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What Are the Symptoms?

It's important to keep in mind that most people with open-angle glaucoma - the most common type affecting over 90% of people with the condition - have no symptoms until they have lost a significant amount of vision. That is why it's very important to get regular exams with your eye doctor, particularly if there is a family history of glaucoma. The symptoms vary depending on the type of glaucoma.

Chronic Open Angle Glaucoma (COAG)

• Blurry vision, decreased color and light perception.
• Progressive loss of visual field. Peripheral field loss happens first. The individual usually does not typically notice peripheral field loss because the central visual field is initially preserved. Good peripheral vision is essential for good driving. It alerts you that other vehicles or road hazards are approaching. Central vision is necessary for fine visual tasks. If unsuccessfully treated COAG can eventually lead to irreversible loss of central vision and eventual blindness.

Acute Closed Angle Glaucoma

• Sudden onset of severe throbbing pain, headaches, blurred vision, rainbow halos around lights, redness in the eye, dilated pupils, and sometimes nausea and vomiting.
• This type of glaucoma is a medical emergency and should be treated immediately or severe permanent loss of vision - even blindness - can occur.

Congenital Glaucoma in Infants

• Excessive tearing, clouding of the normally transparent cornea, unusual sensitivity to light and enlarged corneas.
• The baby may habitually rub eyes, squint, or keep the eyes closed much of the time.
• The baby's eyes may appear larger than normal because the connective tissues in the eye can stretch as a result of persistent high pressure. This change in eyeball dimensions does not occur in adults.

Secondary Glaucoma

• The specific symptom pattern will depend on the underlying eye problem contributing to the abnormal rise in pressure. For example, if a hypermature cataract is to blame then a significant decrease in vision is expected. Severe inflammation inside the eye (uveitis) frequently causes halos and extreme light sensitivity (photophobia). Injured eyes can masquerade glaucoma symptoms if eye damage (corneal edema, bleeding, retinal detachment,etc.) is already present. Physicians managing complicated eye patients know to monitor the intraocular pressure in order to detect the earliest pressure rise.

How Do I know I Have It?

Tests for glaucoma are brief and painless. Your eye doctor will routinely measure your intraocular pressure (IOP) with a tonometer. There are several different types of tonometers and all work quickly and painlessly. The simple air-puff test is a reliable screening tool. Direct IOP measurements can be obtained using a handheld device. The Goldmann tonometry is widely accepted as the most reliable technique and is mounted on the doctor's slit-lamp biomicroscope. Patients simply see a blue light. Tell your doctor if you have ever had any prior refractive surgery because it can artificially alter the pressure measurement.

Doctors treat patients, not numbers. The mere presence of higher-than-normal pressure measurement does not mean that you have glaucoma. Important treatment decisions typically do not follow one measurement - doctors follow trends. Elevated pressure in the eye without evidence of damage to the optic nerve is called ocular hypertension. In most cases, this condition calls only for repeat testing at regular intervals to check for early signs of nerve damage.

If glaucoma is suspected, your ophthalmologist will carefully examine the optic nerve to check for damage. You will also have a visual field test, which measures whether you can see all kinds of light targets (big, small, bright and dim) throughout your visual field.

Congenital glaucoma is typically diagnosed by the eye doctor because infants cannot describe symptoms. If the cornea in your child's eyes appears cloudy, a congenital condition may be present. Babies are routinely checked for the disorder at birth, but if you suspect congenital glaucoma, request prompt ophthalmology consultation.

Call Your Doctor If:

• You have symptoms of acute closed-angle glaucoma. You need immediate medical attention to prevent potentially permanent eye damage or blindness.
• You become drowsy, fatigued or short of breath after using eye drops to treat glaucoma. The medication may be aggravating a heart or lung problem.
• You are prescribed drugs for other ailments. Many medications, especially those used to treat sinus and cold congestion, stomach and intestinal disorders may provoke an attack of acute closed-angle glaucoma.

 

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