Glaucoma

Types of glaucoma 

There’s no one‑size‑fits‑all when it comes to glaucoma. Some types come on slowly, while others happen fast. Some are linked to other health problems. Here’s what you need to know.

Primary open‑angle glaucoma

This is the most common type. It builds up quietly over time. Most people don’t notice anything wrong until they start to lose some of their side vision. That’s why it’s often called the “silent thief of sight”. It doesn’t hurt, and your central vision might stay sharp at first. Regular eye tests are the best way to catch it early, before any optic nerve damage occurs.

Angle‑closure glaucoma 

This type is more sudden. It happens when the fluid inside your eye can’t drain properly because the drainage angle is blocked. It can cause a sharp rise in pressure and comes with noticeable symptoms like eye pain, red eye, blurred vision, seeing halos around lights, headache, or feeling sick. It needs urgent treatment to stop permanent vision loss, so if you get these symptoms, don’t wait. Call your optometrist or doctor straight away. 

Secondary glaucoma 

This is when glaucoma is caused by something else going on in your eye. There are a few types:

Inflammatory glaucoma

Linked to swelling inside the eye, often from a condition like uveitis. The inflammation can clog the drainage system and raise pressure. 

Neovascular glaucoma

Caused by abnormal blood vessels growing where they shouldn’t, often due to diabetic eye disease or a blocked vein. These vessels block the drainage angle and raise pressure.

Traumatic glaucoma

Happens after an eye injury. The damage might not be obvious at first but can affect how fluid flows through and drains from the eye.

Your optometrist will be able to diagnose any of these and talk you through the right treatment plan.

Normal‑tension glaucoma 

Not all glaucoma comes with raised eye pressure. In this type, the pressure is in the “normal” range, but the optic nerve still gets damaged. We’re not sure why this happens, but it’s more common if you have low blood pressure or a family history. That’s why we don’t just rely on pressure tests; we check your optic nerve and vision too.

How glaucoma affects your vision 

What you can expect as glaucoma develops, and how your sight might change. 

Early stage 

At this point, you probably won’t notice anything. Glaucoma usually starts by affecting your side vision, not the part you use to read or drive. At this stage, most people only find out through a routine eye test. That’s why regular checks are so important. 

Moderate stage 

Your peripheral vision starts to narrow. You might bump into things, struggle to see people coming from the side, or miss steps and kerbs. It’s like your field of view is shrinking slowly, and often without pain. This is when people tend to realise something’s not right. 

Advanced stage

Without treatment, the tunnel of vision keeps closing in. Central vision can become blurred or patchy. Everyday tasks like reading, recognising faces, or walking outside can become harder. This vision loss can’t be reversed, but we can still help protect what’s left.

Symptoms of glaucoma 

Glaucoma often develops without early symptoms, but it can gradually affect your vision.

Blurry vision

You might notice your sight isn’t quite as sharp as it used to be. Letters might look smudged when reading, faces could appear slightly out of focus, or driving might feel more difficult, especially at night. In glaucoma, this can happen as pressure builds in the eye and affects the nerve over time.
Learn more about blurry vision

Cloudy vision

Things might look foggy, like you’re seeing through a misted‑up window. Colours may seem duller, and it might be harder to see clearly in bright or low light. This can happen when fluid builds up and disrupts how your eye works. A symptom worth checking. 
Learn more about cloudy vision

Tunnel vision

Glaucoma often begins at the edges of your vision. You may start missing things to the side, someone walking up beside you, a cyclist coming past, or obstacles like steps. You’re not going blind overnight, but your field of view can gradually shrink without you realising it.

Halos around lights

You might see bright rings or rainbow‑like circles around lights, especially at night or in dim lighting. It can make driving harder and affect your confidence in low light. This is a symptom of raised eye pressure and shouldn’t be ignored. 
Learn more about halos around lights

Eye pain

Some types of glaucoma, like angle‑closure glaucoma, can cause pain around or behind the eye. It might feel like pressure, and be associated with redness or a headache, or make you feel sick. It can come on quickly and needs urgent care.
Learn more about eye pain

Sudden changes or vision loss

If your vision suddenly becomes blurry, dark, or patchy, or if you see flashing lights or floaters, it could be a sign of a serious issue. These changes can happen fast and should always be checked as soon as possible. 
Learn more about floaters and flashes

Red eye

If your eye looks unusually red or bloodshot, especially when paired with pain, blurred vision or nausea, it could be a sign of raised eye pressure. A red eye on its own isn’t always serious, but when it’s linked with other symptoms, it’s best to get checked. 
Learn more about red eye

Nausea or feeling sick

Sudden nausea, especially alongside eye discomfort or vision changes, can be linked to angle‑closure glaucoma. It’s not something most people would connect to their eyes, but it can happen when eye pressure rises quickly. 

