Ask An Expert: How Do I Know If I Have Glaucoma?

Scientifically reviewed by Preeti Subramanian, PhD, BrightFocus Foundation  

Protecting your eyes is one of the main actions you can take to prioritize your health as you age. Some eye diseases, like glaucoma, can sneak up on you when you least expect it.  

Nearly 80 million people are living with glaucoma—the leading cause of irreversible blindness worldwide. Half of them may not even know it because glaucoma usually has no noticeable symptoms in its early stages. 

We sat down with glaucoma expert Dr. Constance Okeke, MD, MSCE, to discuss risk factors, symptoms, and treatment options. Check out our conversation below.  

Q: How can I tell if I have glaucoma? 

A: The reality is that in the early and moderate stages, it's not easy to tell that someone has glaucoma. That's the part of glaucoma that we call “sneaky.” We call it the sneak thief of sight because it's very gradual.

There are different types of glaucoma, but the most common form is typically something that is going to happen in a gradual way where you're not really noticing the damage that's being done. There might be small blind spots that are present but fused together when both eyes are open. It’s not until you get into the more advanced stages that you notice that you've had some vision loss.

There are multiple types of glaucoma, including open-angle glaucoma and narrow-angle glaucoma. Narrow-angle glaucoma is not as common in the United States — it's more common in Asian populations. But there are sometimes more symptoms with that, where you can get sudden eye pain, pressure loss, hazy vision, and redness in the eye. Those are signs that would acutely tell you that you need to get your eyes examined right away. But again, by far the more common glaucoma that's present in the U.S., open-angle glaucoma, is very asymptomatic in its early stages. 

Q: How can I find out if I have glaucoma or am at risk of developing it? 

A: There is a great screening tool. It's not specific for glaucoma, but it's a quick tool that one can do at home very easily. It's called the cover-uncover test. It's not uncommon for someone to have advanced glaucoma and not realize it. They come into the office, and we have them cover one eye and look at a chart and read it, then cover the other eye and have them look at it and read it. What you're doing with this cover-uncover test is looking for some type of asymmetry or difference between the two eyes.

It's important to shape your hand so you're cupping it, not pressing on the eye but covering it completely. Then, with one eye, you're going to look out and see if everything looks pretty normal. Then you're going to do the same thing and cover the first initial eye, and now, with the second eye, you're going to look to see if there's anything that looks different.

Now, if you start to say, “Wow, I'm not seeing as well out of this eye as I am out of this eye,” then that is a big sign that you need to get your eyes examined. Again, it's not necessarily specific for glaucoma. It could be, but it could also be some other eye conditions that can potentially be treatable, so you want to get your eyes checked.  

It's also important to know that when it comes to glaucoma, several different people are at higher risk. The only way you can be diagnosed with glaucoma is by having someone look inside your eye and assess for signs of glaucoma by changes in a structure in your eye called the optic nerve. They will also do certain types of diagnostic tests that are common for being able to diagnose glaucoma.  

If you have a family history (blood relative) of glaucoma, you are at a higher risk for developing it. If you are elderly, as you age, you have more risk of developing glaucoma. So, if you're in your 60s and above, you should start thinking about getting your eyes checked annually. If you are of African descent or Hispanic descent, those populations tend to get open-angle glaucoma more commonly. They also tend to get glaucoma at earlier ages, and it tends to be more aggressive. 

It's important to get regular screening exams, meaning going to an eye doctor and being evaluated to see if there are signs of glaucoma.  

Q: Is there a cure for glaucoma?  

A: Right now, we don't have a cure. The good news is that we have good treatments that help slow the process of glaucoma damage down quite significantly. Also, innovations are happening all the time for different treatment methods, whether with medications, light energy, laser treatments, or certain types of surgery. We have a whole class of what we call minimally invasive glaucoma surgery that is effective and has a high safety profile.  

The exciting thing is that there are a lot of innovations on the horizon. But, in the meantime, we have treatments that help to lower eye pressure. You should get assessed by an eye care provider that you trust to determine whether it's present, and if it is present, you need to have chronic continued care. Glaucoma doesn't go away, even if you're treated adequately. You still need to be monitored because things can change, and you need to ensure that things are stable and protect your vision. 

Dr. Okeke is an Ivy League-trained, board-certified ophthalmologist specializing in glaucoma and cataract surgery. Listen to a conversation with Dr. Okeke about tips for taking charge of your glaucoma diagnosis, part of our Glaucoma Chats audio series. 

You may also be interested in: 

• The Glaucoma Eye Exam: 6 Common Tests 

• Lifestyle Changes for Glaucoma Patients 

About BrightFocus Foundation

BrightFocus Foundation is a premier global nonprofit funder of research to defeat Alzheimer’s, macular degeneration, and glaucoma. Through its flagship research programs — Alzheimer’s Disease Research, National Glaucoma Research, and Macular Degeneration Research — the Foundation has awarded nearly $290 million in groundbreaking research funding over the past 50 years and shares the latest research findings, expert information, and resources to empower the millions impacted by these devastating diseases. Learn more at brightfocus.org.   

The information provided in this section is a public service of BrightFocus Foundation, should not in any way substitute for the advice of a qualified healthcare professional, and is not intended to constitute medical advice. Although we make efforts to keep the medical information on our website updated, we cannot guarantee that the information on our website reflects the most up-to-date research.     

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