Reviewed by Jonathan Miu, B Optom / B Sci, Kellyville Optical
Glaucoma is a group of eye conditions that damage the optic nerve, which carries information from the eye to the brain. It usually develops slowly, with no early symptoms, and can cause permanent loss of side (peripheral) vision if it isn't detected. Regular eye tests are the best way to pick it up early, when treatment can help protect your sight.
Glaucoma Australia estimates that 1 in 50 Australians will develop glaucoma in their lifetime, and that half of people with glaucoma don't know they have it. This guide explains the types, the warning signs, who's most at risk and how it's checked.
Glaucoma at a glance
- What it is: damage to the optic nerve, often linked to pressure inside the eye.
- Most common type: open-angle glaucoma, which develops slowly with no pain and no early symptoms.
- Emergency type: acute angle-closure glaucoma, which causes sudden eye pain, redness, blurred vision, halos and nausea. Get urgent care.
- Who’s at risk: people over 50, people with a family history of glaucoma, and people with diabetes, high blood pressure, high short-sightedness or long-term steroid use.
- Family history: you’re up to 10 times more likely to develop glaucoma if a close relative has it.
- How it’s detected: an eye test that checks your optic nerve and eye pressure, plus a visual field test if needed.
- Treatment: eye drops, laser or surgery to lower eye pressure. Treatment can slow or stop further damage, but lost vision can’t be restored.
- When to get checked: every 2 years from age 50, or from age 40 if you have a family history or are of Asian or African descent.
Frequently asked questions
The most common type of glaucoma, open-angle glaucoma, usually has no early symptoms. There’s no pain, and vision loss starts slowly at the edges of your sight, so most people don’t notice until a lot of damage has been done. That’s why regular eye tests matter, even if your vision seems fine.
Acute angle-closure glaucoma comes on suddenly and is a medical emergency. Symptoms include severe eye pain, a red eye, blurred vision, seeing halos or rainbows around lights, headache, nausea and vomiting. If this happens, go to a hospital emergency department straight away.
Glaucoma usually affects side (peripheral) vision first. Patchy blind spots form at the edges of your view while central vision stays clear. As glaucoma progresses, the field of vision can narrow, a bit like looking through a tunnel. Because the brain fills in the gaps, many people don’t notice these changes on their own.
In open-angle glaucoma, the eye’s drainage channel stays open but drains fluid too slowly, so pressure rises gradually over years. In angle-closure glaucoma, the drainage angle becomes narrow or blocked. That can cause a sudden, painful rise in pressure. Open-angle glaucoma is much more common in Australia.
Glaucoma often runs in families. Glaucoma Australia says you’re up to 10 times more likely to develop it if a close relative, such as a parent or sibling, has glaucoma. If glaucoma runs in your family, tell your optometrist and start regular eye tests from age 40, or earlier if a relative was diagnosed young.
Glaucoma can’t be cured, and vision already lost to glaucoma can’t be restored. But it can usually be managed. Treatment such as eye drops, laser or surgery lowers the pressure in the eye and can slow or stop further damage. The earlier it’s found, the more sight can be protected.
Yes. Some people develop optic nerve damage even though their eye pressure is in the normal range. This is called normal-tension glaucoma. That’s why a glaucoma check looks at the optic nerve and your field of vision, not just eye pressure.
Glaucoma is checked during a comprehensive eye test. Our optometrist measures the pressure in your eyes and examines the optic nerve at the back of the eye. If anything looks unusual, they may do a visual field test (perimetry) to map your side vision, and may refer you to an ophthalmologist
Glaucoma Australia recommends a comprehensive eye test every 2 years from age 50. If you have a family history of glaucoma, or are of Asian or African descent, start every 2 years from age 40. If a relative has advanced glaucoma, start 10 years earlier than the age they were diagnosed.
Kellyville Optical checks for signs of glaucoma as part of a comprehensive eye test, at Shop 8, 90 Wrights Road, Kellyville NSW 2155, in Kellyville Village. We refer to ophthalmologists when further assessment or treatment is needed. We’re a short drive from Rouse Hill, Castle Hill, Bella Vista and The Ponds. Book online or call (02) 8814 7450.
What is glaucoma?
