This section  is for  people with glaucoma and their families and friends. It provides  information about open-angle glaucoma, the most common form of glaucoma.  This booklet answers questions about the cause and symptoms of the  disease and discusses diagnosis and types of treatment.  This  information was obtained from the NEI website

The National Eye Institute (NEI) conducts  and supports research that leads to sight-saving treatments and plays a  key role in reducing visual impairment and blindness. The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services.

What is glaucoma?  

Glaucoma is a group of diseases that  can damage the eye's optic nerve and result in vision loss and  blindness. However, with early treatment, you can often protect your  eyes against serious vision loss.

What is the optic nerve?  

The optic nerve is a bundle of more than 1 million nerve fibers. It connects the retina to the brain. (See diagram below.) The retina is the light-sensitive tissue at the back of the eye. A healthy optic nerve is necessary for good vision.

How does open-angle glaucoma damage the optic nerve?  

In the front of the eye is a  space called the anterior chamber. A clear fluid flows continuously in  and out of the chamber and nourishes nearby tissues. The fluid leaves  the chamber at the open angle where the cornea and iris meet. (See diagram below.) When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

Sometimes, when the fluid reaches the  angle, it passes too slowly through the meshwork drain. As the fluid  builds up, the pressure inside the eye rises to a level that may damage  the optic nerve. When the optic nerve is damaged from increased  pressure, open-angle glaucoma--and vision loss--may result. That's why  controlling pressure inside the eye is important.

Does increased eye pressure mean that I have glaucoma?  

Not necessarily. Increased eye pressure  means you are at risk for glaucoma, but does not mean you have the  disease. A person has glaucoma only if the optic nerve is damaged. If  you have increased eye pressure but no damage to the optic nerve, you do  not have glaucoma. However, you are at risk. Follow the advice of your  eye care professional.

Can I develop glaucoma if I have increased eye pressure?  

Not necessarily. Not every person with  increased eye pressure will develop glaucoma. Some people can tolerate  higher eye pressure better than others. Also, a certain level of eye  pressure may be high for one person but normal for another.

Whether you develop glaucoma depends on  the level of pressure your optic nerve can tolerate without being  damaged. This level is different for each person. That's why a  comprehensive dilated eye exam is very important. It can help your eye  care professional determine what level of eye pressure is normal for  you.

Can I develop glaucoma without an increase in my eye pressure?  

Yes. Glaucoma can develop without increased eye pressure. This form of glaucoma is called low-tension or normal-tension glaucoma. It is not as common as open-angle glaucoma.

Who is at risk for open-angle glaucoma?  

Anyone can develop glaucoma. Some people are at higher risk than others. They include:

  • African Americans over age 40.  
  • Everyone over age 60, especially Mexican Americans.  
  • People with a family history of glaucoma. 

A comprehensive dilated eye exam can  reveal more risk factors, such as high eye pressure, thinness of the  cornea, and abnormal optic nerve anatomy. In some people with certain  combinations of these high-risk factors, medicines in the form of  eyedrops reduce the risk of developing glaucoma by about half.

What are the symptoms of glaucoma?  

At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal.

As glaucoma remains untreated, people  may miss objects to the side and out of the corner of their eye. Without  treatment, people with glaucoma will slowly lose their peripheral  (side) vision. They seem to be looking through a tunnel. Over time,  straight-ahead vision may decrease until no vision remains.

Glaucoma can develop in one or both eyes.

Normal vision 

Same scene as viewed by a person with glaucoma 

How is glaucoma detected?  

Glaucoma is detected through a comprehensive eye exam that includes:

Visual acuity test. This eye chart test measures how well you see at various distances.


A tonometer measures pressure inside the eye to detect glaucoma. 

Visual field test. This  test measures your side (peripheral) vision. It helps your eye care  professional tell if you have lost side vision, a sign of glaucoma.

Dilated eye exam. Drops  are placed in your eyes to widen, or dilate, the pupils. Your eye care  professional uses a special magnifying lens to examine your retina and  optic nerve for signs of damage and other eye problems. After the exam,  your close-up vision may remain blurred for several hours.

Tonometry. An instrument (right) measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Pachymetry. A numbing drop  is applied to your eye. Your eye care professional uses an ultrasonic  wave instrument to measure the thickness of your cornea.

Can glaucoma be cured? No. There is no cure for glaucoma. Vision lost from the disease cannot be restored.  

Can glaucoma be treated?  

Yes. Immediate treatment for early  stage, open-angle glaucoma can delay progression of the disease. That's  why early diagnosis is very important.

Glaucoma treatments include medicines,  laser trabeculoplasty, conventional surgery, or a combination of any of  these. While these treatments may save remaining vision, they do not  improve sight already lost from glaucoma.

