Glaucoma is an eye condition that damages your optic nerve, the link between your eye and your brain. Patients with glaucoma often don't notice any symptoms until it has reached its end stage, which makes it known as a silent disease.

What are the symptoms associated with glaucoma?

One of the most common symptoms is loss of peripheral vision. Once it gets severe enough, it causes tunnel vision and, ultimately, blindness. Eye pain, severe headache, blurred vision, redness in eyes, halos around lights, vomiting and nausea are some of the symptoms of acute closed angle glaucoma.

Since glaucoma is a slowly progressive condition, if you are properly treated and you adhere to your treatment, then the risk of any vision complications as a result of glaucoma is typically low. However, it also depends on the type of glaucoma you have.

What are the risk factors for glaucoma?

Generally, your eye doctor will go over several different components during your eye exam. Your eye doctor will first review your risk factors for glaucoma.

Family history: One of the main risk factors for glaucoma is whether you have a family history of glaucoma. Does your mom, dad, siblings, grandparents have the disease? If yes, then you are at a greater risk for developing it.

High eye pressure: High eye pressure is another risk factor. During your eye exam, you will be screened for these risk factors by measuring your eye pressure. While it is possible to have normal eye pressure and still have glaucoma, almost all kinds of glaucoma are related to high eye pressure. Typically, normal eye pressure falls between 10 and 21. If it's higher than 21, it's more concerning.

Other factors: In addition to looking at your age, race, ethnicity, and medical history, they also look at whether you have diabetes, high blood pressure, or are taking high doses of steroids, all of which can increase your risk of glaucoma.

How does glaucoma affect the eye?

Our eyes are filled with a fluid that supplies them with nutrients and energy. It is called aqueous humour. The ciliary body in our eye produces it and it's discharged out of the angle component. This angle component is formed by the junction between the colored part of your eye called the iris and the front part of your eye called the cornea. Whenever your drainage area starts to get clogged up, it prevents that aqueous from draining properly, which causes your eye pressure to increase. High eye pressure can start to compress on the back part of your eye, which is your optic nerve, and that is why it increases your risk of glaucoma. In addition, it can cause damage as well as a condition called cupping that can impair your vision.

How is glaucoma diagnosed?

During your eye exam, it is very important for your eye doctor to dilate your eyes so they can look at the back of the eye, look at the optic nerves to make sure there is no thinning, no cupping, or damage so that you can properly check for glaucoma. In cases where it appears that your optic nerves look a little suspicious or that there’s an increase in your cupping, or thinning, different images of your eyes are taken with a device that is called OCT.  In addition to measuring the different layers of the back part of your eye, it detects whether your optic nerve has thinned. Visual field testing is also done. It tests your side vision, looking for any blind spots. Certain patterns on this visual field may indicate you have some early stages of glaucoma. If you are at risk of developing glaucoma, then they take these images as baselines and compare them to your original images at your follow-up. If your condition progresses and your risk increases, then your treatment may begin immediately.

How is glaucoma treated?

In the event that you do suffer from glaucoma, there are a variety of treatment options. However, the treatment will depend on the type of glaucoma you have. In open angle glaucoma, the drainage areas open but you still have an elevated eye pressure, whereas in angle closure glaucoma, the drainage area closes and you experience severe eye pain and redness. It can impair your vision and cause nausea and vomiting. The main treatment for that is to quickly attempt to lower your eye pressure as fast as possible with different eye drops, possibly even oral medications as well. Furthermore, there is a laser procedure that attempts to create a hole to allow your aqueous to drain out and bring your eye pressure down. There are also various other types of glaucoma such as pseudoexfoliative glaucoma, and neovascular glaucoma, so your eye doctor will tell you which one you have, but typically the treatment is to drop the pressure in your eyes using various eye drops.

Depending on the severity of your glaucoma, there are various oral medications or surgical procedures such as lasers or other procedures to alleviate your condition.

Why is it important to have an annual comprehensive eye exam?

Having your annual eye exams is important as glaucoma that is detected and treated early is the best way to reduce the risk of vision loss. In some cases your eye doctor may want to follow up with you earlier as soon as every three to four months so they can observe you and catch the disease in its early stages, since you won't notice symptoms until it's already too late. While any comprhensive eye exam is crucial, it is also important to visit an optometrist that has the best technology available to monitor the progress of the disease.