Understanding Glaucoma: Causes, Symptoms, and Diagnosis

Have you ever heard about glaucoma?

Often referred to as the "silent thief of sight," Glaucoma develops slowly, typically without any noticeable symptoms at first.  

Did you know?

Glaucoma can cause permanent blindness worldwide. It damages the optic nerve, causing vision loss or blindness. The disease can occur at any age, but is more common in older adults. Additionally, it causes blindness in people over the age of 60. 

There are no specific warning signs of glaucoma, and the effect is so gradual that you may not observe changes in vision until the condition is in its later stages. 

In this article, we'll explore what glaucoma is, its leading causes, early symptoms, and how it is diagnosed. 

What is Glaucoma?

Glaucoma is a group of eye diseases that damage your optic nerve, which is crucial for vision. Usually, this damage happens because the pressure inside your eye is too high. If you don't get it checked out, this pressure can damage your optic nerve and lead to permanent blindness. 

Getting your eyes checked regularly can slow or prevent Glaucoma. If you have glaucoma, you'll need treatment or checkups for the long haul. 

Also read: 20 ways to improve eyesight

There are several types of glaucoma, but the two most common are:

• Primary Open-Angle Glaucoma (POAG) is the most common type, progressing slowly and often causing no pain. "Open angle" points towards the spot where the white part of your eye connects to the colored part, which is open wide. The aqueous humor flows into the drainage angle, allowing it to exit the front part of the eye. 
• Angle-Closure Glaucoma is less common but more sudden and severe. It's a medical emergency. Aqueous humor fluid should move smoothly from the back part, behind your iris, through your pupil, and then into the front part. However, if the lens in your eye pushes too far forward, it can stop the fluid from going through your pupil. 

When that happens, the fluid builds up in the back, pushing your iris forward and reducing the drainage angle, or even blocking it completely. 

• Secondary Glaucoma: This occurs when another condition increases the pressure in your eye, which can lead to glaucoma. Conditions such as eye injuries, pigment dispersion syndrome, uveitis, certain medications (especially corticosteroids and cycloplegics), and eye surgeries can cause it.
• Congenital Glaucoma: This type of glaucoma happens because of changes or differences that occurred during fetal development. Conditions like aniridia, Axenfeld-Rieger syndrome, Marfan syndrome, congenital rubella syndrome, and neurofibromatosis type 1 can cause it.

Common Causes and Risk Factors of Glaucoma:

In its early stages, glaucoma may not cause symptoms. However, several factors increase your risk. The most common cause is poor drainage of fluid (aqueous humor) in the eye, leading to pressure buildup. Here are the key causes and risk factors:

• Increased eye pressure (intraocular pressure)
• Age over 60
• Family history of glaucoma
• Medical conditions like diabetes, high blood pressure, sickle cell anemia, migraine, and heart disease
• Thin corneas
• Severe eye injury or inflammation
• Long-term use of corticosteroid medications
• Black, Asian, or Hispanic Heritage

Early Signs and Symptoms of Glaucoma

In its early stages, glaucoma often has no noticeable symptoms. That's why regular eye checkups are so important. However, depending on the type of glaucoma, some symptoms may eventually appear.

1. Open-angle Glaucoma

This type of glaucoma is common. The angle at which your iris and cornea remain open, but the rest of the drainage system doesn't function as well as it should. Therefore, the pressure in your eye might slowly increase over time.

Symptoms include

Here are symptoms of open-angle glaucoma:

• Gradual loss of peripheral (side) vision, usually in both eyes. 
• Tunnel vision in advanced stages. 
• No pain or discomfort in the early stages. 
• Difficulty seeing in low light. 
• Needing more light to read or do close work. 
• Frequent changes in eyeglass prescription. 
• Blind spots in your visual field, especially in the peripheral or central vision (as it progresses). 

2. Acute angle-closure Glaucoma

This type of glaucoma occurs when the iris bulges. When this happens, it can block the drainage angle in your eye, either a little or completely. If that angle is blocked, fluid can't flow properly, and the pressure inside your eye increases. Angle-closure glaucoma can occur suddenly or develop gradually over time. 

