When you first receive a glaucoma diagnosis, you’re bound to have a lot of questions about what you can expect going forward, regarding both vision changes and care. Glaucoma specialist Yvonne Ou, MD, of the University of California, San Francisco, UCSF Medical Center, addresses some of the most common questions patients ask upon learning they have glaucoma.*

What does it mean to have glaucoma?

Glaucoma is a group of diseases in which the optic nerve—a bundle of fibers connecting the eye and the brain—is damaged and deteriorates over time. The optic nerve connects the eye to the brain. Glaucoma generally causes peripheral (side) vision loss first, and only in the late stages is central vision affected. Patients often don’t notice the side vision loss for some time. Early vision loss can be mild, and the unaffected, or less-affected, eye usually compensates for the other one.

What are the different types of glaucoma?

While there are several types of glaucoma, the two most common forms are open-angle glaucoma (OAG) and angle-closure glaucoma (ACG). The primary risk factor for both is elevated internal eye pressure, also known as intraocular pressure (IOP). 

The type and stage of your glaucoma will determine what kind of treatment your doctor prescribes. The main goals of treatment are to:

• Lower your eye pressure 
• Halt or at least delay further degeneration of the optic nerve 
• Preserve your remaining vision

What are my treatment options?

Current treatments for glaucoma include medication, laser therapy, and surgery. 

Medication

Glaucoma medication generally comes in the form of eye drops. You will need to administer them regularly and on-time for the rest of your life for them to be effective. As with most medications, the drops can cause a variety of side effects, which may result in your inability to continue using them. In such a case, laser therapy would be the next step.

Laser therapy

Laser therapy is not a cure for glaucoma, but like eye drops, it can help lower pressure inside your eye. At least one study suggests that laser therapy is more effective than eye drops for lowering eye pressure. A benefit of laser therapy is that it is a low-risk procedure that can be repeated, though only a certain number of times.

Surgery

There are two kinds of surgery available for glaucoma patients:

• Minimally invasive glaucoma surgery (MIGS), which can be also be performed during cataract surgery 
• Trabeculectomy, also called tube shunt surgery, which is the traditional filtering surgery for advanced glaucoma 

Speak with your ophthalmologist about all possible treatment options. New treatments are being developed on an ongoing basis. Different ophthalmologists may recommend different surgeries for different reasons. Don’t hesitate to get a second opinion, even if you trust your doctor implicitly. 

What questions should I ask my ophthalmologist?

You will likely be seeing a lot of your eye care team going forward. Some important questions to ask the team include:

• How, and how often, you will be monitored
• What tests you’ll need, and the purpose of those tests
• Why your treatments were prescribed and how they are supposed to work
• Any other questions you have about your vision, treatment, and care

Inform your doctor right away if your treatment does not appear to be working as it should or if your vision changes.

*Ou, Y. (2020, June 15). I Was Diagnosed with Glaucoma: Now What?. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/i-was-diagnosed-glaucoma-now-what

Any sources from outside of Prevent Blindness do not imply an endorsement from Prevent Blindness. The contents of the material used are the responsibility of the authoring organization, Responsum Health.