What Are the Symptoms of Glaucoma?
Glaucoma (ocular hypertension) is a disease that usually causes no symptoms in its early stages. It progresses slowly over many years and damages the optic nerve. As vision gradually deteriorates, by the time symptoms appear permanent damage has already affected the visual field. In the “acute glaucoma attack” type, intra-ocular pressure rises suddenly and dramatically. Symptoms include redness of the eye, pain, blurred vision, coloured haloes around lights, nausea and vomiting. In these patients the diagnosis can be made earlier.
What Is the Normal Intra-ocular Pressure?
Today, intra-ocular pressure is considered an individual value. In healthy eyes the normal intra-ocular pressure is between 9 and 20 mmHg. Some patients with a low intra-ocular pressure show glaucomatous damage, while others with a high pressure show no damage at all. For that reason the upper limit of intra-ocular pressure varies from person to person according to risk factors.
How Is Glaucoma Diagnosed?
Glaucoma is usually diagnosed incidentally during a routine eye examination.
During the examination the doctor measures the intra-ocular pressure and examines the optic nerve.
In suspicious cases additional tests such as pachymetry, visual-field testing, OCT or HRT are requested.
The diagnosis is made by evaluating all of the findings together.
How Is Glaucoma Treated?
The aim of treatment is to preserve the patient’s sight for life. Glaucoma treatment has three modalities: medication, laser therapy and surgical treatment.
Treatment usually starts with medication; if damage continues, laser therapy or surgery is applied.
Which treatment is used depends on the patient’s individual situation. Important factors in choosing the treatment include whether the diagnosis was early or late, the patient’s age and whether the medication has been used correctly.
Treatment cannot restore previously lost vision; it can only prevent further visual loss.
SLT (Selective Laser Trabeculoplasty) is an alternative option in glaucoma. In patients already on medication it offers a supportive solution when therapy is no longer sufficient. SLT can only be used in open-angle glaucoma. In well-selected patients it is highly effective: it is a simple procedure lasting just 3–4 minutes, has no side effects and is harmless. It can lower intra-ocular pressure by 20–30%, can be repeated every 6 months and its effect lasts between 6 months and 2 years.
What Happens If Glaucoma Is Left Untreated?
Raised intra-ocular pressure puts pressure on the layer of nerve fibres at the back of the eye and causes damage. The damage progresses slowly over the years. The patient’s visual field gradually narrows, and at that stage the patient starts to notice that he or she cannot see. If left untreated, the disease ends in blindness.
TREATMENT CAN ONLY PRESERVE THE VISION YOU HAVE AT THAT MOMENT. THE RETURN OF GOOD VISION IS NOT POSSIBLE. THIS IS WHY EARLY DIAGNOSIS IS SO IMPORTANT.
What Should Glaucoma Patients Pay Attention To?
- Eye drops must be used as prescribed by the doctor and at the same time every day.
- If side effects such as redness or stinging occur, the drops should not be stopped — the doctor should be consulted.
- If more than one drop is required, there should be a 5-minute interval between them.
- Follow-up examinations must be attended at the intervals recommended by the doctor.
- Systemic conditions such as hypertension, diabetes and asthma should be treated. General health rules — regular exercise, regular sleep and not smoking — are also recommended.
- Those with a family history of glaucoma, hypertension or diabetes should have an annual eye examination.
- Some medications you take can raise intra-ocular pressure. Bring the list of medications with you when you visit your ophthalmologist.
- When you visit doctors other than your ophthalmologist, inform them that you have glaucoma and show them the eye drops you use.
Who Is at Risk of Glaucoma?
- Those with a family history of GLAUCOMA
- Those with HYPERTENSION
- People with diabetes
- Patients with myopia
- Those over the age of 40
- Smokers
- Patients on long-term steroid therapy should be carefully monitored for glaucoma.
The content on this site is prepared for informational purposes only, in order to raise awareness. For the diagnosis and treatment of eye conditions, please consult a specialist ophthalmologist.
Prepared by the Editorial Board of Eye Foundation Hospitals.
