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What is glaucoma?
Glaucoma is a common eye condition that causes damage to the optic nerve, often linked to increased pressure inside the eye. It can develop gradually without noticeable symptoms at first, but over time may lead to permanent vision loss, typically affecting peripheral (side) vision.
Early detection and treatment are essential to help protect your sight. Our eye specialists offer expert assessment and a full range of glaucoma treatments, tailored to the type and stage of your condition. This may include monitoring, eye drops, laser treatment or glaucoma surgery (trabeculectomy) to reduce pressure and prevent further damage. Our ophthalmologists use advanced diagnostic tools to identify glaucoma early and recommend the most appropriate treatment plan for you.
Glaucoma care is provided by our private ophthalmology service at St Thomas’ Hospital, offering access to expert-led diagnosis, treatment and ongoing monitoring. You will receive personalised care focused on preserving your vision and supporting long-term eye health.
Ophthalmology specialists
Our expertise and ophthalmology services include:
- short-notice appointments
- fast and accurate diagnosis
- quick access to treatment
Types of glaucoma and their symptoms
Most of the time, glaucoma has no symptoms, and damage occurs to your optic nerve silently. Glaucoma tends to develop gradually and you may not notice any vision changes until it becomes more advanced. It’s essential to attend regular eye check-ups, as the earlier glaucoma is detected, the more effective treatment can be and the less vision loss you are likely to experience.
There are different types of glaucoma, and each has various symptoms depending on the stage of your condition.
The main types of glaucoma are:
- primary open-angle glaucoma – the most common type, which develops slowly over time
- angle-closure glaucoma – a rare type of glaucoma that can develop slowly (chronic) or suddenly (acute)
- secondary glaucoma – occurs because of an eye injury or another eye condition like uveitis (inflammation in the eye)
The symptoms of each type of glaucoma can vary and they may not become noticeable until your condition has advanced.
Primary open-angle glaucoma symptoms
Symptoms of primary open-angle glaucoma do not usually occur in the early stages, but they may include:
- reduction in your peripheral vision (often without any symptoms)
- changes to your central vision as it becomes more advanced
- migraines, cold hands, and cold feet as a result of poor circulation, including poor circulation to the optic nerve (this occurs in normal-pressure glaucoma, a type of open-angle glaucoma)
Angle-closure glaucoma symptoms
Symptoms of angle-closure glaucoma may include:
- headaches
- eye pain
- nausea or vomiting
- blurry vision
- halos around lights
- redness of the eyes
Secondary glaucoma symptoms
Symptoms of secondary glaucoma do not usually appear in the early stages but, as it develops, they may include:
- loss of peripheral vision
- changes to your central vision
- cloudy or blurry vision
If you’re experiencing any of the above symptoms, it’s important to get your eyes checked. Get in touch to book an appointment and discuss your options with a specialist.
What causes glaucoma?
The cause of glaucoma will depend on the type you have. However, the leading reason is a build-up of pressure in your eye when fluid cannot drain properly. This fluid is different to tears or watery eyes. When the pressure within the eye increases, damage occurs to your optic nerve, leading to glaucoma.
Primary open-angle glaucoma develops when parts of the drainage system in your eye do not function correctly. It leads to a gradual increase in eye pressure (intraocular pressure).
Angle-closure glaucoma occurs when your iris (the coloured part of your eye) bulges and blocks your drainage system, causing increased pressure. It can occur rapidly or gradually.
Secondary glaucoma is often caused by an eye injury, another eye condition that causes inflammation, or certain medications that elevate eye pressure, such as steroids.
Risk factors for glaucoma
Some people may have a higher risk of developing glaucoma.
Risk factors for glaucoma can include:
- your age – it’s much more common in older people
- your ethnicity – people of African, Caribbean or Asian descent may have a higher risk of developing particular types of glaucoma
- family history – if a close family member has glaucoma, you can be more likely to develop it
- certain medical conditions – diabetes, uveitis, inflammation and steroid use can increase your risk of elevated eye pressure
- pigment (brown deposits) or exfoliation (dandruff-like deposits) in your iris – these deposits can block drainage channels within the eye, leading to an increase in pressure
Glaucoma can be prevented with regular eye check-ups, early detection and suitable treatments.
