Even if you’re not entirely sure what glaucoma is, it’s likely you’ve at least heard of the term. Conversely, you may be well familiar with this disease through a family member who is under the care of a glaucoma specialist for ongoing management. If you do have a blood relative undergoing glaucoma treatment, this puts you at a higher risk of one day requiring glaucoma management yourself. Although glaucoma symptoms are experienced in only a minority of cases, being aware of them could potentially save your sight.
What are the Glaucoma Symptoms?
As mentioned earlier, glaucoma symptoms actually occur quite infrequently. This is because the majority of glaucoma cases are a subtype known as open-angle glaucoma, which tends to develop slowly and silently.
In another subtype of glaucoma known as closed angle or angle-closure glaucoma, you may experience some glaucoma symptoms. In situations of sudden, acute angle closure, glaucoma symptoms can include:
- Sudden and severe pain around the eye
- Nausea with or without vomiting
- Watering eye
- Red eye
- Blurred vision
- Haloes around lights
Angle-closure glaucoma is an ocular emergency, and you should seek urgent glaucoma management if you suspect your symptoms are due to this condition.
What is Glaucoma?
Glaucoma is a type of eye disease that can result in permanent loss of sight. It’s not common to lose all your sight, but there can be a significant loss if glaucoma treatment is delayed.
Glaucoma involves damage to the optic nerve. The optic nerve brings neural signals from the eyeball to the brain. During this disease, retinal nerve fibres slowly die away. The damage usually begins in the nerves that connect to the periphery of the retina, meaning most cases of glaucoma begin with loss in the peripheral visual field. However, this damage to the nerve fibres and loss of sight is painless, which is why experiencing glaucoma symptoms is not common. It is also the reason why many people don’t seek glaucoma treatment in a timely manner. In fact, around 50% of Australians with glaucoma don’t realise they have the condition.
It’s not fully understood what causes this disease. In essence, the pressure inside the eyeball, known as intraocular pressure, is too high for the health of the optic nerve. However, it is not clear why some optic nerves are more susceptible to intraocular pressure or why some people require glaucoma management even when their intraocular pressures are within a normal range.
Your glaucoma specialist divides this condition into two broad categories mentioned above – open-angle glaucoma and closed-angle glaucoma. The angle refers to the gap created between where the coloured iris meets the transparent cornea. Aqueous humour fluid is drained through this structure as part of the normal cycle of aqueous production and outflow. As described in the name, open-angle glaucoma involves this gap being adequately open for the sufficient drainage of fluid. However, fluid is still unable to drain through these channels at a normal rate, typically resulting in an increase in intraocular pressure.
In closed-angle glaucoma, there is very little space between the iris and the cornea for fluid to enter the drainage channels at the angle. This physical hindrance to fluid drainage causes a rise in intraocular pressure. Sometimes, this angle can close very suddenly, resulting in a sudden and very high spike in intraocular pressure. This is known as acute angle closure glaucoma.
If you’re looking for glaucoma treatment, it is not always necessary to see a glaucoma specialist. Many general ophthalmologists are capable of providing glaucoma treatment. However, you may be referred to an ophthalmologist with a specialised interest in glaucoma if you require more complex treatments, such as surgery.
Because most cases of glaucoma begin silently with no noticeable symptoms, it’s most likely that your condition will first be picked up during a routine eye exam, perhaps with your local optometrist. You may have some or all of the following tests to diagnose glaucoma:
- Tonometry to measure the intraocular pressure
- Fundoscopy to visualise the optic nerve
- Retinal photography to record the appearance of the optic nerve
- Optical coherence tomography scanning for additional measurements of the retinal nerve fibre layer
- Visual field testing to assess any damage to your peripheral vision
While some cases of glaucoma are obvious, others can take some time to diagnose. The results of the tests may not always be conclusive or may need several results over a period of time to ascertain if there is true progressive glaucomatous damage.
If your optometrist is the first to suspect glaucoma, he or she may initiate treatment if suitably qualified or may refer you immediately to an ophthalmologist.
Treatment for glaucoma will vary based on a number of factors. If you have angle closure glaucoma, the primary aim is to widen the angle to allow aqueous humour to flow out. This is typically achieved through a procedure known as a peripheral laser iridotomy. During this in-room procedure, the ophthalmologist uses a laser to create a small hole near the outer edge of your iris to allow aqueous to drain out that way. Some people with angle closure may also benefit from cataract surgery. Removing the eye’s natural lens allows the iris to move backward, creating more space between the iris and the cornea.
For those with open-angle glaucoma, first-line treatment is usually in the form of eye drops to lower the intraocular pressure. If eyedrops are ineffective or if you have difficulty instilling them, you may be offered surgery or selective laser trabeculoplasty. Both these treatment options are aimed at increasing the outflow of aqueous from the eye.
Call us on (03) 9070 5753 today.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
What is Glaucoma? Symptoms, Causes, Diagnosis, Treatment.