Symptoms of Glaucoma

Introduction

Glaucoma is one of the leading causes of irreversible blindness worldwide. Often called the “silent thief of sight,” it typically progresses without noticeable symptoms until significant vision loss has occurred. The condition is marked by damage to the optic nerve, most commonly due to increased intraocular pressure (IOP). However, not all types of glaucoma are the same, and their symptoms can differ depending on the form and severity of the disease.

There are several types of glaucoma, such as primary open-angle glaucoma, angle-closure glaucoma, congenital glaucoma, and secondary glaucoma. While some progress slowly and painlessly, others may cause sudden and severe symptoms. Recognizing early signs even when they seem minor is crucial for timely diagnosis and treatment, which can help preserve vision and prevent permanent damage.

Understanding the symptoms of glaucoma helps in early detection, especially in people at higher risk, such as those with a family history of glaucoma, individuals over 40, and people with conditions like diabetes or high blood pressure. 

Symptoms of Glaucoma

1. Gradual Loss of Peripheral Vision :- One of the earliest and most common symptoms of open-angle glaucoma is the slow and progressive loss of peripheral vision, also known as side vision. This often occurs so gradually that many patients are unaware of the change until significant vision is lost. The visual field becomes narrower over time, and patients might notice that they are bumping into objects, misjudging steps, or having trouble driving, particularly at night. Because central vision remains intact until later stages, the condition can go unnoticed for years unless caught through routine eye exams. By the time central vision is affected, the disease is already advanced.

2. Eye Pain and Headaches :- Acute angle-closure glaucoma, a more sudden and serious type, often presents with intense eye pain and headaches. These symptoms may occur abruptly and require immediate medical attention to prevent permanent vision loss. The pain may be concentrated around the eye or radiate across the forehead and temple. It’s often described as a deep, throbbing ache. The headaches associated with glaucoma are not relieved with rest or over-the-counter medications. The underlying cause is a rapid rise in intraocular pressure due to the sudden blockage of the eye’s drainage angle. Ignoring these symptoms can lead to permanent damage to the optic nerve in a short period. Early emergency treatment can restore pressure levels and save vision.

3. Blurred or Hazy Vision :- Blurred vision is another warning sign of glaucoma, particularly during acute episodes. In angle-closure glaucoma, patients may experience sudden blurring of vision due to the buildup of fluid and pressure inside the eye. Blurred vision may be intermittent in the early stages, especially during physical exertion, emotional stress, or when entering a dark room. Some people may also describe a “hazy” or “cloudy” visual quality, especially during the morning hours when intraocular pressure tends to peak. If blurry vision persists or is accompanied by eye redness, pain, or halos around lights, it’s essential to seek immediate ophthalmic evaluation.

4. Halos Around Lights :- Seeing halos around lights is a particularly common symptom in angle-closure glaucoma but may also occur in advanced open-angle glaucoma. These halos often appear as rainbow-colored circles around light sources like streetlights, headlights, or ceiling lamps. This visual disturbance is caused by corneal swelling due to increased pressure in the eye. It tends to worsen at night or in low-light environments, where the pupil dilates, exacerbating the angle closure. Halos may come and go or become persistent over time. If combined with pain or blurred vision, it indicates a medical emergency and should not be ignored.

5. Redness in the Eye :- Eye redness in glaucoma is usually not due to infection but is caused by increased intraocular pressure and vascular congestion. In acute angle-closure glaucoma, the affected eye may appear visibly red and inflamed. Unlike typical eye irritation from fatigue or allergens, the redness associated with glaucoma does not resolve quickly and may be accompanied by other serious symptoms like pain, nausea, or vision disturbances. This redness is often more pronounced and localized near the iris and cornea. The presence of a red eye in someone experiencing vision problems or eye discomfort should prompt an immediate visit to an eye care professional.

6. Nausea and Vomiting :- In severe or sudden cases of glaucoma, such as acute angle-closure glaucoma, the rise in eye pressure can lead to systemic symptoms like nausea and vomiting. These symptoms are more commonly associated with eye-related headaches and are often misinterpreted as signs of gastrointestinal issues or migraines. The connection between eye pressure and nausea lies in the autonomic nervous system, which reacts strongly to severe ocular pain or pressure changes. When these symptoms occur with eye discomfort or vision loss, glaucoma should be considered as a possible cause. Immediate intervention is necessary, as untreated acute glaucoma can cause irreversible vision damage within hours.

7. Vision Loss :- When glaucoma is left undiagnosed or untreated, it eventually leads to significant vision loss. This can begin as patchy blind spots in the peripheral vision and may progress toward central vision over time. In advanced stages, patients may develop tunnel vision, where only a small central field of vision remains. In cases of congenital glaucoma (present at birth), vision impairment may be evident early in life. In secondary glaucoma, vision loss may result from trauma, inflammation, or other eye diseases. Unfortunately, vision lost due to glaucoma cannot be restored. That’s why identifying symptoms early and managing eye pressure is critical in slowing the progression of the disease.

Conclusion

Glaucoma is a complex eye disease that can present with a wide range of symptoms, depending on its type and stage. In its most common form, it progresses silently, without obvious signs, making regular eye exams essential for early detection. Symptoms such as gradual peripheral vision loss, halos around lights, and eye pain should never be dismissed as minor issues.

In acute forms, glaucoma may present suddenly with severe symptoms like headache, blurred vision, and nausea, requiring emergency treatment to prevent permanent blindness. Understanding and recognizing these warning signs can make a life-changing difference. If you or someone you know experiences any of the symptoms mentioned above, it is crucial to consult an ophthalmologist immediately.

Timely diagnosis, consistent monitoring, and appropriate treatment can significantly reduce the risk of vision loss and help patients maintain a good quality of life. Glaucoma may not be curable, but it is certainly manageable with the right care.