Glaucoma is a broad term that refers to a group of eye conditions that damage the optic nerve, which is vital for good vision. Once you receive a glaucoma diagnosis, your doctor will determine if it’s primary or secondary glaucoma and whether it’s open-angle or angle-closure glaucoma. Understanding the different types of glaucoma, including what kinds fall under secondary glaucoma, will help you better understand your diagnosis or that of a loved one.*

What is secondary glaucoma?

Unlike primary glaucoma, secondary glaucoma has known underlying causes, which include:

• Injury
• Inflammation
• Certain drugs
• Advanced cases of cataract or diabetes

Like primary glaucoma, treatment options are similar and typically include eye drops, laser treatment, or surgery.  

What are the two forms of secondary glaucoma? 

• Secondary open-angle glaucoma happens when the eye’s drainage angle (between the iris and the cornea) has an “open” configuration.

• Secondary angle-closure glaucoma occurs when the eye’s angle between the iris and the cornea is narrow or closed by an identifiable cause.

What are the common types of secondary open-angle glaucoma? 

Steroid-induced glaucoma

This type of glaucoma occurs most often after using steroid eye drops, but it may also occur from:

• Steroids injected on the skin around the eye
• Steroids injected into the eye
• Oral steroids
• Inhaled steroids
• Intravenous steroids

When and if possible, your doctor may try to discontinue steroids and use a non-steroidal anti-inflammatory medication instead. Sometimes, and in some people, however, steroids are a necessary treatment option.

Pigmentary glaucoma 

Pigmentary glaucoma is caused by the release of pigment from the colored part of the eye, also known as the iris. The pigment may deposit into the cornea, lens, and other parts of the eye. A common risk factor is nearsightedness (myopia).  

Pseudoexfoliation glaucoma 

Pseudoexfoliation glaucoma occurs when flakes of material build upon or within the eye—primarily in front of the eye. When the eye’s drainage system clogs up with flaky pseudoexfoliative material, eye pressure increases, which can damage the optic nerve. 

What are the common types of secondary angle-closure glaucoma?

Neovascular glaucoma

This kind of glaucoma happens when abnormal new blood vessels grow on the iris and over the front of the eye. It commonly occurs with diabetic retinopathy or after a retinal vessel occlusion, which is a blockage of the small veins that carry blood from the retina. For those with diabetic retinopathy, neovascular glaucoma may be treated by improving your diabetes care.

Uveitic glaucoma

Uveitic glaucoma can be open-angle glaucoma, angle-closure glaucoma, or both. Common causes of this type of glaucoma include:

• Eye injuries
• Medications (including steroids)
• Autoimmune disorders

With uveitic glaucoma, inflammation within the eye leads to scarring and poor blood flow. As inflammation and scarring persist, the angle between the iris and cornea may close leading to angle-closure glaucoma. 

Additional information on secondary glaucoma can be found on the BrightFocus Foundation and Glaucoma Research Foundation websites.

*Ou, Y. (2020, Jan. 3). Secondary Glaucoma. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/secondary-glaucoma