Question 1

How will it affect my sight?

Accepted Answer

Typically the peripheral vision is lost first and so goes unnoticed because the central vision, for reading and recognising faces, remains good. One eye can also make up for vision loss in the other eye, until both eyes have lost vision in the same area. If left untreated, the damage continues ('progresses'), usually slowly over years, and may eventually affect your ability to drive or make you more likely to fall. In glaucoma, vision loss is permanent and cannot be recovered. However, with early diagnosis, careful monitoring and regular use of the treatments, the vast majority of people with glaucoma retain useful sight for life.

Question 2

Will I have any symptoms?

Accepted Answer

You can't 'feel' primary open angle glaucoma; it doesn't cause any symptoms and the eye pressure doesn't cause any pain. You may not notice any difference in your vision because glaucoma affects your peripheral (side) vision first, which is not as sensitive as your central vision — so it is difficult to notice any early changes even though your sight is being damaged. Because you may not notice a problem until your glaucoma is more advanced, it is important to have regular eye tests. The earlier your glaucoma is picked up and treated, the more of your sight can be protected.

Question 3

Are some people more susceptible to glaucoma?

Accepted Answer

Anyone can develop glaucoma but some factors put you at more risk. Age: it is more common as you get older, occurring in about 2% of people over 40 and almost 10% of people over 75. Blood pressure: low blood pressure is linked to a greater risk of worsening glaucomatous sight loss. Race: people of African-Caribbean background have a higher risk of open angle glaucoma, which can develop earlier and progress more quickly; those of East Asian origin have a higher risk of closed angle glaucoma. Family history: your risk is higher if a parent, sibling or child has glaucoma — relatives over 40 should have annual eye examinations. Eyesight prescription: short-sightedness increases the risk of open angle glaucoma; long-sightedness increases the risk of closed angle glaucoma. Diabetes and long-term steroid use are also associated with an increased risk.

Question 4

What is ocular hypertension (high eye pressure)?

Accepted Answer

Some people naturally have eye pressure above the normal range, but this pressure doesn't cause any damage to their optic nerve — this is described as ocular hypertension rather than glaucoma. Different people can have different optic nerve strengths, and some optic nerves stay healthy at higher than normal pressures. Most people's eye pressures are in the range of 10–21 mmHg. If your pressure is higher than 21 mmHg your optometrist may refer you to hospital for more tests to check whether it is likely to cause any problems to the optic nerve. A high pressure may be completely normal for your eye.

Question 5

How do you treat primary open angle glaucoma?

Accepted Answer

The aim of treating primary open angle glaucoma (POAG) is to reduce the pressure within the eye to a level at which no further damage occurs to the optic nerve. Initial treatment is usually with eye drops.

Question 6

How is ocular hypertension treated?

Accepted Answer

Ocular hypertension can increase your risk of developing glaucoma, so it needs to be monitored. Sometimes you may be prescribed eye drops to help reduce your eye pressure and reduce the risk of glaucoma developing.

Question 7

What other treatments are available?

Accepted Answer

Selective Laser Trabeculoplasty (SLT) is a laser treatment for open angle glaucoma. Trabeculectomy is a surgical procedure that helps lower and control eye pressure. Other options include cyclodiode laser, shunt (tube) surgery and the PRESERFLO MicroShunt — see the dedicated pages for each of these treatments.

Question 8

What are the different types of glaucoma?

Accepted Answer

Primary open angle glaucoma — damage to the optic nerve occurs slowly over a long period due to eye pressure rising above 21 mmHg. Closed angle glaucoma — damage can happen very quickly due to a sudden rise in eye pressure. Normal tension glaucoma — optic nerve damage occurs even when eye pressure is within the normal range (below 21 mmHg); it is treated in the same way as open angle glaucoma. Secondary glaucoma — occurs as a result of another eye condition, an injury to the eye or due to medication. Congenital glaucoma — when a baby is born with glaucoma.

Question 9

How do I manage my glaucoma?

Accepted Answer

Having glaucoma may mean making a few changes to your everyday life to prevent sight loss. For most people, this includes taking eye drops daily and attending regular hospital visits to make sure the eye pressure stays stable. Changes in eye pressure have no symptoms, so without regular checks you won't be able to tell that your treatment is working. These visits are also a good opportunity to ask any questions about your treatment. You will have a regular visual field test at your clinic visits, which helps us monitor how the glaucoma is affecting your sight and make the right decisions about treatment.

Question 10

What if my glaucoma cannot be fully controlled?

Accepted Answer

More than 90% of people diagnosed with glaucoma today will retain useful vision — blindness is rare. In certain cases, however, it may not be possible to control the glaucoma well enough to retain useful vision. This is often where the condition was diagnosed at a late stage, treatments have been ineffective, or the person has had difficulty taking the prescribed medications. It is completely natural to be upset when you have been diagnosed with glaucoma and normal to worry about the future. It can sometimes be helpful to talk about these feelings with someone outside your circle of friends or family — we can help you find further practical and emotional support.

Question 11

Can I continue to drive with glaucoma?

Accepted Answer

Most people are still able to drive, provided that their visual field loss is not severe. However, if you have glaucoma in both eyes you must, by law, inform the Driver and Vehicle Licensing Agency (DVLA) about your condition and undergo a special visual field test to check the extent of damage to your sight. See the 'Driving with Glaucoma' page for more detail.

How do you treat primary open angle glaucoma?

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