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Symptoms of Glaucoma

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In most cases glaucoma does not produce any symptoms. The peripheral vision loss it causes usually goes unnoticed, especially in emerging cases as the brain can “fill in” the missing parts of the image based on information from the surrounding areas or from the other eye.

In such cases of mild glaucoma, patients may sometimes notice that they are less coordinated when carrying out everyday activities requiring good peripheral vision, for example, they have difficulty walking down stairs, bump into objects at the side of them, etc. However, they rarely attribute it to their vision, but rather they equate it to an age-related loss of agility. Patients with glaucoma are more prone to suffer falls (e.g., they have a higher incidence of broken legs) and traffic accidents.

It is not until advanced stages that patients are fully aware of their peripheral vision loss, when they start to notice they have “tunnel vision” or “gun-barrel vision”.

One exception is angle-closure glaucoma, which can produce symptoms in certain cases as it is caused by a sudden increase in pressure that the eye cannot compensate for. In such cases, patients notice the sudden onset of the following:

Blurred vision.

Redness.

Pain.

Headache.

Nausea and vomiting.

This is an emergency situation because if the pressure remains too high it can damage the nerve and have a severe effect on their vision.

Signs of Glaucoma

In the most frequent type of glaucoma (primary open-angle glaucoma), at plain sight the eye has a completely normal external appearance. In the fundus of the eye, a healthy optic nerve takes the form of a doughnut with a central hole (excavation) surrounded by a circular area (the “meat” of the doughnut), which is where the nerve tissue is found. Patients with glaucoma, on the other hand, lose optic nerve tissue from the ring (the meat of the doughnut) and therefore the central hole looks bigger, until in advanced cases a large central crater is visible due to the almost complete absence of nerve tissue.

In angle-closure glaucoma, when there is a sudden increase in intraocular pressure (an “attack”) the eye may appear red and an external examination could reveal an immobile pupil compared to the other eye.

In congenital glaucoma, since children are in a stage of growth, the affected eye may increase in size and appear larger than the other eye and, depending on each case, externally it may appear white (because the cornea loses its transparency due to the pressure increase).

Substantiated information by:

Elena Fraga Pumar Optometrist Ophthalmology Department

Elena Milla Griñó Ophthalmologist Ophthalmology Department

Marta Pazos López Ophthalmologist Ophthalmology Department

Published: 19 October 2018
Updated: 19 October 2018

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