Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain.
Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure.
Open-angle glaucoma; Chronic glaucoma; Chronic open-angle glaucoma; Primary open-angle glaucoma; Closed-angle glaucoma; Narrow-angle glaucoma; Angle-closure glaucoma; Acute glaucoma; Secondary glaucoma; Congenital glaucoma; Vision loss - glaucoma
Glaucoma is the second most common cause of blindness in the United States. There are four major types of glaucoma:
The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is made in an area behind the colored part of the eye (iris). It leaves the eye through channels where the iris and cornea meet. This area is called the anterior chamber angle, or the angle. The cornea is the clear covering on the front of the eye that covers the iris, pupil, and angle.
Anything that slows or blocks the flow of this fluid will cause pressure to build up in the eye.
Open-angle glaucoma is the most common type of glaucoma.
Closed-angle glaucoma occurs when the fluid is suddenly blocked and cannot flow out of the eye. This causes a quick, severe rise in eye pressure.
Secondary glaucoma occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include:
Congenital glaucoma occurs in babies.
Symptoms may come and go at first, or steadily become worse. You may notice:
Symptoms are most often noticed when the child is a few months old.
Exams and Tests
The only way to diagnose glaucoma is by having a complete eye exam.
Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include:
The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have.
If drops alone do not work, you may need other treatment:
ACUTE ANGLE GLAUCOMA
An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated.
If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed.
Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions.
Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision.
Babies with congenital glaucoma usually do well when surgery is done early.
How you do with secondary glaucoma depends on what is causing the condition.
When to Contact a Medical Professional
If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma.
You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss.
If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss.
Gross RL, McMillan BD. Current medical management of glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 10.24.
Heijl A. Glaucoma treatment: by the highest level of evidence. Lancet. 2015;385(9975):1264-1266. PMID: 25533655 www.ncbi.nlm.nih.gov/pubmed/25533655.
Jampel HD, Villarreal G. Evidence-based medicine in glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 10.34.
Madu A, Rhee DJ. Which therapy to use in glaucoma.In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 10.23.
Moyer VA; US Preventive Services Task Force. Screening for glaucoma: US Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2013;159(7):484-489. PMID: 24325017 www.ncbi.nlm.nih.gov/pubmed/24325017.
Prum BE Jr, Lim MC, Mansberger SL, et al. Primary open-angle glaucoma suspect preferred practice pattern guidelines. Ophthalmology. 2016;123(1):P112-P151. PMID: 26581560 www.ncbi.nlm.nih.gov/pubmed/26581560.
Review Date: 8/28/2018
Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Internal review and update on 10/18/2019 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.