7 Signs You’re at High Risk for Glaucoma

Our eye experts reveal how to know if you're at high risk for glaucoma, the second-leading cause of blindness.

Picture waking up one day only to see dark spots that won’t go away. They can start to worsen your vision until you become blind. This is what can happen when you have glaucoma, an eye disease that affects more than three million Americans, according to the Glaucoma Research Foundation. Also, be aware of 11 more signs your eyes could be in danger.

What glaucoma does to your eyes

Glaucoma is a disease that damages the eye’s optic nerve, which connects the eye to your brain, says Davinder Grover, MD, a clinical spokesperson for the American Academy of Ophthalmology (AAO). The disease is usually caused by too much fluid in the front part of your eye. There are two main ways that this can happen. The most common, called primary open-angle glaucoma, is when the fluid inside your eye doesn’t drain properly, like a clogged drain. This increases eye pressure, which harms the nerve. This form of glaucoma is painless and often happens so slowly that you don’t realize it until you have vision loss.

Angle-closure glaucoma is when the iris, or colored part of your eyes, bulges forward to block your eye’s drainage angle. This can happen gradually (chronic) or suddenly (acute). Signs of acute angle-closure glaucoma include severe eye pain, headache, nausea, halos, and sudden blurriness. You should see your eye doctor ASAP.

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Who gets glaucoma

Anyone can develop glaucoma, from babies to adults, says Dr. Grover. But it’s most common in people over age 40.

Glaucoma is the second-leading cause of blindness. But it’s estimated that only half of people who have the disease know that they have it. That’s why it’s important to get regular eye exams. “In the vast majority of cases, there are no symptoms until it’s too late,” says Dr. Grover. “When you lose nerve tissue, you can’t get it back.” That means any vision that you lose because of glaucoma is permanent.

That’s why it’s important to know if you have a greater chance of developing glaucoma. Talk to your eye doctor if you have any of the following risk factors. Also, did you know drinking tea may help prevent glaucoma?

It runs in your family

Your genes can put you at higher risk for the disease. A family history of glaucoma can increase your risk four to nine times, according to a 2017 study published in the Journal of Optometry. That’s even more if it’s a sibling: If you have a brother or sister with the disease, you’re 10 times more likely to develop it yourself according to the Glaucoma Research Foundation. But it not as simple as, say, inheriting hair color from a parent, says Dr. Grover. Glaucoma is likely caused by a series of different genes, along with environmental factors.

You’re over age 60

About 2 to 3 percent of people have glaucoma. “After age 65, the prevalence increases to the 8 percent range,” Dr. Grover says. That’s because, as you age, the fluid in your eye may not drain as well, increasing eye pressure. To make matters worse, your optic nerve may weaken and become more vulnerable. It’s more susceptible to damage caused by that rise in pressure. These two factors can set the stage for glaucoma.

You’re African-, Latino-, or Asian-American

Your ethnic background plays a role in your odds of having glaucoma. About 6.5 percent of Latino-Americans and Asian-Americans over age 40 have glaucoma, according to research published in the journal Ophthalmology. That’s compared to 5.6 percent of Caucasian-Americans. African-Americans are at highest risk; they have a 12 percent chance of developing the disease. In African-Americans, glaucoma often happens at an earlier age, with a greater chance of vision loss, according to the Glaucoma Research Foundation.

You’ve had an eye injury

A poorly timed baseball. Debris from a car accident. Whatever the reason, anything that injures the eye can lead to glaucoma. This is called traumatic glaucoma. It can happen right after the event or years later. If something cuts into your eye, such as flying debris, your eye pressure lessens as it heals. But after the wound is closed, swelling occurs, which raises your risk of glaucoma. “Injury can also dislocate the lens, closing the drainage angle and increasing pressure,” says Barbara L. Horn, president of the American Optometric Association.

Your doctor can prescribe drugs to prevent scarring, or you may need surgery to remove the extra eye fluid or swollen tissue. If you get whacked with something but it doesn’t pierce the eye, this is called blunt trauma. This can damage the part of the eye that makes fluid or clog the eye’s drainage system, causing increased pressure. Your doctor may prescribe glaucoma medications to lessen the pressure. If severe cases, you may need surgery.

You take or have taken corticosteroids for an extended period

Corticosteroids are the most common drugs linked to glaucoma. They’re taken for a variety of conditions, including arthritis, asthma, and sinus issues. “If you think of the eye as a faucet with a drain, there’s mesh on top of your pipes,” Dr. Grover says. Experts think that, over time, steroid use clogs up the mesh and makes it less permeable. This leads to fluid buildup and pressure in the eye, he says. A short dose of steroids likely won’t raise your risk; taking corticosteroids regularly over a long stretch can raise your risk.

You’re farsighted or very nearsighted

Need glasses to see clearly? There’s a chance you may be at greater risk for glaucoma. If you’re far-sighted, that means your eye is smaller than average, says Dr. Grover. This may mean the drainage system for your eye is more crowded, which may set the stage for angle-closure glaucoma. If you’re very near-sighted, your eye is longer than normal. “We don’t fully understand the underlying mechanism, but this puts you a higher risk of having open-angle glaucoma,” he says. This applies to extreme near-sightedness, says Dr. Grover. Your vision’s so blurry that you’d have trouble making your way out of your house on your own. If you think you need reading glasses, look for these 7 sneaky signs.

You have high or low blood pressure, diabetes, or heart disease

These conditions affect your blood flow, which can impair the amount of oxygen that reaches the eye and cause damage, says Dr. Grover. In poorly controlled cases, these diseases can harm microscopic blood vessels, triggering the growth of more blood vessels. “But they’re kind of like ivy,” says Dr. Grover. “The overgrowth mucks up your drain.” Also, low blood pressure can raise glaucoma risk, according to a study published in BioMed Research International. That’s because “blood has difficulty getting into the eye to supply oxygen and important nutrients, and to remove waste products,” says Horn.

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Diagnosis and treatment

A complete eye exam is needed to diagnose glaucoma, according to the American Academy of Ophthalmology. That’s when your doctor measures your eye pressure and the thickness of your cornea. He or she also looks at your drainage angle, optic nerve, and side vision.

Everyone should get a comprehensive eye exam starting at age 40, although you may need to get one earlier if you have one or more risk factors. After the exam, your doctor will tell you how often you’ll need to get screened. People age 65 and above should get an exam every year or two.

Screening is crucial because “when caught early on and with proper treatment, we can prevent vision loss in 90 to 95 percent of cases,” says Dr. Grover. In most cases, glaucoma is treated with eye drop medicine that lowers the pressure in the eye.

In some cases, surgery is needed. It can be done by laser or in an operating room. In laser surgery, a trabeculoplasty helps those with open-angle glaucoma. It makes the drainage angle work better. For those with angle-closure glaucoma, an ophthalmologist can make a tiny hole in the iris to help drain the fluid. This is called an iridotomy.

Your doctor may also decide to perform surgery to create a new drainage channel for the fluid. In a trabeculectomy, the surgeon creates a tiny flap for drainage. Or, he or she may implant a tube that helps release the fluid.

Remember, an eye exam reveals a lot about your health. That’s why it’s important to visit an eye care professional to optimize your vision. Take a look at the AAO’s website to see their guidelines on eye exams for each age group and those with underlying conditions. Next, read about the easy ways to improve your vision.

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