Glaucoma is a serious condition, but it can be treated. While there is no cure, its progression can be slowed.

Glaucoma is a group of eye conditions that cause damage to the optic nerve. It is much more common among people ages 60 and older. There are several different kinds of glaucoma, but all kinds are caused by a buildup of pressure in the eye. (Learn More)

The earlier glaucoma is caught, the better. If left untreated, glaucoma can progress as you age and eventually cause blindness. Once the symptoms of glaucoma become apparent, blindness can occur within a few years.

Blindness may be avoidable for some if glaucoma is caught early enough. Even those with a worse prognosis can delay the progression of the condition substantially with proper treatment. (Learn More)

For the best scenario, get checked by an eye care professional if you’re in a high-risk group or notice vision problems. Once the issue is diagnosed, pressure can be reduced with special eye drops, oral medication, or possibly surgery. Glaucoma is a lifelong condition, but these treatment measures can dramatically slow its progression. (Learn More)

What Is Glaucoma?

glaucoma

Glaucoma, which is really a group of eye conditions even though it is often discussed as if it was a single condition, is the leading cause of blindness among people ages 60 and up. It can strike at any age, but it is much more common in the older population. Glaucoma occurs when the optic nerve is damaged by abnormally high pressure in the eye.

Exactly why glaucoma causes damage in the eye is not fully understood, but it is known that the high pressure is due to aqueous humor (fluid in the eye) either being overproduced and/or not properly drained, causing pressure to build up. Over time, this causes damage and vision loss.

There are several types of glaucoma.

  • Open-angle glaucoma: This type of glaucoma occurs when your trabecular meshwork is partially blocked, partially preventing drainage of fluid and causing the buildup mentioned. It works very slowly, so much so that many people don’t really notice the vision loss as it is happening, sometimes for years.
  • Angle-closure glaucoma/closed-angle glaucoma: This condition can be known by either of the two names. This type of glaucoma involves a bulging of the iris. It comes forward and narrows or blocks the drainage angle between the iris and cornea. Fluid in the eye can’t properly circulate, pressure builds, and damage can occur.

    This condition can occur gradually (chronic angle-closure glaucoma), but it can also occur rapidly (acute angle-closure glaucoma). When rapidly occurring, it is a medical emergency that needs to be dealt with, or it will quickly lead to serious vision problems or blindness.

  • Normal-tension glaucoma: This type of glaucoma is not entirely understood. It happens when people with seemingly normal pressure in their eye still get their optic nerve damaged. Two running theories are that it may be caused by having an unusually sensitive optic nerve and/or by having an unusually low amount of blood being supplied to your eye. Conditions that may reduce blood flow, such as plaque in the arteries, might be at least one culprit that can cause this condition.
  • Pigmentary glaucoma: This type of glaucoma is caused by pigment from your iris building up in the eye’s drainage tunnels. It can be stirred up by vigorous activities like jogging, lodged in the trabecular meshwork, and cause intermittent and unwanted pressure elevations in your eye.

Glaucoma in Children

glasses held by boy

While rare, glaucoma can occur in babies and children. This is usually because they have an underlying medical condition causing the problem or drainage blockages similar to those described above. Detecting glaucoma in young children can be difficult, as they may lack the communication skills necessary to tell you what is wrong or even the context to know their vision is unusual.

Signs a child may have glaucoma include:

  • Photophobia (light sensitivity), signified by closing one or both eyes when exposed to light.
  • Excessive tearing.
  • Cloudy and/or enlarged corneas.
  • One eye being larger than the other.
  • Any sign of vision loss.

Glaucoma in babies caused by incorrect or incomplete development of the eye's drainage canals (congenital glaucoma) is often fixable with surgery. This type of glaucoma is still serious, and you need to get prompt treatment if you think there may be an issue.

If you aren’t sure if your child has vision problems, take them to an eye doctor to get evaluated. It is important to treat glaucoma as soon as possible for the best results.

