Eye condition

Glaucoma: Causes, Symptoms & Treatment

Glaucoma damages the optic nerve and can cause vision loss. Learn its symptoms, causes, tests and glaucoma surgery options at personalEYES.

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What is glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve, the cable that carries images from the eye to the brain. The damage is permanent and can reduce your vision over time if it is not found and treated.

Side (peripheral) vision is lost first. Most people do not notice this until the disease is advanced, which is why it is called the “silent thief of sight”.

Raised pressure inside the eye, called intraocular pressure (IOP), is the main risk factor and the main thing treatment can change. Damage can still occur when eye pressure is normal.

Glaucoma Australia estimates more than 300,000 Australians have the condition, and around half do not know it. Of all eye diseases, glaucoma is one where early checks can save sight.

What are the early signs and symptoms of glaucoma?

Most people have no symptoms of glaucoma in the early stages. Glaucoma symptoms depend on the type, so a regular eye check is more reliable than waiting for a change you can see.

What are open angle glaucoma symptoms?

Open angle glaucoma develops over years and has no early symptoms. Glaucoma of this type is easy to miss because the brain fills in the gaps. Early signs of glaucoma and later signs and symptoms of glaucoma include:

Gradual loss of side (peripheral) vision
Blind spots in your field of vision
Trouble noticing objects to the side
Tunnel vision in advanced disease

What are the symptoms of acute angle closure glaucoma?

Acute angle closure glaucoma is a medical emergency. Seek urgent care if you have sudden severe eye pain, a red eye, fast-worsening blurred vision, halos around lights, headache, nausea or vomiting. It often starts in one eye. Glaucoma attacks like this need treatment within hours. Go to the nearest emergency department or call 000.

What causes glaucoma and who is at risk?

Glaucoma causes optic nerve damage, most often linked to eye pressure that is too high for that nerve. Pressure builds when the clear fluid inside the eye does not drain well. Common causes of glaucoma and risk factors include:

A parent, sibling or child with glaucoma
Age over 50
Raised eye pressure
High short- or long-sightedness
Long-term steroid medicines
Diabetes, blood pressure problems or sleep apnoea
Asian or African ancestry
A past eye injury or eye surgery

What are the 5 types of glaucoma?

The five main types of glaucoma are primary open-angle, angle-closure, normal-tension, secondary and congenital glaucoma. Each affects fluid drainage and the optic nerve in a different way.

Primary open-angle glaucoma

The most common type in Australia. The drainage angle is open, but fluid does not drain well enough to keep pressure safe for the optic nerve. It develops over years with no early symptoms.

Angle closure glaucoma (narrow angle glaucoma)

Angle closure glaucoma happens when the gap between the iris and cornea is narrow or closed and blocks drainage. Narrow angle glaucoma can build over time or cause a sudden pressure spike. Laser can lower the risk of an attack.

Normal-tension glaucoma

Optic nerve damage occurs even though eye pressure is in the normal range. The cause is not well understood, but lowering pressure with drops, laser or surgery can still slow the damage.

Secondary glaucoma

Secondary glaucoma is caused by another eye condition, injury or medicine. Treatment targets both the eye pressure and the cause. Types include:

Pseudoexfoliation: flaky material blocks drainage
Pigmentary: iris pigment clogs drainage
Uveitic: inflammation inside the eye
Neovascular: new blood vessels, often linked to diabetes
Steroid-induced: pressure rise from steroid medicines
Traumatic: damage after an eye injury, sometimes years later

Congenital glaucoma

Congenital glaucoma is rare and present at birth or in early childhood. Signs include large or cloudy eyes, watering and light sensitivity. Babies with these signs need a specialist review.

What are the glaucoma treatment options?

Glaucoma treatment lowers eye pressure to protect the optic nerve and the vision you still have. No treatment can bring back vision already lost. Glaucoma symptoms and treatment needs differ for each person, so your plan depends on the type, stage, eye pressure and your general health.

Glaucoma eye drops

Prescription drops lower pressure by reducing fluid, helping it drain, or both. Some people need more than one type. Use them each day as prescribed.

SLT laser

Selective laser trabeculoplasty (SLT) treats the eye’s drainage tissue to improve outflow. It can be a first treatment for open angle glaucoma or used with drops.

Laser for narrow angles

Laser peripheral iridotomy makes a tiny opening in the iris so fluid can flow and the angle is less likely to close.

What is glaucoma surgery?