Symptoms include

Here are symptoms of acute angle-closure glaucoma:

• Sudden, severe eye pain
• Blurred or cloudy vision
• Redness in the eye
• Seeing halos or rainbow-colored rings around lights
• Headache
• Nausea and vomiting
• Sudden loss of vision
• The eye feels hard to the touch due to high intraocular pressure

3. Normal-tension Glaucoma (NTG) s

Experts believe this may occur due to increased nerve sensitivity or reduced blood flow to the optic nerve, possibly resulting from conditions such as atherosclerosis or low blood pressure. There are usually no early symptoms, but NTG can still cause gradual vision loss over time.

Risk factors for NTG include

Here are symptoms of normal-tension glaucoma:

• Family history of glaucoma
• Thin cornea
• Low blood pressure or poor circulation
• Migraines or vasospastic conditions
• Japanese or East Asian ancestry

What are the Complications of Glaucoma?

Glaucoma can cause serious, permanent problems if it's not treated or managed well. The damage to your optic nerve can't be reversed; it's essential to get diagnosed early and stick with your treatment plan.

7 Major Complications of Glaucoma include:

If glaucoma isn't treated, it can cause severe, permanent damage to your sight and life. Here are seven significant problems that can arise from glaucoma. 

• Permanent Vision Loss: It is the most serious complication of glaucoma. It begins with peripheral vision loss and can progress to total blindness if untreated.
• Tunnel Vision: When glaucoma gets bad, it can cause tunnel vision. It means you can only see what's directly in front of you, which makes simple things like driving or walking a real pain.
• Blind Spots (Scotomas): Damage to the optic nerve can lead to dark spots in your vision, affecting both central and peripheral vision.
• Decreased Quality of Life: Losing your sight gradually can impact reading, driving, and independence. This can cause sadness or depression.
• Acute Glaucoma Attack: Angle-closure glaucoma can lead to intense pain, feeling sick, and blurry vision. It's a medical emergency because, without quick treatment, you could lose your vision fast.
• Damage to the Other Eye: Glaucoma typically impacts both eyes, but it might be more severe in one. If glaucoma is not detected early in one eye, it can risk the other eye.
• Side Effects of Glaucoma Treatment: Prolonged use of eye drops or surgery may lead to eye irritation or redness, allergic reactions, cataract formation, scarring, or infections. 

How is Glaucoma Diagnosed?

An ophthalmologist typically performs a glaucoma diagnosis during a comprehensive eye examination. Several tests may be performed:

1. Tonometry 

It measures the pressure inside your eye, known as intraocular pressure (IOP). Typically, it should range between 10 and 21 mmHg. 

2. Ophthalmoscopy 

This test allows the doctor to examine the optic nerve for signs of damage. 

3. Perimetry

The test helps check your peripheral vision, which is often the first area affected in glaucoma. 

4. Gonioscopy

In this eye test, the expert checks the angle where the Iris meets the cornea to see if the drainage angle is open or closed. 

5. Pascymtery

It measures the thickness of your cornea, which can affect IOP readings. Early detection through routine eye exams is the best way to protect your eyes. 

Other most helpful glaucoma tests include: 

• Visual acuity: Testing helps check how well you see things near and far.
• Depth perception: It assesses your ability to judge distances and perceive objects in three dimensions.
• A slit lamp exam uses a microscope to get a close-up look at the front part of your eye.
• An optical coherence tomography (OCT) scan provides the doctor with detailed images of your retina and optic nerve. This helps catch eye problems early.
• Fluorescein angiography uses a dye and camera to visualize blood flow in the retina and detect abnormalities.
• An ultrasound uses sound waves to create pictures of the inside of your eye. 
• CT scan or MRI: These imaging tests produce detailed images of the eye and brain to detect tumors, injuries, or nerve issues.

How Is Glaucoma Treated?

Healthcare professionals use intraocular pressure to treat glaucoma. They may suggest medications to lower the pressure inside your eye and prevent the progression of the disease. 

Additionally, the healthcare providers may suggest glaucoma surgeries such as trabeculectomy, tube shunts, laser therapy, and minimally invasive glaucoma surgeries (MIGS). This is to improve the drainage of aqueous humor fluid, thereby lowering the pressure inside the eyes. 

How Glaucoma Can Be Prevented?

Glaucoma can't be prevented. However, early detection and treatment can manage pressure inside your eye and help prevent or delay vision loss. 