Estimated Glaucoma Timelines

Primary open-angled glaucoma progresses slowly enough that many people don’t really see a difference in their quality of life related to vision if the condition is caught early. If detected later, once the condition has already caused moderate to severe damage to your vision, the prognosis is more serious. It’s possible that blindness can occur within a few years in severe cases.

Angle-closure glaucoma/closed-angle glaucoma usually has similar timelines. As noted above, it can sometimes progress at a rate that should be considered a medical emergency. If you notice changes in your vision in a short span of time, do not delay seeing a doctor as it could rapidly progress to blindness.

It's harder to predict a timeline for rarer types of glaucoma, such as pigmentary glaucoma, due to less data being available and more unknowns. Pigmentary glaucoma’s timeline can also vary based on how much activity you perform that stirs the particles of pigment.

Talk to your doctor. They can give a better timeline based on your exact situation, but it likely will be similar to the above. The sooner things are caught, the better off you are.

Glaucoma is a lifelong condition that does its damage slowly. Again, the prognosis is significantly better if it is diagnosed and treated early.

There are still treatment options if you don’t catch your glaucoma right away. It doesn’t necessarily mean you will go blind. Instead, talk to your doctor about your options and prognosis. Treatment can almost always significantly extend how long you will have good vision, even if a decline is still inevitable.

Treatments for Glaucoma

Glaucoma damage cannot be reversed, and the condition’s progression cannot always be totally stopped. However, it almost always can be slowed with proper treatment. The appropriate treatment will depend on your specific case and the type of glaucoma being dealt with.

The best thing you can do for glaucoma is to stay on top of it. Catching it early is key. It is recommended you get eye exams that check for glaucoma starting at age 60. African Americans are at greater risk of getting glaucoma. As such, it is recommended to get checked starting at age 40 instead. If diagnosed, schedule regular visits with your ophthalmologist.

Prescription eye drops — such as prostaglandins (Xalatan, Travatan Z), beta blockers (Istalol, Timoptic), and alpha-adrenergic agonists (Alphagan P, Qoliana) — are often used as the initial method of combating glaucoma. These drops usually work by either decreasing the fluid your eye makes or improving how that fluid drains, reducing pressure.

If eye drops prove ineffective, your doctor may switch you to oral medications instead, such as carbonic anhydrase inhibitors. These can better reduce pressure but may come with more serious side effects, such as urination problems, depression, upset stomach, strange tingling sensations in the extremities, and an increased risk of kidney stones.

Surgery and special therapies are more immediate measures that are sometimes necessary to treat glaucoma, especially if you are suffering from acute angle-closure glaucoma and need more or less immediate pressure relief.

  • Laser therapy: Able to treat open-angle glaucoma, this therapy can be done in a doctor’s office. It involves the use of a special laser to clear blockages in your trabecular meshwork. It can take a few weeks to see results, but it should help to reduce pressure.
  • Filtering surgery (trabeculectomy): This surgery involves removing part of your trabecular meshwork, helping to reduce pressure.
  • Drainage tubes: By inserting drainage tubes (tube shunts) into your eye, a surgeon can help your eye better drain excess fluid, thus reducing pressure.
  • Minimally invasive glaucoma surgery (MIGS): A broad grouping of procedures, this type of surgery (as the name suggests) tends to be less risky and requires less postoperative care than installing a shunt or performing a trabeculectomy. Overall, these surgeries are just highly precise surgeries that don’t risk much lasting damage to your eyes but still help reduce pressure in your eye.

The Bottom Line

Glaucoma is a serious eye condition, but it can be managed. With early and effective treatment, you may be able to avoid substantial vision loss.

 

References

Glaucoma. (July 2019). National Eye Institute.

What Is Glaucoma? (August 2019). American Academy of Ophthalmology.

How Long Does it Take to Go Blind from Glaucoma? (February 2019). BrightFocus Foundation.

Types of Glaucoma. (October 2017). Glaucoma Research Foundation.

Childhood Glaucoma. The Children’s Hospital of Philadelphia.