Glaucoma surgery creates a new or better drainage path to lower eye pressure. It is an option when drops or laser do not control pressure, or the disease keeps getting worse. Options include minimally invasive glaucoma surgery (MIGS), trabeculectomy and drainage devices. Some MIGS can be done during cataract surgery. Your glaucoma surgeon will explain the risks and benefits of each option.

What happens during a glaucoma eye test?

A glaucoma test for eyes checks the optic nerve, eye pressure and side vision, because pressure alone cannot confirm or rule out glaucoma. Your assessment may include:

Tonometry: measures eye pressure
Optic nerve exam: checks the nerve’s shape and health
OCT scan: measures the nerve fibre layer around the optic nerve
Glaucoma visual field test: maps missing areas of side vision
Gonioscopy: checks the drainage angle
Pachymetry: measures corneal thickness

Your doctor repeats some tests over time to look for change. Ask for a full eye test. Glaucoma is found by checking the nerve, not by waiting for symptoms.

How often should you have an eye test for glaucoma?

Glaucoma Australia recommends an eye test for glaucoma at least every two years from age 50. Start from age 40 if glaucoma runs in your family or you have Asian or African ancestry. Once diagnosed, you need checks for life to confirm treatment is working.

Book online or call personalEYES on 1300 68 3937.

What does a glaucoma specialist do?

A glaucoma specialist is an ophthalmologist (eye surgeon) who diagnoses the disease, sets a pressure target and manages drops, laser and surgery. At personalEYES, our ophthalmologists assess, treat and monitor glaucoma at clinics across NSW and the ACT, with laser and glaucoma surgery on site when needed.

Treatment options

Every way to correct it.

From laser surgery to lens implants - your assessment identifies the safest, most effective option for your eyes and lifestyle.

Glaucoma treatment

Our glaucoma treatment service offers laser surgery to lower eye pressure, reduce optic nerve damage and help protect long-term vision health.

Learn more

FAQ

Common questions.

Glaucoma is the medical name for a group of eye diseases that damage the optic nerve. The word comes from the Greek ‘glaukos’, meaning blue-grey, a colour once seen in eyes with very advanced disease. Today it describes nerve damage that causes side vision loss and, without treatment, blindness.

For most people there is no early sign. In primary open-angle glaucoma, side vision fades over years and the brain fills in the gaps, so many people only notice once the disease is advanced. An eye test can find optic nerve damage years before you notice any change.

Early glaucoma vision looks normal to most people. As damage grows, blurred or missing patches appear in your side vision. In late stages only central vision remains, like looking through a tube. A visual field test can show this loss before you are aware of it.

No. Floaters are not one of the typical glaucoma symptoms. Floaters are specks or threads that drift across your vision, caused by changes in the gel inside the eye. A sudden shower of new floaters or flashes can signal a retinal tear and needs urgent assessment the same day.

Yes, glaucoma can run in families. Glaucoma Australia reports that having a parent, sibling or child with the condition raises your risk by around 10 times. If a close relative is affected, tell your optometrist or ophthalmologist and start eye checks from age 40.

Glaucoma is caused by damage to the optic nerve, most often linked to eye pressure that is too high for that nerve. Pressure rises when fluid inside the eye does not drain well. Age, family history, diabetes, steroid use, eye injury and short- or long-sightedness all raise your risk.

No. There are no glaucoma cures that can restore vision already lost. Optic nerve damage is permanent. Treatment with eye drops, laser or surgery lowers eye pressure and can slow or stop further loss, which is why finding it early matters.

Glaucoma can cause blindness if it is not treated. With early diagnosis, treatment and regular checks, most people keep useful vision for life. The risk is highest when it is found late or treatment is stopped, so keep using your drops and attend every review.

No glaucoma natural treatment, diet or supplement can replace prescribed treatment. A healthy diet and regular exercise support your general and eye health, but they do not lower eye pressure enough to protect the optic nerve. Talk to your doctor before stopping or changing any eye medicine.

There is no sure way to prevent glaucoma, but you can prevent avoidable vision loss. Have regular eye tests, know your family history, manage diabetes and blood pressure, protect your eyes from injury and use any prescribed drops as directed.

The cost of glaucoma surgery in Australia depends on the procedure, the hospital and your health cover. It is a medical procedure, so Medicare and private health insurance may pay part of it. After your assessment, your surgeon gives you a written quote with any out-of-pocket costs.

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