Medicines. Medicines, in  the form of eyedrops or pills, are the most common early treatment for  glaucoma. Some medicines cause the eye to make less fluid. Others lower  pressure by helping fluid drain from the eye.

Before you begin glaucoma treatment,  tell your eye care professional about other medicines you may be taking.  Sometimes the drops can interfere with the way other medicines work.

Glaucoma medicines may be taken several  times a day. Most people have no problems. However, some medicines can  cause headaches or other side effects. For example, drops may cause  stinging, burning, and redness in the eyes.

Many drugs are available to treat  glaucoma. If you have problems with one medicine, tell your eye care  professional. Treatment with a different dose or a new drug may be  possible.

Because glaucoma often has no symptoms,  people may be tempted to stop taking, or may forget to take, their  medicine. You need to use the drops or pills as long as they help  control your eye pressure. Regular use is very important.

Make sure your eye care professional shows you how to put the drops into your eye. See tips on using your glaucoma eyedrops.

Laser trabeculoplasty.  Laser trabeculoplasty helps fluid drain out of the eye. Your doctor may  suggest this step at any time. In many cases, you need to keep taking  glaucoma drugs after this procedure.

Laser trabeculoplasty is performed in  your doctor's office or eye clinic. Before the surgery, numbing drops  will be applied to your eye. As you sit facing the laser machine, your  doctor will hold a special lens to your eye. A high-intensity beam of  light is aimed at the lens and reflected onto the meshwork inside your  eye. You may see flashes of bright green or red light. The laser makes  several evenly spaced burns that stretch the drainage holes in the  meshwork. This allows the fluid to drain better.

Like any surgery, laser surgery can  cause side effects, such as inflammation. Your doctor may give you some  drops to take home for any soreness or inflammation inside the eye. You  need to make several followup visits to have your eye pressure  monitored.

If you have glaucoma in both eyes, only  one eye will be treated at a time. Laser treatments for each eye will  be scheduled several days to several weeks apart.

Studies show that laser surgery is very  good at reducing the pressure in some patients. However, its effects  can wear off over time. Your doctor may suggest further treatment.

Conventional surgery. Conventional surgery makes a new opening for the fluid to leave the eye. (See diagram.)  Your doctor may suggest this treatment at any time. Conventional  surgery often is done after medicines and laser surgery have failed to  control pressure.

Conventional surgery is performed in an  eye clinic or hospital. Before the surgery, you will be given medicine  to help you relax. Your doctor will make small injections around the eye  to numb it. A small piece of tissue is removed to create a new channel  for the fluid to drain from the eye.

For several weeks after the surgery,  you must put drops in the eye to fight infection and inflammation. These  drops will be different from those you may have been using before  surgery.

As with laser surgery, conventional  surgery is performed on one eye at a time. Usually the operations are  four to six weeks apart.

Conventional surgery is about 60 to 80  percent effective at lowering eye pressure. If the new drainage opening  narrows, a second operation may be needed. Conventional surgery works  best if you have not had previous eye surgery, such as a cataract  operation.

In some instances, your vision may not  be as good as it was before conventional surgery. Conventional surgery  can cause side effects, including cataract, problems with the cornea,  and inflammation or infection inside the eye. The buildup of fluid in  the back of the eye may cause some patients to see shadows in their  vision. If you have any of these problems, tell your doctor so a  treatment plan can be developed.

Conventional surgery makes a new opening for the fluid to leave the eye. 

What are some other forms of glaucoma?  

Open-angle glaucoma is the most common form. Some people have other types of the disease.

In low-tension or normal-tension glaucoma,  optic nerve damage and narrowed side vision occur in people with normal  eye pressure. Lowering eye pressure at least 30 percent through  medicines slows the disease in some people. Glaucoma may worsen in  others despite low pressures.

A comprehensive medical history is  important in identifying other potential risk factors, such as low blood  pressure, that contribute to low-tension glaucoma. If no risk factors  are identified, the treatment options for low-tension glaucoma are the  same as for open-angle glaucoma.

In angle-closure glaucoma, the  fluid at the front of the eye cannot reach the angle and leave the eye.  The angle gets blocked by part of the iris. People with this type of  glaucoma have a sudden increase in eye pressure. Symptoms include severe  pain and nausea, as well as redness of the eye and blurred vision. If  you have these symptoms, you need to seek treatment immediately. This is a medical emergency.  If your doctor is unavailable, go to the nearest hospital or clinic.  Without treatment to improve the flow of fluid, the eye can become blind  in as few as one or two days. Usually, prompt laser surgery and  medicines can clear the blockage and protect sight.

