Finding out you have glaucoma before you have vision changes gives you the chance to start treatment that can preserve your vision. So if you’re at higher risk for developing glaucoma, your eye doctor might recommend that you have eye exams once a year or more often. 

How do you treat glaucoma?

Glaucoma treatment focuses on decreasing the pressure in the eye. You may be able to do this with:

• Eye drops: Eye drops are usually the first treatment for glaucoma. Many types of eye drops can treat glaucoma, which you may use together or as combination products. 

• Lasers: Laser procedures can lower eye pressure. This is often the first intervention in a person with angle-closure glaucoma to help relieve the pressure quickly. 

• Surgery: Surgical procedures, such as trabeculectomy, reduce the eye pressure if glaucoma is getting worse despite eye drops and medications. 

Can changing your diet stop glaucoma from getting worse?

There’s no evidence that any particular diet can prevent glaucoma from getting worse. But a healthy diet can help you manage your high blood pressure and diabetes, which in turn can decrease your risk of developing glaucoma.

Why trust our experts?

Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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