GLAUCOMA SIGNS AND SYMPTOMSGlaucoma is a silent thief of vision. But it doesn't have to steal YOUR vision. Here are signs and symptoms associated with the disease. People that are experiencing minor problems with their eyes, such as itching, excessive tear production, or feeling a popping sensation when rubbing their eyes,  often come to my office with concerns that these might be signs and symptoms of something more serious, such as glaucoma.To clear up any confusion, itching and tear production are more commonly caused by allergies or irritants in the atmosphere. The popping you feel sometimes when you rub your eyes is simply a normal redistribution of air in the eye socket. This example raises some interesting questions. What are important signs and symptoms of glaucoma? What does glaucoma feel like?
In most cases, patients that I see in my office know little or nothing about glaucoma. Among those that have some familiarity, they believe that a glaucoma diagnosis means that they are doomed to go blind. Glaucoma can lead to blindness if it is left undetected or if the patient fails to adhere to treatments prescribed by their ophthalmologist. But trust me. A glaucoma diagnosis does NOT have to lead to blindness in your particular case. With the proper treatment, you can control the progression of the disease. There is hope. It is very important that everyone understands this.
Many serious diseases are associated with noticeable signs and symptoms. For example, a symptom of tuberculosis is a persistent cough with bloody sputum (mucous). Most people know that coughing up blood is very serious and usually visit a doctor to find out what's wrong. There are other diseases, such as lung cancer, that also have persistent cough with bloody phlegm (sputum) as a symptom. The average person cannot distinguish between tuberculosis and lung cancer, or other potential problems. It is your doctor's job to differentiate among the various possibilities, arrive at a specific diagnosis, and develop a treatment plan. Diagnosing a medical problem is not your responsibility and you should not attempt it. A lot of unnecessary pain and suffering could be avoided, in addition to money saved, if patients did not attempt to engage in a process of
self-diagnosis.
Signs and symptoms of glaucoma can be organized into three categories: those that a patient notices, those that an ophthalmologist measures, and problems that often are misunderstood as signs and symptoms of glaucoma. Signs and symptoms that you may notice (usually at advanced stages of the disease)
Signs and symptoms that an ophthalmologist measures
EVALUATING SIGNS AND SYMPTOMS OF GLAUCOMA I had a frustrating experience with a patient a couple of years ago that illustrates how patients can misinterpret symptoms. A woman in her early fifties had come to my office complaining of itching and redness in her eyes. These symptoms are most commonly associated with allergies, conjuntivitis, and dry eye syndrome. I asked if she had a history of allergies. She said that she had a long history. “I seem to be allergic to every airborne thing they test for,” she remarked. “Perhaps I'm allergic to air itself!” We both laughed. I then asked if she was taking any medications. She removed a small bottle of eye drops from her purse and handed it to me. “I used to take pills every day, but this stuff works just as well, at least for my eyes.” I looked at the bottle and recognized it as a medication normally requiring a doctor's prescription. “Did your doctor prescribe this for you?” I asked. She told me that she had stopped seeing her doctor more than a year ago. “A friend told me about the eye drops and how to buy them online,” she said. “I've been taking them regularly for about a year and they've worked fine. But right now seems to be a really bad time for allergies. I was wondering if you could give me something to supplement the drops when I'm having bad attacks?” I informed her that I needed to perform an examination and that afterward we could discuss treatment options. She did not like this very much, but reluctantly agreed. My examination indicated that she indeed was suffering from allergies. However, it also revealed a disturbingly high intraocular pressure (pressure inside the eye) and abnormal changes in the appearance of her optic nerves. I explained that she was showing signs and symptoms of glaucoma and that they probably were linked to the eye drops that she had been taking, which contained steroids. “There is a type of glaucoma that is caused by the chronic use of steroids,” I said. “In fact, it is called
steroid glaucoma.”
