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Glaucoma symptoms

What are the symptoms?

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

Chronic open-angle glaucoma

Loss of peripheral field vision happens first, but because the peripheral field loss of open-angle glaucoma happens so gradually, the individual usually does not notice. That is why it is so important to have regular eye examinations, particularly if you have any risk factors.

Acute-angle closure glaucoma

  • Sudden onset of throbbing pain and redness in the eye, headaches, blurred vision, halos around lights, a dilated pupil and sometimes nausea and vomiting.
  • This type of glaucoma is a medical emergency and should be treated immediately. If not treated, it may result in severe permanent loss of vision or blindness. 

Developmental (congenital) glaucoma in infants

  • Tearing (watery eyes), sensitivity to light, and eyelid spasm are the three primary signs of congenital glaucoma.
  • A larger cornea and clouding of the normally transparent cornea may also be noticed.
  • The baby may habitually rub the eyes, squint or keep the eyes closed much of the time.

If you notice any of these symptoms you should consult your GP or an optician as soon as possible.

Secondary and other forms of glaucoma

Symptoms will depend on the underlying condition contributing to the abnormal rise in pressure. Inflammation inside the eye (uveitis) frequently causes halos and light sensitivity (photophobia). Injured eyes may mask glaucoma symptoms if eye damage (corneal oedema, bleeding, retinal detachment etc) is already present. If a cataract is the cause, vision will have been markedly reduced for a long time. Doctors managing complicated eye conditions in patients will monitor the intraocular pressure in order to detect the earliest pressure rise.

How do I know if I have it?

Tests for glaucoma are brief and painless. The optometrist will routinely measure your intraocular pressure (IOP) with a tonometer. There are different types of tonometers, and all work quickly and painlessly. The 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 optometrist’s slit-lamp biomicroscope. Patients simply see a blue light.

If the optician finds glaucoma, you will be referred to an eye specialist for treatment. The specialist will perform more detailed eye tests to discover how developed the glaucoma is and how much damage it has done. Tests may also be carried out to check the cause of the glaucoma.

Tell your optometrist or ophthalmologist if you have ever had any prior refractive surgery because it can artificially alter the pressure measurement.

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