Glaucoma is a disease that affects the optic nerve, which is responsible for sending images from your eyes to your brain.
It can result in blindness without proper treatment and diagnosis to prevent it.
There are also different types of glaucoma, but the most common is open-angle glaucoma.
This occurs when the drainage canals in your eye become clogged over time, leading to an increase in pressure within your eyeball.
The increased pressure can damage the optic nerve fibers and cause vision loss.
At first, glaucoma patients may not even know they have eye disease.
Most of them are asymptomatic until later when significant vision loss can occur.
For this reason, everyone needs to be aware of the signs and symptoms that indicate an individual might be developing glaucomatous changes in their eyes.
Stages of Glaucoma
Like any other disease, glaucoma has a variety of phases and degrees of severity.
Each stage has its own risks and should be treated as soon as possible.
The early stage of glaucoma is often asymptomatic but can be recognized by a mildly increased intraocular pressure.
This stage occurs as the drainage system in the eye begins to change due to the eye’s inability to drain fluid from the trabecular meshwork.
As a result, the intraocular pressure in your eye rises, causing damage to the optic nerve.
If left untreated, this can lead to the moderate stage where vision loss begins to occur, and the optic nerve damage becomes more apparent.
The advanced stage is the most severe, where blindness can set in.
The symptoms of glaucoma always vary on a person-to-person basis, type, and stage of your condition.
So, it’s essential to get regular eye exams to check for glaucoma and catch it in its early stages.
Treatment is more effective when the condition is caught earlier.
Signs of Early Stages of Eye Glaucoma
While there are few early warning signs of glaucoma, there are a few key things to look out for if you have a higher risk for the disease. For example:
Peripheral or Side Vision Loss
Peripheral vision, also called indirect vision, is a significant risk factor for glaucoma, as it can be a key indicator that optic nerve damage has begun.
In most cases, it is common for people with open-angle glaucoma.
It happens due to retina damage, macula degeneration, and optic nerve narrowing.
As a result of this retina damage, peripheral vision is lost first before central vision loss occurs as it progresses into glaucoma.
It usually starts on one side and affects both eyes over time if left untreated. This type of vision loss is different from losing sight in the center of your vision.
The loss of peripheral vision may affect your ability to see what’s directly in front of you or off the side with ease.
The best way to understand peripheral side/indirect vision is by holding a finger up about an inch from one eye and looking at something across the room without moving your eyes or turning your head.
You will now be able to see only what is directly in front of your finger and not what is to the side or behind you.
If this occurs, it’s essential to see an eye doctor as soon as possible for a comprehensive glaucoma exam.
Seeing Halos Around Lights
Halos around lights can be an indication of the early stages of glaucoma.
This is because as glaucoma worsens, pressure in your eye increases and causes optic nerve damage.
You might start to see a halo or rainbow-colored circle around bright lights when this happens.
If you notice this happening, be sure to schedule an appointment with your eye doctor as soon as possible.
Complete Vision Loss
If you experience a sudden vision loss, it’s important to see an eye doctor as soon as possible.
This occurs when optic nerve fibers are damaged, leading to a gradual loss of peripheral vision and eventually central vision.
However, it is worth noting that vision loss from glaucoma is usually gradual. This means that you may not even realize you have the disease until it has progressed significantly.
Early diagnosis and treatment are key to preserving your vision, so be sure to get regular eye exams, even if you don’t think you’re at risk for glaucoma.
Redness in the Eye
Having redness in the eye is not something to take lightly.
It could be a sign of something as minor as allergies, but it also might be a more serious issue such as acute glaucoma.
The elevated pressure in the eye caused by glaucoma can cause the tiny blood vessels to expand and become irritated, causing redness in the eye.
Hazy or Cloudy-Looking Eyes
In many cases, hazy eyes or cloudy-looking eyes might be one of the only symptoms that people experience during the early stages of the disease.
This happens when the watery fluid inside the eye, known as ‘aqueous humor‘, starts to push out of its normal boundaries.
So, if the eye pressure rises a little too high, this watery fluid will be pushed into other parts inside of your eyes, such as your cornea.
This is what leads to hazy or cloudy-looking eyes.
In some cases, people might be aware of having hazy or cloudy-looking eyes from a very young age.
This is because one of the early signs of childhood glaucoma is a cloudy-looking cornea.
Nausea or Vomiting
If you are experiencing nausea or vomiting, it is important to seek medical attention right away.
These symptoms can indicate a number of severe health conditions, including but not limited to glaucoma.
