Glaucoma prognosis: understanding the likely course of action
Being diagnosed with glaucoma can be overwhelming. Fortunately, there are many effective treatments available that can prevent your eyesight from getting worse. If you have been diagnosed with this condition, it is very important to take your medications every day exactly as prescribed. Working closely with your eye doctor is essential in protecting yourself against vision loss, as with proper and timely treatment, the risk of your vision deteriorating is greatly reduced.
In this article, we answer some of the most frequently asked questions about glaucoma prognosis, which describes the way your condition could develop, and the course of action your doctor will likely take in treating it.
Can my condition be treated?
Glaucoma is a common condition that is usually caused by a fluid build-up in the front part of the eye, which increases pressure within the eye. It causes damage to the optic nerve, which impacts signals that are sent from the eye to the brain. There is currently no known way to prevent glaucoma from developing, however, there are several successful treatments available to prevent the worsening of vision that the condition causes.
In most people, treatment begins with prescription eye drops to lower the pressure inside the eye (called the ‘intraocular pressure’ or IOP for short). If medications fail to reduce the IOP, laser surgery (trabeculoplasty) can be done to widen the drainage channels in the eye. This allows fluid within the eye to drain out more easily, thereby lowering the intraocular pressure. If medications and laser therapy are unsuccessful, conventional eye surgery may be recommended to make an opening for the fluid to leave the eye1.
You can learn more about the various treatment options for glaucoma here.
How will glaucoma affect my vision?
Unfortunately, there is currently no cure for glaucoma. If you have experienced vision loss due to glaucoma, this is permanent, and you will not be able to regain it. However, several effective treatments can greatly reduce the risk of severe vision loss and blindness.
The loss of vision that occurs with chronic glaucoma is very gradual and may not be noticeable until it’s too late. That’s why it’s important to get regular eye checks, especially for people with a family history of the disease. If glaucoma is discovered in its early stages, vision loss is usually less severe and may not significantly affect your quality of life. .
Many people with early-stage glaucoma have enough vision to work, read, drive, and live independently. However, if you’ve been diagnosed with glaucoma, it’s important to use the eye drops and take the pills you’ve been prescribed exactly as instructed. Neglecting treatment, including missing medications, can make your vision worse and in acute cases, even lead to blindness1.
When will treatment start? How long will it last?
Glaucoma is a lifelong disease that progresses slowly, and treatment usually begins soon after the diagnosis is made. Treatment for glaucoma usually continues indefinitely. Early detection and appropriate treatment are critical to preserving your vision.
Treatment may be started in one eye first. This is typically the ‘worse’ eye, with the higher intraocular pressure. A single drug may be tried to see if it works. Later, your doctor may test different combinations of medications to find a solution that works best for you.
Regular follow-ups with your doctor are required while being treated with glaucoma medication. This helps your doctor to detect any progression of the disease promptly. If your vision is found to be worsening despite treatment, you may need an increased dose of your current medication or to change the medication that you’re taking. You may also be recommended for laser treatment and/or surgery. Stable patients are usually examined at three to six month intervals depending on the severity of the disease and the rate that it is progressing2.
What symptoms should I look out for?
If you have been diagnosed with glaucoma and experience a sudden deterioration in vision, contact your eye doctor immediately. You should also seek immediate medical attention if you have any symptoms of acute glaucoma, which include a severe headache, eye pain, blurred vision, red eyes, halos around the eyes, nausea, and vomiting3. If an episode of acute glaucoma is treated early, it is possible to recover some vision. If the symptoms are neglected, this is considered an eyesight-threatening emergency that can lead to irreversible vision loss in a matter of days1.
Can I make any lifestyle changes that prevent glaucoma from getting worse?
Traditionally, it was believed that lifestyle factors did not affect the development of glaucoma. There is some evidence, however, that certain lifestyle choices can influence pressure inside the eyes — increased intraocular pressure is a major risk factor for glaucoma. Nonetheless, there is not enough scientific evidence to make broad recommendations about lifestyle changes in glaucoma patients. You should discuss specific choices with your ophthalmologist to see if they are suitable, complementary additions to your care plan4.
Aerobic exercises — any type of cardio — can help reduce intraocular pressure. Weightlifting and certain yoga positions (head-down positions) may increase IOP. Talk to your doctor about what types of exercises may be suitable for you4.
Playing wind instruments
Playing certain wind instruments, such as the trumpet or the bassoon, may not be recommended for glaucoma patients because this can lead to an increase in eye pressure. It’s a good idea to get approval from your ophthalmologist if you play, or would like to play, a wind instrument.4
Besides the overall negative impact smoking has on your health, smoking cigarettes significantly increases the risk of glaucoma5. If you are a smoker, talk to your GP about services that can help you quit.
Alcohol consumption is possibly linked to a short-lived reduction in eye pressure. However, if you consume alcoholic beverages daily, this may increase your eye pressure. Always drink in moderation and talk to your eye doctor about specific recommendations.
The caffeine in coffee and tea may cause a temporary increase in eye pressure. However, this effect is small and most glaucoma patients can continue to drink these beverages in small amounts. People with glaucoma should spread out their fluid intake throughout the day: it is recommended that they avoid consuming large volumes of drinks in a short duration as this can increase IOP6.
1. Johns Hopkins Medicine Wilmer Eye Institute. (no date). Glaucoma FAQs. [Online].
[Accessed 29 August 2019].
2. Parikh RS, Parikh SR, Navin S, Arun E, Thomas R. Practical approach to medical management of glaucoma. Indian J Ophthalmol. 2008;56(3):223–230. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636120/ [Accessed 29 August 2019].
3. Mayo Clinic. (no date). Glaucoma. [Online]. Available at: https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839 [Accessed 29 August 2019].
4. Glaucoma Research Foundation. (no date). Do Lifestyle Choices Affect Glaucoma. [Online]. Available at: https://www.glaucoma.org/glaucoma/do-lifestyle-choices-affect-glaucoma.php#targetText=Sustained%20lowering%20of%20eye%20pressure,from%20your%20primary%20physician%20first . [Accessed 29 August 2019].
5. Pérez-de-Arcelus M, Toledo E, Martínez-González MÁ, Martín-Calvo N, Fernández-Montero A, Moreno-Montañés J. Smoking and incidence of glaucoma: The SUN Cohort. Medicine (Baltimore). 2017;96(1):e5761. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228680/ [Accessed 29 August 2019].
6. International Glaucoma Association. (no date). Drinking. [Online]. Available at: http://www.glaucoma-association.com/about-glaucoma/living-with-glaucoma/drinking [Accessed 29 August 2019].