Glaucoma: Symptoms, Risk Factors and How to Protect Your Sight

Glaucoma is called the silent thief of sight, because in most people it steals vision slowly and painlessly. By the time you notice that something is wrong, a large part of the side vision may already be lost, and lost vision cannot be brought back. The reassuring part is that regular eye checks find it early, and eye drops can protect the vision you still have.

What is glaucoma?

Glaucoma is damage to the optic nerve, the cable that carries images from the eye to the brain. It is usually caused by high pressure inside the eye, because the fluid that normally drains out does not drain well. There are two main forms:

• Open-angle glaucoma is the common type. It builds up slowly over years, causes no pain, and steals side (peripheral) vision first, so people often do not notice until late.
• Angle-closure glaucoma can happen suddenly. The drainage angle closes and the pressure shoots up in hours.

Symptoms

Open-angle glaucoma usually has no symptoms in the early and middle stages. Later you may notice patches of missing vision, bumping into things, or tunnel vision.

An acute angle-closure attack is an emergency. Go straight to an eye hospital if you have:

• Severe pain in or around one eye, with a headache
• Sudden blurring of vision
• Rainbow-coloured halos around lights
• A red eye
• Nausea and vomiting

Treatment within hours can save the sight.

Who is at risk?

• Age over 40, and especially over 60
• A family history of glaucoma
• Diabetes and high blood pressure
• Short-sightedness or, for angle closure, long-sightedness
• Long-term use of steroids, including steroid eye drops, tablets and sometimes creams around the eyes
• A past eye injury or eye surgery

The danger of steroid eye drops

In Pakistan many people, especially children with itchy allergic eyes, use steroid eye drops bought from a chemist and used for weeks or months. Steroid drops can raise the eye pressure silently and cause glaucoma, and also cataracts and infections. Never use steroid or “strong” eye drops without an eye doctor’s advice, and have the pressure checked if you have been using them.

How is glaucoma found?

An eye doctor measures the eye pressure, looks at the optic nerve, tests the visual field, and may use scans such as OCT and a test of the drainage angle. These tests are painless. Adults should have an eye check every one to two years after the age of 40, and every year if they have risk factors.

Treatment

Treatment cannot restore lost vision, but lowering the pressure slows or stops further damage. Options include:

• Eye drops are the usual first step. Common types are prostaglandin drops such as latanoprost and travoprost, usually used once a day at night, beta-blocker drops such as timolol, and others such as brimonidine and dorzolamide. Combination bottles reduce the number of drops.
• Tablets such as acetazolamide, used for short periods to lower pressure quickly.
• Laser treatment to improve drainage or, in angle closure, to make a small hole in the iris.
• Surgery when drops and laser are not enough.

Using eye drops properly

• Wash your hands, tilt your head back and pull the lower lid down to form a pocket.
• Put one drop in without touching the tip of the bottle to the eye or lashes.
• Close your eye gently, and press on the inner corner for a minute or two, so less drug is absorbed into the body.
• If you use more than one drop, wait about five minutes between them.
• Use them every day, even when you feel fine. Glaucoma drops work only while you use them.
• Check the label for how long an opened bottle stays good, often about four weeks, and do not share bottles.
• Tell your doctor if you have asthma or a slow heartbeat, as timolol drops are not suitable for some people.

When to see a doctor

• Sudden eye pain, redness and blurred vision with halos or vomiting. Go to emergency care.
• You are over 40 and have never had a full eye check
• A close relative has glaucoma
• You have diabetes, or use steroid drops or tablets regularly
• You notice missing patches or narrowing of your vision

Key takeaways

• Glaucoma usually causes no symptoms until vision is already damaged, so regular eye checks matter.
• Sudden severe eye pain with halos and vomiting is an emergency.
• Never use steroid eye drops without an eye doctor’s advice.
• Use glaucoma drops every day exactly as prescribed, and do not stop when you feel fine.

Related medicines on Medimart

These are commonly prescribed by eye doctors for glaucoma:

• Latanoprost: a once-daily drop that lowers eye pressure
• Travoprost: another prostaglandin drop
• Timolol: a beta-blocker eye drop
• Dorzolamide and timolol: a combination drop
• Latanoprost and timolol: a combination drop
• Brimonidine: lowers eye pressure
• Acetazolamide: tablets for short-term pressure reduction

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse glaucoma eye drops on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from an eye doctor. Please have your eyes checked regularly after the age of 40.