How do I know if I have Glaucoma?
Unfortunately, glaucoma in its commonest form with open angles is entirely asymptomatic in its early stages and you cannot notice small changes in your vision or other eye symptoms that indicate you may have early glaucoma disease. Hence, you have to have a medical professional examine your eyes.
Risk of Glaucoma
You MUST have an annual eye check if you are aged 40 or over. If you have a family member or history of family with glaucoma, we strongly recommended that you have an annual eye check from early adulthood. Many treatments are available, including medicines, laser and surgery.
If your vision is already blurred from visual field loss, it is already too late to reverse and save that lost vision, but with the correct treatment, further vision loss can be prevented in many cases.
What should I do if I already have Glaucoma or it runs in my family?
If you already have glaucoma or are at risk of the condition, for instance, because it runs in your family, there are some important things to be aware of and which you should report to your glaucoma specialist promptly. Also if you have an eye or medical condition predisposing you to glaucoma, you need to be aware of warning signs that you need to see a glaucoma specialist urgently.
Click here to learn what Glaucoma is.
Symptoms you need to be aware of
There is a lot you can do by paying attention to the symptoms of the “5 Key Alerts”.
1. Eye pain, blurred vision, nausea and vomiting with Narrow Angle Glaucoma. This is an Eye Emergency
If you have been diagnosed with “narrow drainage channels or narrow angles” you must always be alert to a sudden painful drop in vision, which occurs usually in one eye. This is not a mild discomfort but significant pain that is associated with nausea or vomiting.
The triad of
- Eye pain
- Blurred vision
- Nausea and vomiting
These are hallmarks of a rapid and dramatic rise in pressure in your eye known as acute glaucoma.
Acute glaucoma can rarely affect patients with open drainage angles. Therefore it is important that you know what type of glaucoma you have and the risk factors for its deterioration. A good glaucoma specialist will tell you about your type of glaucoma and want you to be as fully informed as possible so you can understand and make sensible safe decisions about your eye care.
If you get the triad of symptoms above you must seek urgent help and eye pressure testing within the hour as emergency treatment is needed to save sight. The treatment can be drops, medicines and lasers.
Your pressure can be checked by an optometrist, in an Eye Accident and Emergency Department, at Clinica London by one of our ten consultant ophthalmologists, and by your Glaucoma specialist.
2. Eye redness, burning and stinging. Unwanted symptoms from Glaucoma Drops
If you are on glaucoma drops to control your eye pressure and experience progressive or marked symptoms when you put your eye drops in, to the point where you are tempted to stop using them or are missing doses, you must see and discuss this with your glaucoma specialist as soon as possible.
These symptoms are
- Eye redness
Unmonitored missed doses of your eyedrops puts you at risk of losing your vision permanently, please do not miss your drops but see your glaucoma specialist urgently as there are alternatives. In the vast majority of cases, suitable glaucoma drop alternatives can be found that don’t have these significant side effects, where I avoid giving you drops with preservatives in them.
Here’s a guide to using Glaucoma Drops.
Alternatively, you could be suitable for SLT (selective laser trabeculoplasty), which is a highly effective and safe treatment that may mean you can stop the glaucoma drops entirely or for a few years.
Click here to learn what are the treatment options for Glaucoma.
If you want to get off your glaucoma drops because of unwanted and unpleasant side effects there are other options your glaucoma specialist can consider, including laser treatment with Selective Laser Trabeculoplasty (SLT). SLT can be done at Clinica London as an outpatient under topical anaesthesia and does not hurt.
There are very good alternatives to eyedrops with unwanted side effects of eye redness, burning and stinging: do not stop the drops but discuss with your glaucoma specialist urgently.
3. Redness and Pain symptoms after glaucoma surgery
If you get symptoms of redness and pain around the site of your glaucoma surgery, this could be serious from an infective blebitis.
If you have had a trabeculectomy operation where we create a bypass, known as a bleb, to control the pressure there is a small chance that the bypass can become infected over time. This is uncommon but if it occurs it is a serious problem.
The key things to look for and report urgently are
- Any new redness
- Pain at the top of your eyeball between 11 & 1 o’clock.
Your glaucoma specialist will have warned you about this at routine appointments if they think that you might be at risk of this. This “blebitis” can quickly lead to blinding infection inside your eye. They are available to help if there is redness and pain.
At Clinica London, we have a Consultant Ophthalmologist available every day for eye emergencies and I am there every Monday and Wednesday.
Post glaucoma surgery redness and pain, do not delay. Seek urgent help as most blebitis can be treated effectively before vision loss occurs.
4. Symptom of vision blur from cataract: Recommendations if you have both Cataract and Glaucoma
If you have glaucoma and your vision is getting blurry from a cataract, and the optician tells you that you have cataracts that may benefit from cataract surgery, you can consider Cataract Plus surgery. It is important that you see a glaucoma specialist who specializes in “Cataract Plus” which is combined cataract and minimally/micro-invasive glaucoma surgery, known as MIGS. MIGS is a surgical innovation that is transforming the way we manage glaucoma. I am a cataract and glaucoma specialist and frequently carry out this combined surgery.
If you are on eye pressure-lowering drops and need cataract surgery you should discuss with me how placing a stent (MIGS) or even using a laser inside the eye (endo laser) at the same time as your cataract surgery can help reduce or remove the need for drops after the cataract surgery.
If you are a glaucoma patient having cataract surgery, you should see this as a top opportunity to treat both conditions safely and effectively. MIGs can give you a drop-free period or reduce the number of drops you need after cataract surgery on top of enjoying your new clarity of vision.
MIGs adds 10-15 minutes to the end of a cataract operation but the benefits can be felt for years afterwards.
It is a missed opportunity if you are a glaucoma patient to only have cataract surgery without addressing the pressure at the same time and getting the freedom you require.
Click here to learn what patients experience after cataract surgery and glaucoma treatment.
Click here to learn what do patients experience after cataract surgery.
Cataract Plus with MIGS is an opportunity that replaces otherwise traditional glaucoma surgery and can replace medicines in some patients.
5. Symptoms of photophobia or light sensitivity
If you have symptoms of light sensitivity, also known as photophobia, this is a hallmark of inflammation inside the eye known as uveitis or iritis.
People with uveitis often know that they will start to feel a dull ache and become light sensitive at the onset of an attack and that early treatment is vital in order to avoid severe pain and a drop in vision.
Uveitis and inflammatory eye disease can be associated with an acute rise in eye pressure in many people. Many patients will know that their eye pressure has gone up dramatically when they have an attack of uveitis. This painful eye pressure rise requires rapid and adequate treatment.
It is very important that you see an ophthalmologist urgently for effective appropriate treatment when you get a uveitis relapse and avoid a potentially damaging eye pressure rise.
Dr Laura Crawley, Glaucoma and Cataract Surgeon,
Clinica London, May 2021