Glaucoma is a group of eye conditions that damage the optic nerve, which carries information from the eye to the brain. It is usually linked to raised pressure inside the eye. Glaucoma is a leading cause of irreversible blindness worldwide, and people of African descent are at higher risk of developing it earlier and more severely. Because it often causes no symptoms until a lot of sight is lost, regular eye checks are essential.
Key facts
- The most common type causes no pain and no early symptoms.
- Sight lost to glaucoma cannot be restored, but treatment can stop further loss.
- People of African descent, people over 40 and those with a family history are at higher risk.
- Glaucoma is diagnosed with simple eye tests, including eye pressure and optic nerve checks.
- Daily eye drops are the most common treatment and must be used for life.
Types of glaucoma
- Primary open-angle glaucoma: the most common type. It develops slowly over years, gradually narrowing side (peripheral) vision.
- Acute angle-closure glaucoma: a sudden rise in eye pressure that causes severe pain and is an emergency.
- Secondary glaucoma: caused by eye injury, inflammation, long-term steroid use or advanced cataracts.
- Congenital glaucoma: present at birth or in early childhood, causing large, cloudy or watery eyes.
Risk factors
- African ancestry
- Age over 40
- Family history of glaucoma
- Short- or long-sightedness
- Diabetes and possibly high blood pressure
- Long-term use of steroid eye drops, creams or tablets, including bleaching creams containing steroids
- Previous eye injury
Symptoms
Open-angle glaucoma
Usually no symptoms in the early stages. Later, people may notice they bump into things at the side, miss steps, or have “tunnel vision”. By then, much of the damage is permanent.
Acute angle-closure glaucoma
- Sudden, severe eye pain
- Red eye
- Blurred vision and seeing rainbow-coloured rings around lights
- Headache, nausea and vomiting
Diagnosis
An eye health worker or ophthalmologist can check for glaucoma with painless tests:
- Eye pressure measurement (tonometry)
- Examination of the optic nerve at the back of the eye
- Visual field test to check side vision
- Gonioscopy to look at the drainage angle of the eye
- OCT scan in some centres, which measures the nerve fibre layer
Adults of African descent should have an eye check from age 40, or earlier with a family history, and then as advised, often every 1 to 2 years.
Treatment
- Eye drops such as timolol, latanoprost or others lower eye pressure. Use them every day, exactly as prescribed, even though you feel no difference.
- Laser treatment to improve drainage of fluid from the eye
- Surgery (trabeculectomy or drainage devices) when drops and laser are not enough
- Emergency treatment for acute angle-closure glaucoma with medicines and laser
Tips for using eye drops
- Wash your hands, tilt your head back and pull down the lower lid.
- Put one drop in, then close your eye and press gently on the inner corner for 1 to 2 minutes.
- Wait 5 minutes between different drops.
- Do not stop drops because they are expensive or you feel fine. Talk to your eye doctor about affordable options.
Avoid harmful remedies
Do not put traditional preparations, breast milk, urine or unprescribed drops in your eyes. They can cause infection and damage. Only use eye medicines prescribed by a qualified eye health worker.
When to see a doctor
Book an eye check if you are over 40, have a family history of glaucoma, or notice changes in your side vision. Seek emergency care for sudden severe eye pain with redness, blurred vision, halos around lights, or vomiting.
Frequently asked questions
Can glaucoma be cured?
No, but treatment can stop or slow further damage and preserve your remaining sight.
Will I go blind?
Most people who are diagnosed early and use their treatment as prescribed keep useful sight for life.
Related guides
Sources
- NHS: Glaucoma
- National Eye Institute (NIH): Glaucoma
- World Health Organization: Blindness and vision impairment fact sheet