This can occur as a response to the oculoabdominal reflex, which is triggered by the corneoscleral stretch caused by high eye pressure.
Head and Eye Pain
One of the most apparent symptoms of angle-closure glaucoma is eye pain and headaches.
The pains may be caused by the increased build-up of pressure in the eye, which can lead to a throbbing sensation.
The eyes may also feel gritty or itchy.
The pain often occurs in combination with other symptoms, such as redness of the eye, nausea, or vomiting.
Tunnel Vision
When glaucoma progresses, patients may experience a loss in peripheral vision.
This is often called tunnel vision because it can make the patient feel like they are looking through a narrow tube or tunnel.
As the disease worsens, this tunnel vision effect can become more pronounced and eventually block central vision as well.
If this happens, patients will only be able to see what is directly in front of them and will lose their ability to see objects or people on the periphery.
This can make it difficult for patients to complete everyday tasks, such as driving or reading.
Sensitivity to Light
As time progresses, sensitivity to light may indicate the early stages of glaucoma.
When the eye pressure increases, the cornea becomes more cloudy, making light bounce off irregularly and cause glare.
This sensitivity to light may also cause sufferers to squint or have a headache.
Pigmentary Glaucoma Symptoms
Pigmentary glaucoma is a rare form of the disease, accounting for only about five percent of all cases.
It occurs when pigment granules from the iris clog the drainage angle in the eye, causing slow fluid drainage.
Sometimes, some activities might trigger this pigmentary glaucoma, such as exercising, whereby the pigment granules are stirred up and deposited on the trabecular meshwork.
This can cause intermittent pressure elevations, which over time may damage optic nerve fibers and lead to vision loss.
If you have a family history of pigmentary glaucoma or other risk factors, be sure to talk to your doctor about being screened for this condition
The most common symptoms can include:
Blurred Vision
People with pigmentary glaucoma may experience a gradual blurring of vision in the affected eye.
As the disease progresses, optic nerve fibers become damaged and can’t transmit images clearly to the brain.
In some cases, this blurred vision may be the only symptom that someone has until significant damage has occurred. You may also notice that colors appear faded or muted.
Halos During Physical Activity
Patients with pigmentary glaucoma may also see a halo or circle of color around lights during physical activities.
They are caused by the clogged drainage angle due to pigment dispersion in front of the retina, causing light to scatter in different directions as it enters the eye.
The halo may be yellow or green and typically takes about two hours after it first appears for it to fade away completely.
Typically, halos occur in the field of vision that is not being affected by glaucoma. The area where you see a halo isn’t blurry or distorted and often appears to be moving around.
If you do experience, this may indicate more significant problems with your eyes, so it’s best to have this checked out by a doctor.
Diagnosis of Glaucoma
The best way to diagnose glaucoma is through a comprehensive eye exam.
Your doctor will measure the pressure inside your eyes and may also use other tests to look for signs of damage to your optic nerve.
The Eye Pressure Test (Tonometry)
One of the most common ways to detect changes in your eye pressure is through tonometry.
The test can be done in a doctor’s office with an instrument that touches your eye (an applanation tonometer) or by shooting a puff of air into your eye (the non-contact tonometry).
Before the tonometry test, your doctor may use numbing eye drops to ease any discomfort.
The doctor may then use a tiny strip of paper containing orange dye to stain the surface of your eye to boost the test’s accuracy.
Your doctor will also use a “slit-lamp machine” to get a close-up view of your cornea.
Once the doctor flattens out your cornea, they will take a reading of your eye pressure.
In some cases, the doctor may use tonometry to get an initial diagnosis of glaucoma.
In other cases, they might order it as part of a routine check-up or if you have signs and symptoms that lead them to believe you might be at risk for glaucoma.
Optic Nerve Exam
During the optic nerve exam, your optometrist will check the health of your optic nerve using a special magnifying lens and light.
They may also measure the pressure inside your eye (intraocular pressure) using optical coherence tomography (OCT) — a painless, non-invasive imaging technique that provides a detailed cross-sectional view of the retina and optic nerve.
But before the test begins, your optometrist may first have to dilate your pupils using eye drops.
The optometrist can also opt to use a slit lamp to get a better view of the optic nerve and retina.
The primary purpose of this exam is to detect any changes in the optic nerve that might indicate glaucoma.
Early changes may not cause any symptoms, but they can help your optometrist detect and monitor possible glaucoma progression before vision loss occurs.
Visual Field Test
Your visual field test will help your doctor detect the onset of blind spots (scotoma) in your field of vision.
According to the American Academy of Ophthalmology, this test can also help your doctor determine if you have any signs of peripheral vision loss from glaucoma.