Glaucoma is a group of eye diseases that damage the optic nerve, the cable of nerve fibres that sends what you see to your brain. The damage is often linked to fluid pressure building up inside the eye. When the eye’s drainage system doesn’t work properly, pressure rises and slowly harms the nerve fibres. Once those fibres are lost, the vision they carried can’t be restored.
What are the types of glaucoma?
There are two main types of glaucoma, plus a few less common forms.
Open-angle glaucoma is the most common type. The eye’s drainage channel stays open but works less efficiently over time, so pressure rises slowly. It’s painless and usually has no symptoms until vision is affected.
Angle-closure glaucoma happens when the drainage angle between the iris and cornea becomes narrow or blocked. It can develop slowly, or come on suddenly as acute angle-closure glaucoma, which is a medical emergency.
Other types include normal-tension glaucoma (nerve damage with normal eye pressure), secondary glaucoma (caused by another condition, an injury or medication such as steroids), and rare childhood glaucoma.
What are the types of glaucoma?
There are two main types of glaucoma, plus a few less common forms.
Open-angle glaucoma is the most common type. The eye’s drainage channel stays open but works less efficiently over time, so pressure rises slowly. It’s painless and usually has no symptoms until vision is affected.
Angle-closure glaucoma happens when the drainage angle between the iris and cornea becomes narrow or blocked. It can develop slowly, or come on suddenly as acute angle-closure glaucoma, which is a medical emergency.
Other types include normal-tension glaucoma (nerve damage with normal eye pressure), secondary glaucoma (caused by another condition, an injury or medication such as steroids), and rare childhood glaucoma.
Who is at risk of glaucoma?
Anyone can develop glaucoma, but your risk is higher if you:
- Are over 50
- Have a close family member with glaucoma
- Are of Asian or African descent
- Have diabetes or high blood pressure
- Are highly short-sighted or long-sighted
- Have used steroid medication (including eye drops, puffers or tablets) for a long time
- Have had an eye injury or eye surgery
- Have been told you have high eye pressure
What are the signs and symptoms of glaucoma?
Most people with open-angle glaucoma have no symptoms in the early stages. When symptoms do appear, they can include:
- Patchy blind spots in your side vision
- Bumping into things, or trouble noticing objects to the side
- Tunnel vision in advanced stages
Seek urgent care if you suddenly get severe eye pain, a red eye, blurred vision, halos around lights, headache, nausea or vomiting. These can be signs of acute angle-closure glaucoma.
How is glaucoma detected at an eye test?
Glaucoma is usually detected during a comprehensive eye test, often before you notice any change in your vision. Our optometrist may:
- Ask about your health and family history, including any relatives with glaucoma and any steroid use.
- Measure your eye pressure (tonometry).
- Examine your optic nerve at the back of the eye for signs of damage, and photograph it so any changes can be compared at future visits.
- Test your field of vision (perimetry) if your eye pressure, the look of your optic nerve, or changes in the photos over time suggest a risk, to check for blind spots in your side vision. Learn about visual field testing
If a repeat visual field test shows the same defects in the same place, our optometrist will refer you to an ophthalmologist who specialises in glaucoma for diagnosis and treatment.
How is glaucoma treated?
Glaucoma treatment aims to lower the pressure in the eye to protect the optic nerve from further damage. If your optometrist suspects glaucoma, they’ll refer you to an ophthalmologist (eye specialist) from our referral network for diagnosis and treatment. Treatment may include:
- Eye drops, used daily to lower eye pressure. This is the most common first treatment.
- Laser treatment, such as selective laser trabeculoplasty (SLT), which helps fluid drain more easily.
- Surgery, which creates a new drainage pathway when drops or laser aren’t enough.
Glaucoma is a lifelong condition, so regular check-ups are needed to make sure treatment is working. Your optometrist and ophthalmologist often work together to monitor your eyes over time.
Can glaucoma be prevented?
Glaucoma can’t always be prevented, but early detection can prevent much of the vision loss it causes. The most important steps are:
- Having regular comprehensive eye tests, especially from age 40 if you’re at higher risk
- Telling your optometrist about any family history of glaucoma
- Using glaucoma eye drops exactly as prescribed, if you’ve been diagnosed
- Protecting your eyes from injury during sport and DIY
