Health Conditions

What are the symptoms?

There are two main types of glaucoma, open-angle (which is further sub-typed into normal tension glaucoma and pigmentary glaucoma) and closed-angle. The symptoms and the time to onset of the two main types of the disease are very different.

People with open-angle glaucoma usually do not have symptoms. It is often painless and goes unnoticed until late in the disease when areas of peripheral vision are lost. If the peripheral vision continues to fade, tunnel vision may develop. Normal tension glaucoma is a subtype of open-angle glaucoma. Normal tension glaucoma, also known as "low-tension glaucoma", leads to optic nerve damage and loss of visual field in patients with a normal IOP caused by poor blood flow to the optic nerve. Another subtype of open-angle glaucoma is pigmentary glaucoma which is inherited. Pigmentary glaucoma is more common in men and appears in early adulthood. In pigmentary glaucoma the concave shaped iris creates an unusually wide angle which causes the pigment layer of the eye to rub on the lens of the eye. The rubbing motion causes the iris pigment to shed into the aqueous humor which plugs the pores and causes a clog which then increases the IOP. If open-angle glaucoma is not treated, the tunnel vision may progress into blindness. Screening performed during annual eye exams is extremely important in detecting this disease early so that treatment can be started.

Closed-angle glaucoma, sometimes known as acute glaucoma, differs from open-angle in that the symptoms typically occur suddenly (although not always). The symptoms may include blurred vision, formation of halos around lights at night, pain and redness in the eye, and swelling and clouding of the cornea (the typically clear and transparent coating layer of the outer eyeball). The pain experienced can be so intense that it may cause nausea and vomiting or a headache. Symptoms like this need to be evaluated in the emergency department as soon as possible to prevent permanent eye damage.