In congenital glaucoma, children  are born with a defect in the angle of the eye that slows the normal  drainage of fluid. These children usually have obvious symptoms, such as  cloudy eyes, sensitivity to light, and excessive tearing. Conventional  surgery typically is the suggested treatment, because medicines may have  unknown effects in infants and be difficult to administer. Surgery is  safe and effective. If surgery is done promptly, these children usually  have an excellent chance of having good vision.

Secondary glaucomas can  develop as complications of other medical conditions. These types of  glaucomas are sometimes associated with eye surgery or advanced  cataracts, eye injuries, certain eye tumors, or uveitis (eye  inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma,  is linked to diabetes. Corticosteroid drugs used to treat eye  inflammations and other diseases can trigger glaucoma in some people.  Treatment includes medicines, laser surgery, or conventional surgery.

What can I do if I already have lost some vision from glaucoma?  

If you have lost some sight from  glaucoma, ask your eye care professional about low vision services and  devices that may help you make the most of your remaining vision. Ask  for a referral to a specialist in low vision. Many community  organizations and agencies offer information about low vision  counseling, training, and other special services for people with visual  impairments. A nearby school of medicine or optometry may provide low  vision services.

What research is being done?  

Through studies in the laboratory and  with patients, the National Eye Institute is seeking better ways to  detect, treat, and prevent vision loss in people with glaucoma. For  example, researchers have discovered genes that could help explain how  glaucoma damages the eye.

The NEI also is supporting studies to  learn more about who is likely to get glaucoma, when to treat people  with increased pressure, and which treatment to use first.

What can I do to protect my vision?  

If you are being treated for glaucoma,  be sure to take your glaucoma medicine every day. See your eye care  professional regularly.

You also can help protect the vision of  family members and friends who may be at high risk for  glaucoma--African Americans over age 40; everyone over age 60,  especially Mexican Americans; and people with a family history of the  disease. Encourage them to have a comprehensive dilated eye exam at  least once every two years. Remember: Lowering eye pressure in  glaucoma's early stages slows progression of the disease and helps save  vision.

Medicare covers an annual comprehensive  dilated eye exam for some people at high risk for glaucoma. These  people include those with diabetes, those with a family history of  glaucoma, and African Americans age 50 and older.

What should I ask my eye care professional?  

You can protect yourself against vision  loss by working in partnership with your eye care professional. Ask  questions and get the information you need to take care of yourself and  your family.

What are some questions to ask?

About my eye disease or disorder

  • What is my diagnosis? 
  • What caused my condition? 
  • Can my condition be treated?  
  • How will this condition affect my vision now and in the future?  
  • Should I watch for any particular symptoms and notify you if they occur?  
  • Should I make any lifestyle changes? 

About my treatment

  • What is the treatment for my condition?  
  • When will the treatment start and how long will it last?  
  • What are the benefits of this treatment and how successful is it?  
  • What are the risks and side effects associated with this treatment?  
  • Are there foods, drugs, or activities I should avoid while I'm on this treatment?  
  • If my treatment includes taking medicine, what should I do if I miss a dose?  
  • Are other treatments available? 

About my tests...

  • What kinds of tests will I have?  
  • What can I expect to find out from these tests?  
  • When will I know the results?  
  • Do I have to do anything special to prepare for any of the tests?  
  • Do these tests have any side effects or risks?  
  • Will I need more tests later? 

Other suggestions

  • If you don't understand your eye care professional's responses, ask questions until you do understand.  
  • Take notes or get a friend  or family member to take notes for you. Or, bring a tape recorder to  help you remember the discussion.  
  • Ask your eye care professional to write down his or her instructions to you.  
  • Ask your eye care professional for printed material about your condition.  
  • If you still have trouble understanding your eye care professional's answers, ask where you can go for more information.  
  • Other members of your health care team, such as nurses and pharmacists, can be good sources of information. Talk to them, too. 

Today, patients take an active role in their health care. Be an active patient about your eye care.

Where can I get more information?      

For more information about age-related macular degeneration, you may wish to contact:

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD 20871
(301) 948-3244

Children's Glaucoma Foundation (CGF)
2 Longfellow Place, Suite 201
Boston, MA 02114
(617) 227-3011

EyeCare America

(The) Glaucoma Foundation
116 John Street, Suite 1605
New York, NY 10038
(212) 285-0080

Glaucoma Research Foundation
490 Post Street, Suite 1427
San Francisco, CA 94102
(415) 986-3162

National Eye Institute (NEI)
31 Center Drive MSC 2510
Bethesda, MD 20892-2510
(301) 496-5248

For more information about low vision services and programs, you may wish to contact:

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
(415) 561-8500

American Association of the Deaf-Blind (AADB)
814 Thayer Avenue, Suite 302
Silver Spring, MD 20910-4500
(301) 495-4403
(301) 495-4402--TTY

