Home › Specialities › Glaucoma › Glaucoma symptoms

What are the symptoms of glaucoma, and why is it called silent?

Glaucoma is sometimes called the silent thief of sight. It damages the optic nerve, which carries signals from the eye to the brain, and the vision it takes is not given back. Yet in its most common form it gives almost no warning until late. This guide explains why, what the symptoms are when they do appear, and who should be tested. For glaucoma care at ReNew Vision, see glaucoma check-up and treatment in Vasco.

Why does glaucoma give no early warning?

• It starts at the edges. Open-angle glaucoma usually damages side (peripheral) vision first. Your central vision, which you use to read and look at faces, stays sharp until late.
• The other eye fills the gap. Glaucoma often affects one eye more than the other. With both eyes open, the better eye covers the blind patches of the worse one.
• The brain fills in. The brain smooths over small missing patches, so you do not see a black hole; you simply do not see what is there.
• It does not hurt. In open-angle glaucoma the pressure rises slowly, so the eye does not ache or turn red.
• It is slow. Changes build up over years, too gradually to notice.

By the time someone notices a problem, a large part of the optic nerve may already be damaged.

What are the symptoms of open-angle glaucoma?

In the early and middle stages: usually none. In later stages people may notice:

• bumping into door frames or furniture, or missing a step
• not seeing vehicles or people coming from the side
• difficulty moving around in dim light
• patchy areas missing from the side of the vision
• in advanced glaucoma, tunnel vision, as if looking through a tube

A spectacle power test alone does not find glaucoma. It is found by checking the eye pressure, the drainage angle and the optic nerve, which is why these are part of a complete eye check-up.

What are the symptoms of an angle-closure attack?

In angle-closure glaucoma, the drainage angle at the front of the eye is narrow, and it can suddenly close. The pressure then shoots up within hours. Signs include:

• sudden, severe pain in or around one eye
• a red eye
• blurred or misty vision
• rainbow-coloured haloes around lights
• headache on the same side, often with nausea or vomiting

This is an emergency: without treatment within hours, sight can be lost permanently. Emergency eye care at ReNew Vision is available 24 hours; come in at once or see eye emergency. If you are far from Vasco, go to the nearest eye emergency service.

Some people have smaller warning episodes before a full attack: blurred vision with haloes and an ache around the eye, often in the evening or in dim light, which settle after sleep. These need an eye check soon, because a narrow angle can be treated before an attack happens, often with a YAG laser iridotomy.

What are the signs of glaucoma in babies and children?

Childhood glaucoma is rare. Signs in a baby include eyes that look unusually large, a cornea that looks hazy or cloudy, constant watering, and screwing up the eyes or turning away from light. These need an urgent eye check.

Can other things cause glaucoma?

Yes. Secondary glaucoma can follow an old eye injury, inflammation inside the eye, advanced diabetic eye disease or the long-term use of steroid medicines. Steroid eye drops are sometimes bought over the counter for red or itchy eyes; used for weeks without an eye doctor checking the pressure, they can cause glaucoma. Use steroid drops only when an eye doctor prescribes them and checks you.

Who should be tested for glaucoma, and how often?

• Everyone from about 40: a complete eye check-up including eye pressure and the optic nerve, then as advised, often every one to two years.
• Family history: if a parent, brother or sister has glaucoma, start earlier and check more often; see is glaucoma hereditary?
• Diabetes, high short sight, long sight, long-term steroid use, an old eye injury: regular checks as advised.
• Anyone told they have a narrow angle or raised eye pressure: follow-up as advised, even if they feel fine.

For more on routine checks after 40, see eye check-up after 40.

How is glaucoma found?

1. Eye pressure test. Quick and simple; see normal eye pressure.
2. Drainage angle check, to see whether the angle is open or narrow.
3. Optic nerve examination, often after dilating drops, looking for the typical changes of glaucoma.
4. Visual field test, which maps your side vision. It is not done at ReNew Vision; if you need one, the eye doctor will tell you and explain the next step.

What if I am told I have glaucoma?

Glaucoma cannot be cured, but in most people it can be controlled. Eye drops, YAG laser iridotomy for narrow angles and, when needed, trabeculectomy (glaucoma surgery) lower the pressure and protect the sight you have. All three are done at ReNew Vision. The key is to keep using your drops and to keep your follow-up visits, for life.

Glaucoma check-ups in Vasco

ReNew Vision Eye Hospital, 2nd floor, Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama. Eye OPD Monday to Saturday, 4 pm to 7 pm. Call or WhatsApp 072489 88039. Bring your spectacles, any eye drops you use and a list of your medicines.

Questions patients ask

What are the first signs of glaucoma?

Usually there are none. Open-angle glaucoma damages side vision slowly and without pain, and central vision stays clear until late. It is found by an eye check that measures the pressure and examines the drainage angle and optic nerve.

Does glaucoma cause headaches?

The common open-angle type does not. An angle-closure attack can cause a severe headache with eye pain, a red eye, blurred vision, haloes and vomiting. That is an emergency and needs treatment within hours.

Can glaucoma be found in a normal eye test?

Not by a spectacle power test alone. A complete eye check-up that includes the eye pressure, the drainage angle and the optic nerve can find it, often long before you notice anything.

At what age should I be tested for glaucoma?

From about 40 for everyone, and earlier if a parent, brother or sister has glaucoma, or if you have diabetes, high short sight or long-term steroid use. The eye doctor will tell you how often to come back.

Can treatment bring back vision lost to glaucoma?

No. Treatment protects the sight you still have by lowering the eye pressure, but vision already lost does not return. That is why finding glaucoma early matters.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.