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What are the symptoms of glaucoma?

Eye & LASIK

My uncle was diagnosed with glaucoma, but he claims to not have experienced any symptoms. May I please find out what are the typical symptoms of glaucoma, so that we can better explain to him about the condition? Thank you!

DOCTOR’S ANSWER (3)
To start with, it is important to realise that glaucoma is not one single disease. There are many types of glaucoma, each of which may present or start off with different symptoms/feelings in the eye.

Having said that, the most common type of glaucoma is what we call primary open angle glaucoma, or POAG. This answer will deal only with POAG.

With POAG, pressure in the eyeball slowly increases over a period of time, and this high eye pressure gradually damages nerve cells in the optic nerve.

The high eye pressure from POAG typically causes no symptoms. There is no ache, no pain or even the slightest irritation. And because optic nerve damage is also gradual, there are no visual symptoms in the early stages. When the glaucoma becomes advanced, patients become aware of areas in their vision which they cannot see, or what may be called blind spots. If the condition is not treated, the blind spots enlarge until eventually blindness results.

As POAG causes no symptoms in the early stages, it is sometimes called the thief of sight. It is one of the reasons why regular eye checks are a good idea for older folk, or even younger ones who have a strong family history or who otherwise have a higher risk of developing the condition. If the condition is detected early, medication to lower the eye pressure can stop visual deterioration and stabilise the condition. Sometimes, if medication is not enough to lower eye pressure, then surgery can be considered as a second line.

Each patient should clarify the diagnosis and treatment plan with their own doctor, who will know the specific diagnosis and situation best.

257 views 10 Jan 2019

Hi there!

Symptoms of glaucoma can either be from build-up of pressure within the eye, or visual loss as a result of the high pressures.

Glaucoma can be broadly divided into two categories, "open" or "closed" angle, depending on the configuration of the drainage angle of the eye, where fluid (aqueous) is drained out of the eye. Depending on the rate of build-up of pressure, glaucoma can be further described to be "acute" (or sudden), or "chronic" (or gradual).

In most cases of open angle glaucoma and chronic closed angle glaucoma, the build-up of pressure is gradual, and without symptoms. Some patients may experience some glare and haloes around lights when the pressure is high. Additionally, there is a sub-group of glaucoma known as "normal tension glaucoma" in which the eye pressures are normal, but the optic nerve continues to be damaged. These patients will not have any symptoms from high pressures since the eye pressures will be in the normal range.

Visual loss from glaucoma usually starts from the peripheral field of vision, so blurring of vision due to involvement of central visual field is a late sign, when glaucoma is in its intermediate to advance stages. 

Acute angle closure glaucoma, however, presents with dramatic symptoms of eye redness, pain, blurring of vision, together with headache, nausea, vomiting. This is due to the rapid and extreme build-up of eye pressure within the eye. This is an emergency and immediate medical attention should be sought. 

Hence, most cases of glaucoma are without noticable symptoms in the early to intermediate stages. Patients who are at risk of developing glaucoma (such as those with a family history of glaucoma, who are moderately to severely short or long sighted, or have poorly controlled hypertension, diabetes, or have had previous injury or surgery to the eye) should get their eyes screened for glaucoma. 

I am sorry to learn that your uncle has been diagnosed with glaucoma -- I hope his condition is in its early stages; I would strongly recommend that his family members (especially first degree relatives) get screened so that treatment be started, if necessary, to prevent irreversible visual loss.

Hope this helps!

Regards,

DQ

282 views 10 Jan 2019
Unfortunately most patients with glaucoma do not experience any symptoms. It has derived its moniker as "the silent thief of sight". Patients with advanced glaucoma develop negative scotomas (which unfortunately are not noticed by patients until late in their disease), when significant loss of their visual fields occur.
 
A less common form of glaucoma is acute angle-closure glaucoma that typically occurs in middle-aged Chinese females, and does fortunately present with symptoms of unilateral red eye associated with pain and blurring of vision. These symptoms fortuitously bring patients to medical attention and their condition is diagnosed, and treatment is commenced.
 
It is indeed fortunate that your Uncle was diagnosed and may receive the appropriate care and follow-up.
 
ESG
240 views 11 Jan 2019
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