American Council of the Blind
1155 15th Street, NW, Suite 1004
Washington, DC 20005
(202) 467-5081

American Foundation for the Blind
11 Penn Plaza, Suite 300
New York, NY 10001
(212) 502-7600

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD 20871
(301) 948-3244

American Printing House for the Blind
1839 Frankfort Avenue
P.O. Box 6085
Louisville, KY 40206-0085
(502) 895-2405

Associated Services for the Blind
919 Walnut Street, 2nd Floor
Philadelphia, PA 19107
(215) 627-0600

Association for Education and Rehabilitation of the Blind and Visually Impaired
1703 N. Beauregard Street, Suite 440
Alexandria, VA 22311
(703) 671-4500

Association for Retinopathy of Prematurity and Related Diseases (ROPARD)
P.O. Box 250425
Franklin, MI 48025

Blinded Veterans Association
477 H Street, NW
Washington, DC 20001
(202) 371-8880

Braille Circulating Library, Inc.
2700 Stuart Avenue
Richmond, VA 23220
(804) 359-3743
(804) 359-3771

Choice Magazine Listening
85 Channel Drive
Port Washington, NY 11050
(516) 883-8280

Christian Record Services, Inc.
4444 South 52nd Street
Lincoln, NE 68516
(402) 488-0981

Council of Citizens with Low Vision International
1859 N. Washington Avenue, Suite 2000
Clearwater, FL 33755-1862
(727) 443-0350

DB-LINK: National Information Clearinghouse on Children Who are Deaf-Blind
345 N. Monmouth Avenue
Monmouth, OR 97361

Guide Dogs for the Blind
P.O. Box 151200
San Rafael, CA 94915-1200

(The) Hadley School for the Blind
700 Elm Street
Winnetka, IL 60093
(847) 446-8111

Helen Keller National Center for Deaf-Blind Youths & Adults (HKNC)
111 Middle Neck Road
Sands Point, NY 11050
(516) 944-8900

Independent Living Services for Older Individuals Who Are Blind
U.S. Department of Education, OSERS
400 Maryland Avenue, SW, Room 3326, MES
Washington, DC 20202-2741
(202) 205-9362

Jewish Braille Institute of America
110 E. 30th Street
New York, NY 10016
(212) 889-2525

(The) Jewish Guild for the Blind
15 West 65th Street
New York, NY 10023
(212) 769-6200

Lighthouse International
111 E. 59th Street
New York, NY 10022
(212) 821-9200
(212) 821-9713 (TDD)

Low Vision Gateway

National Association for Parents of Children with Visual Impairments
P.O. Box 317
Watertown, MA 02471
(617) 972-7441

National Association for Visually Handicapped
22 W. 21st Street, 6th Floor
New York, NY 10010
(212) 889-3141
(212) 255-2804

National Family Association for Deaf-Blind (NFADB)
111 Middle Neck Road
Sands Point, NY 11050

National Federation of the Blind
1800 Johnson Street
Baltimore, MD 21230
(410) 659-9314

National Library Service for Blind and Physically Handicapped
Library of Congress
Washington, DC 20542
(202) 707-5100
(202) 707-0744 (TDD)

Recording for the Blind and Dyslexic - Headquarters
20 Roszel Road
Princeton, NJ 08540
(609) 520-8031

Resources for Rehabilitation
22 Bonad Road
Winchester, MA 01890

Talking Tapes/Textbooks for the Blind
16 Sunnen Drive, Suite 162
St. Louis, MO 63143-3800
(314) 646-0500

VISIONS/Services for the Blind and Visually Impaired
500 Greenwich Street, 3rd Floor
New York, NY 10013-1354
(212) 625-1616

Xavier Society for the Blind
154 E. 23rd Street
New York, NY 10010-4595
(212) 473-7800

* These organizations also provide information on low vision.

   How should I use my glaucoma eyedrops?  

If eyedrops have been prescribed for  treating your glaucoma, you need to use them properly and as instructed  by your eye care professional. Proper use of your glaucoma medication  can improve the medicine's effectiveness and reduce your risk of side  effects.

To properly apply your eyedrops, follow these steps:

  • First, wash your hands.  
  • Hold the bottle upside down.  
  • Tilt your head back.  
  • Hold the bottle in one hand and place it as close as possible to the eye.  
  • With the other hand, pull down your lower eyelid. This forms a pocket.  
  • Place the prescribed number  of drops into the lower eyelid pocket. If you are using more than one  eyedrop, be sure to wait at least five minutes before applying the  second eyedrop.  
  • Close your eye OR press the  lower lid lightly with your finger for at least one minute. Either of  these steps keeps the drops in the eye and helps prevent the drops from  draining into the tear duct, which can increase your risk of side  effects.