How is glaucoma diagnosed?
Glaucoma can be diagnosed by carrying out a range of tests during an eye test.
Some of the tests you might undergo are:
- tonometry to measure the pressure in your eye
- dilating your pupils (the black part of your eyes) to check for optic nerve damage
- visual field tests to check the extent of your vision loss
- inspecting the drainage system in your eye through gonioscopy (a specific lens is placed over the eye for the ophthalmologist to look through)
- optical coherence tomography to scan the back of your eye and optic nerve at high resolution (this checks for early undetectable damage)
If you’re seeking a diagnosis of glaucoma, get in touch to book an appointment with our specialists and discuss your options for diagnosis and treatment.
Glaucoma treatment
Treating glaucoma as soon as possible is vital as nothing can reverse the damage caused to your optic nerve after it has occurred. The main aim of glaucoma treatment is to lower the pressure in your eyes, and there are many ways to do this, with treatment options varying depending on how advanced your glaucoma is.
Early glaucoma treatment
Your ophthalmologist may prescribe eye drops to decrease eye pressure and improve fluid drainage. Depending on the type of glaucoma you have, they may also recommend some specialist laser treatments, such as selective laser trabeculoplasty (for open angle glaucoma) or laser iridotomy (for angle closure glaucoma). In some cases, minimally invasive glaucoma surgery can be combined with cataract surgery, if both conditions are present together.
The main treatment for most patients with glaucoma is eye drops which are used 1-3 times a day. These contain medications called prostaglandin analogues, beta-blockers, or carbonic anhydrase inhibitors which lower your eye pressure. Using these regularly is the most effective way to treat early glaucoma and reduce the likelihood of potential damage occurring, and your consultant ophthalmologist will advise which eye drops are your best option.
If these first lines of treatment do not work, you may need surgery to control your eye pressure. Laser treatments are often used instead of eye drops to lower eye pressure in the early stages of glaucoma.
Advanced glaucoma treatment
The standard operation for advanced glaucoma is a trabeculectomy. During this procedure, the surgeon creates a drainage reservoir to divert fluid from inside the eye into a bleb (a small blister created inside the eye), which bypasses the eye’s blocked drainage system and reduces pressure. The bleb is typically made underneath your eyelid, so you won’t notice it.
The procedure usually takes less than an hour to complete and is generally carried out under local anaesthetic, so you are awake for the procedure but will feel no pain. If the surgery is more complex, general anaesthetic may be recommended, but your ophthalmologist will keep you informed of all options to help you make the best decision for you.
After a trabeculectomy, you will usually visit your ophthalmologist weekly to monitor your healing progress and check that your eye pressure has decreased as expected.
Our team also offers alternative procedures for advanced glaucoma treatment, including PreserFlo microshunt and tube implant surgery. Your ophthalmologist can provide you with further information should you require it.
Stable glaucoma
Once glaucoma is stable, meaning your eye pressure readings are regularly below the target pressure, your specialist will monitor for changes in your visual field test, or OCT scan, to detect the earliest signs of deterioration.
As glaucoma is a long-term condition, you may also develop cataracts due to natural aging of the lens in the eye, and can have some glaucoma intervention at the time of your cataract surgery.
Get in touch about glaucoma treatment
Our experienced ophthalmology specialists provide expert diagnosis and treatment for glaucoma, helping to reduce eye pressure and protect your vision over the long term. You will receive personalised care using the latest techniques and ongoing support to manage your condition effectively.
If you have symptoms of glaucoma or have been advised to seek treatment, contact our team for expert advice and next steps.
Reviewed regularly to reflect clinical best practice
Last reviewed: 18 March 2025
Locations
Our private ophthalmology services are offered at the following locations:
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