9 Things to Watch Out for With Glaucoma
If you’re one of the 2.7 million Americans with the progressive eye disease known as glaucoma, you know: It’s scary. It’s the leading cause of blindness for people over 60—but thankfully, the vast majority do not go blind, says Harry A. Quigley, M.D., director of the Glaucoma Center of Excellence at the Wilmer Eye Institute at John’s Hopkins Medicine in Baltimore. “Between 5 and 15 percent of people with glaucoma have major vision loss—and the most common reason is that they don’t know they have the disease,” he says. So what are some signs it’s time to see your eye doc? Here’s the 411.
You Feel Pain in Your Eye
The inside of the eye contains a fluid that maintains internal eye pressure. This fluid is important for the health of the internal eye structures. It is constantly being produced and being drained. If this balance is disrupted, pressure can build up in the eye. In people with glaucoma, the internal drainage system of this fluid is either not formed correctly, becomes damaged, or becomes blocked so fluid builds up, says Jodi Moore-Weiss, O.D., assistant professor of ophthalmology at the Mayo Clinic in Rochester, MN. This increases the pressure in your eye, which you may experience as a painful sensation. The pressure also causes long-term damage to the optic nerve, reducing your vision, If untreated, it can lead to total blindness.
You Can’t Give Side Glances
And we mean that literally. Each part of your visual field corresponds to part of the optic nerve, and when the optic nerve becomes impaired, part of your visual field is lost, Dr. Moore-Weiss says. Because loss of eyesight often begins with peripheral or side vision, you may start unconsciously turning your face to the side to compensate. If you catch yourself adjusting your head position in order to view an object straight-on, try sneaking a peek from the corner of your eye. If you're having trouble seeing, head to your doc.
Things Are Getting Fuzzy
Glaucoma is generally divided into 2 categories: Open angle and closed or narrow angle. The angle structures are located inside the eye behind the cornea or clear part of the eye. This area is responsible for draining the internal fluid. In open angle glaucoma, the structures are still draining the fluid but might be draining it inefficiently, causing pressure to rise. “It happens slowly and may have no immediate symptoms,” Dr. Moore-Weiss says. “In later stages of more severe glaucoma, however, you may notice areas of missing vision.” In closed angle glaucoma, the angle structures can suddenly be blocked off completely causing a very fast rise in eye pressure and more severe symptoms of eye pain and nausea.
You’re Seeing Halos
In the second type of glaucoma, known as angle-closure, the iris is located too close to the drainage area in the eye, which makes the angle very narrow, blocking the drain. “It can cause a very sudden and severe rise in eye pressure, called acute angle-closure, or can close and open periodically causing chronic angle-closure,” Dr. Moore-Weiss says. Along with pain, headaches, and nausea, you may see rainbow-colored rings or halos around lights. These are signs of an acute attack and you should see you doc right away.
Your Eyes Are Red or Swollen
While aging itself may cause redness (as we get older, the drainage system in the eye just doesn’t function as well as it should, and pressure can build), the majority of people with glaucoma will not develop redness as a side effect of the disease, and it's very rare to see redness in open angle glaucoma patients. However, in some cases, people with a severe angle closure attack will experience redness and swelling of the eyelids. That's because of an acute rise in pressure, and that redness will likely also be accompanied by eye pain.
You Have High Blood Pressure
High blood pressure is not a symptom of glaucoma, but if you have it, it does put you at higher risk for developing the disease. Here’s why: The health of the eye requires good blood flow to the optic nerve. Over time, high blood pressure can damage blood vessels in your body, including those in and around your eye, raising your odds of glaucoma. (If your blood pressure chronically dips too low, that can also increase the risk of glaucoma.) Having diabetes also affects the small blood vessels in your eyes.
The structure of the eye itself may also influence your risk for glaucoma. People who have extreme nearsightedness often have an elliptical or elongated shaped eye. This causes the optic nerve to have increased vulnerability to eye pressure. Certain anatomical features of the eye, like thinner corneas, can also indicate an increased risk for developing glaucoma. Of course, there are millions of people who are nearsighted who never develop glaucoma. But because it’s a risk factor, make sure you stay on top of regular eye exams.
Your Parents Have Glaucoma
Just like your hair color and height, open-angle glaucoma is inherited. In fact, around 50% of people with open-angle glaucoma have a family history of the disease. Having a first-degree relative (parents, siblings, or children) with the condition increases your chances of getting it nine-fold. The good news is, even if you have no visible symptoms, knowing your family history means you can get ahead of the disease by talking to your doctor about more frequent screenings. Catching glaucoma early greatly improves treatment outcomes.
African Americans are five times more likely to have open-angle glaucoma than Caucasians, according to the Glaucoma Research Foundation. This is due to biometric differences in eye structure, making African American eyes more susceptible to the effects of pressure, Dr. Quigley says. (African Americans also have fewer vision-processing retinal ganglion cells to begin with.) Meanwhile, Asians have a higher incidence of angle-closure glaucoma than Caucasians.
If any of these glaucoma symptoms and risk factors sound familiar, it's time to see an eye doc. Early treatment gives you the best odds of successfully managing the disease.
Glaucoma Risk Factors: Journal of Optometry. (2016). “Glaucoma History and Risk Factors.” ncbi.nlm.nih.gov/pmc/articles/PMC5383456/
African Americans & Glaucoma: Current Genetic Medical Reports. (2017). “Primary Open-Angle Glaucoma Genetics in African Americans.” ncbi.nlm.nih.gov/pmc/articles/PMC5739069/
Glaucoma Facts: Journal of the American Medical Association. (2014). “The Pathophysiology and Treatment of Glaucoma.” ncbi.nlm.nih.gov/pmc/articles/PMC4523637/