Headaches

A deep, dull ache around the eyes or forehead might point to eye strain or raised eye pressure. If it’s new, getting worse, or comes with vision problems, it could be linked to glaucoma.
Learn more about headaches and your eyes

Who is at greater risk of glaucoma?

Anyone can get glaucoma. But some people are more likely to develop it than others, especially if certain risk factors apply. 

Below we have listed some of the key factors that may increase your chances of developing glaucoma.

Living with glaucoma 

Glaucoma is a lifelong condition, but with the right care and regular checks, most people keep their vision stable. It can’t be reversed, but early treatment can stop things from getting worse. That’s why we recommend eye tests at least every two years, or more often if your optometrist advises it, especially if someone in your family has glaucoma. 

Starting treatment

If your optometrist spots signs of glaucoma, you’ll be referred to an eye specialist for more tests. If it is confirmed, your ophthalmologist will explain what stage it’s at, what’s caused it, and what to do next. Treatment usually begins shortly after diagnosis, to reduce pressure in the eye and protect your vision.

Glaucoma drops (or eye drops) 

Most people begin with either drops or SLT (a type of laser treatment), so let’s explore what that means. Drops are usually the first step. They help lower the pressure inside your eye and are used every day, often for life. Your doctor might try different types or tweak the dose to find what works best for you. If drops or SLT don’t work well enough, other treatments might be needed. 

How to use eye drops

Your doctor or nurse will show you how to use them. Usually, you’ll need to tilt your head back, gently pull down your lower lid, and squeeze one drop into the pocket between your eye and lid. Try not to blink too much straight after. Using drops properly helps them work and reduces the chance of side effects. 

Laser treatment (SLT)

Selective Laser Trabeculoplasty (SLT) is another option for lowering eye pressure. It’s a quick, pain‑free laser procedure that can delay or even remove the need for daily drops. Your ophthalmologist might recommend SLT first, depending on what’s best for your eyes and lifestyle. 

Ongoing care and follow‑ups 

Glaucoma doesn’t go away, so regular appointments are important. These help us check if treatment is working and catch any signs of change. Some people are seen every three to six months, depending on how their eyes are doing. If anything changes, your treatment can be adjusted to suit.

Cataracts and glaucoma treatment 

Some glaucoma drops can affect how your eyes respond to light, which might be more noticeable if you have cataracts too. If you are having trouble with glare, or feel like your vision has dipped, let your doctor know. If you need surgery for both conditions, your eye specialist will guide you on the best timing and treatment plan.

Types of eye drops used to treat glaucoma

There are several types of eye drops that can help reduce pressure in the eye. Your specialist will recommend the one that suits your eyes, health and lifestyle best.

1. Prostaglandin analogues 

These drops work by helping fluid drain out of the eye more effectively. They’re usually used once a day, often at night. They tend to have fewer side effects than some other drops, but can sometimes cause redness, longer lashes or changes in eye colour. 

2. Alpha‑adrenergic agonists 

These drops both reduce how much fluid the eye makes and help drain it away more effectively. They’re often used three times a day. Some people may notice dry mouth or fatigue as side effects, so your doctor will check whether they’re right for you. 

3. Beta blockers 

These drops lower the amount of fluid your eye produces. They’re usually taken twice a day. They can affect heart and lung conditions in some people, so it’s important to let your optometrist or ophthalmologist know about your full medical history. 

4. Combination eye drops 

Sometimes, a mix of two different types of drops is needed to bring the pressure down. Combination drops make things simpler by combining more than one medication in a single bottle. This can help make it easier to stick to your treatment routine. 

5. Carbonic anhydrase inhibitors 

These drops reduce the amount of fluid your eye makes, which helps lower the pressure. They’re usually used two or three times a day. Some people may notice a metallic taste or a tingling feeling in their fingers or toes. Your specialist will keep an eye on how you’re getting on with them. 

More treatment options for glaucoma 

Not everyone will follow the same treatment path. Your eye specialist will recommend what’s best based on the type of glaucoma you have and how far it has progressed. 

Laser treatment 

Laser helps fluid drain better from the eye, lowering pressure. It’s quick, usually painless, and often done in clinic. It can sometimes reduce the need for drops. 

Selective Laser Trabeculoplasty (SLT) 

SLT is a gentle laser used early on. It improves drainage and may delay or reduce the need for drops. Your specialist will advise if it’s a good option for you. 

Secondary glaucoma treatment 

If glaucoma is caused by something else, like an injury, treatment focuses on both. You might need drops, steroids or surgery, depending on the cause. 

Acute angle‑closure glaucoma treatment 

This needs urgent care. You’ll likely have drops to lower pressure fast, then laser to stop it happening again. Sudden eye pain or vision changes? Get help straight away.