3 Important Ways to Prevent Vision Loss from Glaucoma: 

You can prevent glaucoma with: 

• Regular eye checkups: Regular eye checkups can detect glaucoma early, even before you notice any symptoms. This lets doctors start treatment sooner and preserve your vision. 
• Managing ocular hypertension: If you have elevated eye pressure but your optic nerve is still healthy, your doctor may monitor it or treat it to prevent glaucoma from developing.
• Knowing and managing your risk factors: If you have a family history, are over 40, or have conditions such as diabetes or high blood pressure, consult your eye doctor about more frequent screenings and protective measures.

When should you seek medical attention?

You should seek medical attention for the sudden onset of worsening:

• Severe eye pain or pressure
• Headaches
• Double vision or blurred vision
• Nausea and vomiting
• Rainbow-colored halos around lights
• Vision loss
• Flashing lights in your vision
• Appearance or increase in visible floaters

What Deficiencies Cause Eye Problems?

Several vitamin and nutrient deficiencies can negatively impact your eye health. Here are the most common ones:

• Vitamin A deficiency: It can lead to night blindness in the eyes. Eat carrots, spinach, and sweet potatoes to help with weight loss. 
• Vitamin B12 deficiency: It can cause blurred or dim vision. Eat eggs, dairy, and fortified cereals to maintain healthy B12 levels and support nerve function. 
• Vitamin C deficiency: It can increase the risk for cataracts and age-related degeneration (AMD). Eat oranges, strawberries, bell peppers, and broccoli to support eye health and protect against oxidative stress. 
• Vitamin E deficiency: Its low levels are associated with retinal degeneration. Eat almonds, sunflower seeds, spinach, and avocados to protect your eyes from oxidative damage. 
• Omega-3 fatty acid deficiency: It can cause dry eyes, poor tear quality, and inflammation. Eat flaxseeds and walnuts to improve retinal function and visual development. 
• Zinc deficiency can impair night vision and increase the risk of AMD. Eat beans, nuts, and dairy to help transport vitamin A from the liver to the retina and maintain healthy vision.
• Lutein and Zeaxanthin deficiency: Their low levels are associated with an increased risk of macular degeneration and cataracts. Eat leafy greens and corn to help protect the retina and maintain long-term eye health.

Conclusion: Don't Let Glaucoma Steal Your Sight

Glaucoma is a serious eye problem, but it can be managed with early detection. You can't prevent it entirely, but regular eye checkups, monitoring eye pressure, and knowing if glaucoma runs in your family can help protect your vision. 

If you are over 40 or glaucoma is common in your family, discuss it with your eye doctor immediately. 

Healthy Body, Healthy Vision: Choose Redcliffe Labs! 

Redcliffe Labs doesn't offer direct eye care, but we do support your overall health, which is crucial for maintaining good eyesight. Conditions like diabetes, high blood pressure, not getting enough vitamins, and thyroid problems can interfere with your vision without you even knowing. 

At Redcliffe Labs, we offer a wide range of blood tests and health checks that can detect these problems early on. By managing your overall health with timely diagnostics, you're also taking a proactive step in protecting your eyes. 

FAQs

1. Can we cure glaucoma?

No. We can't cure glaucoma. However, with early diagnosis and proper treatment, its progression can be slowed to prevent vision loss.

2. Can glaucoma cause severe pain?

Yes, especially if you suffer from angle-closure glaucoma. It can cause sudden, severe eye pain. Consult your doctor immediately. 

3. Who is at greater risk of developing glaucoma?

People over 40, those with a family history, individuals with diabetes, high blood pressure, or high eye pressure, and certain ethnicities like African, Asian, and Hispanic are at higher risk.

4. How often should you get tested for glaucoma?

You should get tested for glaucoma every 1–2 years after you turn 40. If you're at higher risk, your doctor may recommend more frequent check-ups.

5. Can glaucoma lead to blindness?

Yes. If left untreated, it can cause irreversible vision loss and even blindness. 

6. What are the early symptoms of glaucoma?

Early symptoms include eye pain, blurred vision, and nausea. Seek medical assistance immediately to manage the disease and prevent progression. 

7. Can lifestyle changes help manage glaucoma?

Yes. You can manage glaucoma by living an active lifestyle, avoiding smoking, maintaining a healthy weight, and taking prescribed medications as directed by your healthcare professional.

8. What are the other names for the glaucoma test?

The glaucoma test is also referred to as the glaucoma eye test, eye pressure test, or intraocular pressure (IOP) test.