I responded by saying that it actually was good that she let me perform the examination because it had revealed two of the primary signs and symptoms of glaucoma: increased intraocular pressure and damage to the optic nerve. I told her that it was essential that she stop using the eye drops in her purse immediately because the steroids in them were increasing the pressure in her eye to dangerous levels, which in turn was causing damage to her optic nerves. “I will prescribe a different eye drop for you that will help to lower the pressure in your eye along with something to help relieve your allergies,” I said. “But it's important that you follow my instructions. We need to protect your eyesight.” Unfortunately, my efforts to help her were in vain. She did not believe me, largely because she already had self-diagnosed her problem. Additionally, in her mind she equated glaucoma with blindness. Since she had not noticed any changes in her vision, she was unable to accept my diagnosis. I urged her to seek a second opinion, indicating that I would provide her with the names and phone numbers of other ophthalmologists in the area. She refused this advice, indicated that she would not be paying for the visit, and stormed out of my office. I never saw her again.
Although she still will be able to get help to prevent further vision loss, damage to the optic nerve is not reversible. She will not be able to regain the vision that she has lost. Every physician has at least one story like this. Some have many. They all are very sad. In the case of my patient, her glaucoma was preventable. It started when she decided to self-medicate with eye drops containing a steroid. If she had visited a physician for her problem instead of obtaining medication through the Internet, the steroid glaucoma would not have happened. Why? No responsible physician would ever have prescribed the medication at the dosage, frequency, and length of time that she had taken it. (Remember, she self-diagnosed her problem and obtained medication from the Internet to treat it.) Subsequent vision loss from her glaucoma also could be prevented by her paying attention to my advice to stop taking the steroid medication and adhering to a glaucoma treatment regimen that I prescribed. Unfortunately, she was not ready to do this. Let's hope that she took my final piece of advice to seek a second opinion and listened to the recommendations of that physician. If you are a woman fifty years of age or older and would like to avoid some of the errors of judgment that this woman made, I recommend Healthy Aging For Women Baby Boomers. This website offers simple no-nonsense advice on how your body changes as it ages and how to cope with these changes.
In most cases, people are unable to perceive changes in the pressure inside their eyes. This is because elevations in intraocular pressure tend to occur gradually, ranging from a period of several months to several years. The body adapts and the increased pressures are not felt. Only your eye-care professional can detect elevations in intraocular pressure using a tonometer test. For this reason, it is important to see your eye-care professional regularly. There is a type of glaucoma called
primary angle-closure glaucoma (PACG)
in which high pressures inside the eye are felt. This is because it increases rapidly, often resulting in intense pain. When this happens, it is a medical emergency.
No. This is why glaucoma is called a silent thief of sight. There are certain types of glaucoma where pain or discomfort is experienced. However, the location of the pain is not the optic nerve.
Remember. Glaucoma is a stealth destroyer of vision. In many cases, there are no signs and symptoms that are recognizable to individuals in their every day lives. Instead, glaucoma silently and slowly causes damage to the optic nerve fibers until that damage becomes so severe that it causes vision loss. I understand that, like my patient, it is difficult to accept that you have a serious eye disease when your vision is good and you have no other obvious signs and symptoms. But please recognize that this is precisely the reason why glaucoma is a leading cause of blindness worldwide. Make sure that you protect your vision. Visit your ophthalmologist regularly, especially if you are a member of one or more of the risk groups. Listen to your doctor if he or she diagnoses you with glaucoma. Express your doubts and concerns openly, but also pay attention to what your doctor is saying. Most important, follow the treatment regimen that your doctor prescribes for you. A number of visitors have written to me asking for recommendations pertaining to eye-care products and books for obtaining more information. I have joined with Amazon.com to create a dependable resource for books and products. You can find these materials at the Eye-Care Store.
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There were elevated levels of pollen in the air and several other patients had complained of similar symptoms, so I was leaning in the direction of allergies.
If this woman continues to use the eye drops containing steroids, her glaucoma will worsen until she finally does recognize that her vision is deteriorating. But by this time, it will be in a more advanced stage. 
What does intraocular pressure feel like?
