Signs and Symptoms of Glaucoma

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Medically reviewed by Andrew Greenberg, MD

Glaucoma is a group of eye diseases that can cause vision loss due to damage to the optic nerve, which transmits visual signals from the eye to the brain.

Your eyes regularly make a fluid-like material called aqueous humor (which is located between the clear outer layer and the lens of your eye). The formation and drainage of this fluid regulate your eye pressure. When this fluid doesn’t drain properly, a build-up of aqueous humor can put extra pressure on your optic nerve and increase the risk of glaucoma.

Glaucoma is the second leading cause of blindness in the United States. Knowing the symptoms—such as partial vision loss, eye pressure, and headaches—can indicate that you should see an ophthalmologist (eye doctor) sooner rather than later.

Types of Glaucoma

There are two main types of glaucoma:

• Primary glaucoma: Develops when the aqueous humor isn’t draining or functioning properly, causing eye pressure to increase
• Secondary glaucoma: Occurs due to external factors like the presence of other medical conditions or trauma to the eye which can interfere with the eye’s drainage system and increase optic nerve pressure

Both of these types of glaucoma have subtypes. While all types of glaucoma are similar, there are subtle differences in how symptoms of each manifest.

The subtypes of primary glaucoma are open-angle glaucoma, angle-closure glaucoma, normal tension glaucoma, and congenital glaucoma. The subtypes of secondary glaucoma include pigmentary glaucoma, neovascular glaucoma, exfoliative glaucoma, uveitic glaucoma, and traumatic glaucoma.

Open-Angle Glaucoma Symptoms

Open-angle glaucoma is the most common type of glaucoma in the U.S. Most people with open-angle glaucoma do not experience any early symptoms. As the condition progresses, you may experience some loss of your peripheral (side) vision. By this time, the disease is quite advanced and can further progress to central vision loss or blindness.

Unfortunately, vision loss due to open-angle glaucoma is not reversible. However, undergoing regular eye checkups can help detect the condition in the early stages. Your ophthalmologist may then recommend certain preventative measures (such as wearing protective eyewear) to safeguard your vision.

Angle-Closure Glaucoma Symptoms

Angle-closure glaucoma (also known as narrow-angle or closed-angle glaucoma) occurs when the angle between the iris (the colored part of the eye) and the cornea (the clear outer layer of the eye) closes. When this happens, an increase in eye pressure can occur. This increase in eye pressure may occur suddenly or gradually. Symptoms of angle-closure glaucoma include:

• Headache
• Eye pain
• Blurry vision
• Redness
• Nausea or vomiting
• Seeing halos or rainbows around light

If you are experiencing symptoms of angle-closure glaucoma, it’s important to see an ophthalmologist soon. If left untreated, this condition can cause significant damage to the optic nerve which may result in vision loss.

Normal Tension Glaucoma Symptoms

Normal-tension glaucoma (also known as low-pressure glaucoma) is a form of open-angle glaucoma where the eye pressure remains within the normal range. In most cases, you might not experience symptoms during the early stages.

As this type of glaucoma advances, you may develop blind spots in your vision and gradual damage to your optic nerve. As a result, symptoms like blurry vision and difficulty adjusting to bright light are possible.

Congenital Glaucoma Symptoms

Congenital glaucoma is a rare type of glaucoma that affects children and is present at birth. This condition happens due to improper development of the eyes during pregnancy. Children with congenital glaucoma may show the following symptoms:

• Excessive tearing
• Cloudy cornea
• Sensitivity to light
• Larger than normal eyes

Pigmentary Glaucoma Symptoms

Pigmentary glaucoma is a form of open-angle glaucoma where pigments from your iris break off, get trapped in the eye’s drainage system, and block fluid from draining out of the eyes. This in turn increases eye pressure and can cause damage to the optic nerve.

You may not experience symptoms at the early stages. However, pigmentary glaucoma can lead to several symptoms at later stages, including:

• Eye pain
• Blurry vision
• Seeing halos around light
• Redness
• Sensitivity to bright light
• Headaches that intensify with reading, head movements, exercise, or excessive blinking

Neovascular Glaucoma Symptoms

Neovascular glaucoma occurs due to the formation of new blood vessels in the eye area where fluid drainage occurs. This can lead to an increase in eye pressure. In most cases, this type of glaucoma develops due to other medical conditions, like diabetes or high blood pressure.

If you experience this condition, common symptoms include:

• Eye pain
• Redness
• Blurry vision
• Photosensitivity (sensitivity to light)

Exfoliative Glaucoma Symptoms 

Exfoliative glaucoma develops because of a build-up of flaky proteinaceous materials within the eye. This accumulation causes a blockage in the drainage system in your eyes. People with this type of glaucoma experience faster disease progression and higher eye pressure as compared to the other glaucoma.

Exfoliative glaucoma does not show any symptoms at early stages but often leads to peripheral (side) vision loss at later stages.

Uveitic Glaucoma Symptoms

Uveitic glaucoma develops due to an underlying eye condition called uveitis, which causes inflammation and swelling in your eyes. Uveitis typically damages the middle layer of the eye and blocks your eye’s ability to drain fluids. When this happens, an increase in eye pressure occurs, which raises the risk of glaucoma.

If you develop uveitic glaucoma, you might experience other typical glaucoma symptoms like eye pain, redness, blurry vision, and sensitivity to light.

Traumatic Glaucoma Symptoms

Traumatic glaucoma can occur if you experience a trauma or injury to your eyes. Some people develop this type of glaucoma immediately after the injury, while others notice symptoms a few years later. Symptoms of traumatic glaucoma include:

• Swelling
• Eye bruising
• Severe eye pain
• Loss of vision
• A build-up of blood cells in the white part of the eye
• Watery eyes
• Redness

Symptoms in Children

Childhood glaucoma (also known as pediatric glaucoma) is quite rare. While some children are born with congenital glaucoma at birth, other children can develop glaucoma due to secondary reasons like underlying health conditions, surgery, injury, or trauma.

If your child has glaucoma, there are three categories their condition can fall under.

Symptoms of childhood glaucoma, regardless of type, include:

• Cloudy cornea
• Sensitivity to light
• Excessive tearing
• Enlarged eyes
• Loss of vision

Apart from eye symptoms, some children may show certain behavioral symptoms such as being fussy and unhappy without a reason or being picky with foods.

When to Contact a Healthcare Provider

If you’re noticing changes in your vision health, seeing an ophthalmologist is a good idea. However, you may want to schedule an appointment urgently if you’ve developed the following symptoms:

• Severe eye pain
• Vision problems
• Excessive eye redness
• Headache
• Nausea

At your appointment, your ophthalmologist will likely carry out a comprehensive dilated eye exam to confirm the diagnosis of glaucoma or any other eye condition you might have. They can then recommend suitable treatment options based on your type of glaucoma and symptoms.

Questions to Ask Your Healthcare Provider

To learn more about your condition, consider asking your provider the following questions:

• How do I know what type of glaucoma I have?
• Can my glaucoma symptoms go away on their own?
• Is there anything I can do to reverse vision loss?
• What lifestyle habits or assistive devices do you recommend to protect my vision health?

A Quick Review

Glaucoma is a group of eye diseases that can lead to permanent loss of vision and even blindness if left untreated. Unfortunately, many types of glaucoma do not lead to symptoms until advanced stages. If you develop symptoms in the early stages, warning signs may include eye pain, redness, headaches, and sensitivity to light.

See an ophthalmologist if you develop symptoms of glaucoma or notice any changes in your vision. They can help you get a diagnosis and start treatment sooner.

Read the original article on Health.com.