What is glaucoma?

Glaucoma is a common eye problem. It happens when there is an increase in fluid pressure inside your eye that damages your optic nerve (an important nerve for your vision). It can sometimes occur even when eye pressure is normal.

Glaucoma can cause vision loss. If untreated, glaucoma can lead to blindness.

Vision usually worsens slowly and may not be noticeable. Once found, glaucoma can be treated to prevent or delay further vision loss.

Regular eye tests are recommended for most people from 40 years of age.

What are the types of glaucoma?

The 2 main types of glaucoma are:

• 1. Open-angle — where fluid pressure builds up in the front part of your eye, even when the fluid drainage pathways are open.
• 2. Angle-closure (also known as closed-angle) — where the eye's fluid drainage pathways are narrowed or closed, so fluid pressure builds up quickly. This may cause eye pain and sudden loss of vision.

Open-angle glaucoma is a chronic condition, meaning it will last a long time and may get worse. Angle-closure glaucoma can be chronic or acute (begins suddenly and lasts for a short time).

Glaucoma can also be categorised as either:

• primary glaucoma — with an unknown cause
• secondary glaucoma — caused by an eye condition, such as surgery, trauma, drugs or eye disease

Primary open-angle glaucoma is the most common form of glaucoma in Australia.

What are the symptoms of glaucoma?

If you have primary open-angle glaucoma, you may have no symptoms, or you may have small blind spots at the edge of your vision. Without treatment, these spots grow bigger until you can only see objects directly in front of you.

If you have chronic (primary) angle-closure glaucoma, you may sometimes get vision problems. This may be halo-like images around lights, or you may have no symptoms.

If you have acute (primary) angle-closure glaucoma, you may have:

• sudden, severe eye pain
• nausea and vomiting
• headache
• watery eyes
• blurred vision
• halos around bright lights

What causes glaucoma?

Your eyes are filled with fluid. This fluid constantly flows in and out of your eyes, bringing nutrients to your eyes.

If the fluid does not leave your eye as easily as it enters, pressure can build up inside the eye.

The increase in eye pressure can damage your optic nerve. Your optic nerve links the back of your eye to your brain and allows you to see. Damage to your optic nerve results in damage to your vision.

Glaucoma can sometimes occur even when the fluid pressure in your eye is normal.

Who is at risk of glaucoma?

You are at higher risk of developing glaucoma if you:

• have a close relative with glaucoma
• have high eye pressure
• are aged over 50 years
• are short-sighted or long-sighted
• use (or have used) cortisone (steroid) medicines for long periods
• have diabetes, high blood pressure, low blood pressure or migraine headaches
• have had an eye operation or eye injury

When should I see my doctor?

Glaucoma can start suddenly, or it can happen over a long time. You should see your optometrist or doctor if you notice any changes to your vision. You should also see your optometrist for regular check-ups — this can help detect glaucoma and other conditions early and prevent irreversible damage.

When to seek emergency care

You need emergency treatment if:

• one or both of your eyes quickly becomes painful and red
• your vision gets blurred, or you start to lose vision
• you notice halos (rings) around lights

How is glaucoma diagnosed?

An optometrist or ophthalmologist can detect glaucoma early on if you have regular eye tests. They will:

• look at the nerve fibres in your eyes
• look at the structure of your eye drainage network
• test your field of vision
• measure your eye pressure

This test will take 20 to 45 minutes.

You should start having regular eye tests from the age of 40 years.

Talk to your optometrist or doctor about the best time to start having your eyes tested for glaucoma.

How is glaucoma treated?

If you have acute angle-closure glaucoma, you need emergency treatment to reduce the pressure. This may be done with eye drops, tablets or an intravenous medicine. You may also need surgery.

Treatment for chronic angle-closure glaucoma is designed to prevent or slow further damage, mainly by lessening the pressure in the eye. This may involve:

• eye drops
• oral medicine
• laser surgery or other surgery to open or create a new drainage channel

Glaucoma surgery is usually an outpatient or day-surgery procedure. Your surgeon will explain the operation to you and the type of anaesthetic that will be used.

Nerve cells damaged by glaucoma cannot be repaired.

Can glaucoma be prevented?

To protect your vision, it is best to have your eyes tested regularly. Although there is no cure for glaucoma, early detection is important.

Glaucoma can usually be controlled so further loss of vision can be prevented or slowed.

Resources and support

Visit the Glaucoma Australia website for information about glaucoma.

Glaucoma Australia has also published information on how glaucoma can affect your ability to drive.

The Department of Health, Disability and Ageing can help you understand the cost of laser treatment for glaucoma.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The Glaucoma Australia website has information about glaucoma in many community languages.