In this test, you will be shown a series of small lights in various parts of the room from where you are sitting.
Your optometrist may ask you to click a button when light appears at different locations in your field of vision.
If your eyes are healthy, you’ll see some lights at the edges of your vision.
If you can’t see any light dots in the periphery of your vision, it may be an indication of blindness in sports, which could be related to glaucoma.
Make sure to talk to your eye care professional about what tests are best for you and when they should be performed.
Risk Factors of Glaucoma
While glaucoma can kick in at any time, certain risk factors increase the odds of developing this eye condition.
Some of these include:
Genetics
If you have a family history of glaucoma, you’re at a higher risk of developing the condition yourself. This is because glaucoma can be hereditary.
So, if you have a parent or sibling who has the disease, you’re more likely to develop it too. However, you can still develop glaucoma even if you don’t have a family history.
Age
The older you are, the higher your risk of developing glaucoma.
As we age, our eyes’ natural drainage system becomes less efficient at getting rid of excess fluid, increasing pressure inside the eye and damaging the optic nerve.
In fact, this eye disease is more prevalent in older adults over the age of 40.
Race
Glaucoma has been reported to occur more often in African Americans, Hispanics, and people of Asian descent.
However, it is essential to note that anyone can develop glaucoma, regardless of race.
The initial stages of glaucoma eye recognition may be more difficult in some ethnic groups, but all patients should receive regular screenings from an ophthalmologist.
Corticosteroid Use
Corticosteroids are prescription medications used to treat various medical conditions, including eye inflammation.
They can be administered as ophthalmic drops (eye drops) or orally in pill form. Long-term use of corticosteroids is one of the most common risk factors for developing glaucoma.
So, if you are using corticosteroids for any reason, be sure to talk to your doctor about the potential risks of glaucoma.
Hypertension, extreme myopia (nearsightedness), thin corneas, and diabetes
A few health conditions are known to be associated with glaucoma risk. These conditions include high blood pressure, extreme nearsightedness (more common in older people), thin corneas, and diabetes.
People with these medical issues should pay close attention to any signs of early glaucoma and see an eye doctor if they have any concerns.
A Word from Glaucoma Care
While glaucoma is the leading cause of blindness globally, there are steps that can be taken to prevent it. While some of these measures require more than just regular visits with your optometrist, staying aware of the symptoms for the earlier stages of glaucoma and noticing when your eyes do not feel quite right can help lead to a diagnosis early in the future. It is also important to stick to your treatment plan if diagnosed with this condition. This may include taking prescribed medication or undergoing surgery. Following these steps can help prevent vision loss from glaucoma.
Sources
https://www.healthonemedicine.com/blog/5-early-warning-signs-of-glaucoma-that-shouldnt-be-ignored
https://www.nvisioncenters.com/glaucoma/early-signs/
https://floridacataract.com/vision-blog/learn-about-the-stages-of-glaucoma-and-how-they-are-treated
https://tucson2020.com/what-is-the-first-sign-of-glaucoma/
https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839
https://www.aao.org/eye-health/tips-prevention/visual-field-testing
https://responsumhealth.com/glaucoma/stages-of-glaucoma-what-the-mean-and-how-to-manage-them/
https://floridacataract.com/vision-blog/learn-about-the-stages-of-glaucoma-and-how-they-are-treated
Frequently Asked Questions
What Does Vision Look Like With Glaucoma?
Vision loss from glaucoma can be gradual, so many people do not realize they have the condition until significant damage has been done. However, the most common symptom of early-stage glaucoma is a gradual increase in peripheral (side) vision loss. In advanced cases, central vision may also be affected, resulting in blindness.
Is Glaucoma Treatable If Caught Early?
While the condition is not treatable, it is preventable if caught early. Treatment may include medication, surgery, or laser procedures to lower eye pressure and slow glaucoma progression.
Who Is Most At Risk For Glaucoma?
People over the age of 40 are at the highest risk for glaucoma, but anyone can develop it. African Americans and Hispanics are also more likely to have glaucoma than Caucasians. People with a family history of glaucoma are also at increased risk. If you have any of these risk factors, it is important to see your optometrist for regular eye exams.
How Do I Know If I Have Glaucoma?
The only way to know for sure if you have glaucoma is to have a comprehensive eye exam. During this exam, your optometrist will check the pressure in your eyes and test your vision for signs of damage. If you are at high risk for glaucoma, your optometrist may recommend more frequent exams. They may also prescribe eye drops or recommend surgery to slow glaucoma progression.
