Glaucoma education is the key to preserving sight 

If you’ve just been diagnosed with glaucoma, you may be feeling a range of emotions and are worried about how it will affect your vision. 

While glaucoma is one of the leading causes of blindness worldwide, it doesn’t necessarily mean you will lose your sight. Although there is no cure for glaucoma, the risk of irreversible vision loss can be avoided with regular eye examinations and early treatment interventions.^2,3 By educating yourself about this eye condition and maintaining good eye health practices, you can effectively manage your glaucoma and protect your sight.

What is glaucoma?

Glaucoma is the collective term used to describe progressive, irreversible damage to the optic nerve.^2,3,4 This is thought to be characterised by changes in intraocular pressure, which causes structural changes in the eye and the loss of retinal ganglion cells, disrupting their ability to send visual information to the brain^3,4,5 and causing gradual loss of peripheral vision. Glaucoma often has no symptoms in its early stages, which is worrying because, by the time it is detected and diagnosed, permanent damage has probably already occurred.² In fact, 50% of patients don’t realise they have glaucoma until they already have significant visual loss.^2,3,4 

How common is glaucoma?

Glaucoma is the primary cause of low vision globally and affects approximately 3.54%¹ of the population. In 2013, the number of people aged between 40 and 80 diagnosed with glaucoma worldwide was 64.3 million, and this figure is expected to increase to 112 million by 2040.¹

Different forms of glaucoma

Although there are many different forms of glaucoma, the most common type, called open-angle glaucoma, occurs when the aqueous humour, a fluid responsible for maintaining intraocular pressure and nourishing the optic nerve, fails to drain properly, leading to increased eye pressure and permanent optic nerve damage.³ Different types of glaucoma cause different structural changes at the front of the eye, but they all ultimately lead to changes in intraocular pressure, which damages the optic nerve.^2,4 The good news is that early diagnosis and treatment can reduce the rate of optic nerve ganglion cell loss and preserve visual function.^2,3,4,5 

Symptoms to watch for

Given the gradual loss of peripheral vision, open-angle glaucoma tends to have no symptoms initially as central vision remains unaffected; as peripheral vision losses usually do not occur in the same areas of the visual fields of both eyes, early diagnosis is challenging.^2,3,4,5 As the disease progresses, patients may start to notice changes in vision in low light conditions and increased glare sensitivity, causing difficulties with mobility and driving.^2,3 

Being aged 40 and over, as well as having a family history of the disease, increases the risk of developing glaucoma, with a 10 times greater risk of developing glaucoma if a first-degree relative has been diagnosed.^2,3 Other risk factors for developing glaucoma include short-sightedness, diabetes, hypertension, sleep apnoea, previous eye injury, and using long-term steroids.^2,3,4 

Diagnosis and treatment

As glaucoma rarely shows symptoms, the best way to ensure early detection is through regular comprehensive eye examinations. Those over the age of 40 with a family history of glaucoma are strongly advised to see an optometrist every two years.^2,3,4 Your family members are also encouraged to get tested, as there is a 25% chance of having glaucoma if a direct relative has been diagnosed.^2,3 

Eye drops are the most common form of glaucoma treatment, however, there are also oral medications, laser and surgical options, all with the aim of decreasing intraocular pressure to prevent further optic nerve damage.^2,3,4,5 Treatment is often ongoing and, unfortunately, cannot bring back any lost vision, but it will help to keep eye pressure low to prevent further disease progression.^2,4 Given the chronic progressive nature of the disease, treatment compliance is essential in preventing vision loss.³ It is also important to regularly attend follow-up visits with your ophthalmologist for ongoing monitoring of the optic nerves, eye pressure and peripheral vision.³ There are also patient support groups, including s Glaucoma Australia, which can provide a range of services and assistance to those recently diagnosed and throughout their journey with glaucoma.^2,3

Summary

Although glaucoma can cause irreversible vision loss, many treatment options are available to help slow its progression. Given the relatively asymptomatic nature of the disease, regular eye examinations are essential in detecting early signs of glaucoma, which can significantly improve treatment outcomes and slow down the rate of vision loss. The key to maintaining sight is compliance with prescribed treatments, such as drops, and adhering to scheduled appointments with your ophthalmologist for ongoing monitoring and treatment review options.

References: 

1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and

projections of glaucoma burden through 2040: a systematic review and meta-analysis.

Ophthalmology. 2014;121(11):2081-90.

2. Vision Australia. Glaucoma. 2024. Accessed October 4, 2024. https://www.visionaustralia.org/services/eye-conditions/glaucoma

3. Glaucoma Australia. What is glaucoma?. 2024. Accessed October 7, 2024. https://glaucoma.org.au/ 

4. Schuster AK, Erb C, Hoffmann EM, et al. The diagnosis and treatment of glaucoma. Dtsch Arztebl Int. 2020; 117(13):225-234. doi: 10.3238/arztebl.2020.0225. 

5. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11. doi: 10.1001/jama.2014.3192. 

Call-out: 50% of patients don’t realise they have glaucoma until after vision loss has occurred

Call-out: The best way to avoid vision loss is to have regular eye tests with your optometrist