Glaucoma
Symptoms, causes, treatment, and when to see an optician
Overview
Glaucoma is a group of eye conditions in which the optic nerve is progressively damaged, usually due to raised pressure inside the eye. It is the leading cause of irreversible blindness worldwide, affecting around 700,000 people in the UK. Because it typically develops slowly and without noticeable early symptoms, regular eye tests are the most reliable way to catch it before significant vision is lost.
Symptoms
- Gradual loss of peripheral (side) vision, often unnoticed until advanced
- Tunnel vision in later stages
- Blurred vision
- Haloes or rainbow-coloured rings around lights
- In acute angle-closure glaucoma: sudden severe eye pain, headache, nausea, vomiting, red eye, and rapid vision loss
Causes & Risk Factors
- Raised intraocular pressure (IOP) due to impaired drainage of aqueous humour
- Family history — risk is four to nine times higher if a close relative has glaucoma
- Age — risk increases significantly after 40
- Ethnicity — people of African-Caribbean descent are at higher risk of open-angle glaucoma
- High myopia (short-sightedness)
- Long-term use of corticosteroid medications
- Thin corneas or reduced corneal hysteresis
- Previous eye injuries or surgery
Treatment Options
Treatment for glaucoma in the UK aims to lower the pressure inside the eye to prevent further optic nerve damage. The most common first-line treatment is prescription eye drops, usually prostaglandin analogues such as latanoprost, which are used once daily and are highly effective at reducing eye pressure. Your ophthalmologist will monitor your response and may add or change medications if a single drop is not sufficient.
If eye drops do not adequately control the pressure, or if you have difficulty using them, your consultant may recommend selective laser trabeculoplasty (SLT). This is a quick outpatient procedure available on the NHS that uses a laser to improve the drainage of fluid from the eye. Recent UK research (the LiGHT trial) has shown that SLT can be as effective as eye drops as a first treatment, and NICE now supports its use as an initial option.
In more advanced or difficult-to-control cases, surgical options include trabeculectomy (creating a new drainage channel) and drainage tube implants. Minimally invasive glaucoma surgery (MIGS) procedures are also increasingly available in the UK for suitable patients. Whatever the treatment, lifelong monitoring is essential — glaucoma cannot be cured, only managed, and any vision already lost cannot be restored.
Prevention Tips
- Attend regular eye tests — at least every two years, or annually if you are over 40 with a family history of glaucoma
- Take advantage of free NHS eye tests if you have a first-degree relative with glaucoma and are aged 40 or over
- If prescribed eye drops, use them consistently as directed — even when you feel fine
- Maintain a healthy lifestyle with regular exercise, as moderate physical activity may help lower eye pressure
- Inform your optometrist of any family history of glaucoma
- Attend all follow-up appointments if you are being monitored or treated
When to See an Optician
Book an eye test immediately if you notice any loss of peripheral vision, see haloes around lights, or have a family history of glaucoma — early detection through regular eye tests is the single most important step in preventing sight loss from this condition.
Key Facts
- Category
- Age-related condition
- Typically Affects
- Over 40 (risk increases with age)
- Key Symptoms
- 5 identified symptoms
Related Conditions
Detecting Glaucoma
The following eye tests can help detect signs of glaucoma:
- Standard eye test
- OCT retinal scan
- Visual field test
Protect your vision with a regular eye test
Early detection is key. A routine eye test can identify signs of glaucoma before symptoms become noticeable. Book yours today.
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