If your eyes feel sore and swollen and you can’t see clearly, watch out—it might be coming your way.

Glaucoma is an irreversible eye disease caused by various factors that lead to a persistent increase in intraocular pressure, ultimately resulting in damage to the optic nerve.

Simply put, glaucoma occurs when the pressure inside the eye becomes too high, exceeding the tolerance of intraocular tissues such as the optic nerve, which leads to vision loss and a narrowing of the visual field. If intraocular pressure remains elevated over a long period, it can cause ongoing damage to the optic nerve and, in severe cases, may result in irreversible blindness.

What are the early symptoms of glaucoma?

A typical glaucoma attack presents with the following symptoms [1,2]:

Noticeable pain in the eye, which may be accompanied by headaches or discomfort;

When gently touching the eyeball, it feels firm and taut;

When looking at lights or other luminous objects, a rainbow-like halo appears around them, known as halos;

Unexplained vision loss, accompanied by a gradual narrowing of the visual field.

What are the common risk factors for glaucoma?

Common risk factors for glaucoma include:

Unhealthy lifestyle habits: Overuse of the eyes, significant emotional fluctuations (such as frequent anger), and high psychological stress;

High myopia: Individuals with high myopia (600 diopters or higher) have a one-in-three chance of developing glaucoma or gradually progressing to glaucoma [3];

Specific eye anatomical features: A shallow anterior chamber, a thick lens, or a short axial length can all lead to impaired aqueous humor circulation, resulting in elevated intraocular pressure and the development of glaucoma [4].

Genetics, such as a history of the disease in parents or other first-degree relatives: The risk of developing the condition is six times higher in individuals with a family history compared to those without [5].

Age and gender-related factors: Primary glaucoma, the main type of the condition, is classified into open-angle and angle-closure subtypes. Open-angle glaucoma is most common in people around the age of 30, with no significant gender difference in incidence; angle-closure glaucoma, however, is more prevalent in women over the age of 45.[1,2];

Symptoms of angle-closure and chronic angle-closure glaucoma are often atypical; young people may confuse them with eye strain or myopia, while middle-aged and older adults often mistake them for cataracts.

Because most glaucoma patients do not take the condition seriously enough, many are diagnosed at an advanced stage in clinical practice, by which time optic nerve atrophy or visual field defects have often already occurred, resulting in a delay in the optimal window for treatment. In response, Dr. Deng Jiangwen, Director of the Glaucoma Department at Dongguan Aier Eye Hospital, specifically advises that middle-aged and elderly individuals should undergo an annual eye health examination to ensure early detection, early diagnosis, and early treatment.

References

[1] Deborah S Jacobs, MD. Open-angle glaucoma: epidemiology, clinical presentation, and diagnosis. UpToDate Clinical Advisor: https://www.uptodate.com/contents/zh-Hans/open-angle-glaucoma-epidemiology-clinical-presentation-and-diagnosis (Accessed Nov 7, 2018.)

[2] Jennifer S Weizer, MD. Angle-Closure Glaucoma. UpToDate Clinical Advisor: https://www.uptodate.com/contents/zh-Hans/angle-closure-glaucoma (Accessed Dec 14, 2018.)

[3] Tan N, Sng C, Jonas J B, et al. Glaucoma in myopia: Diagnostic dilemmas [J]. British Journal of Ophthalmology, 2019.

[4] Yang Peizeng, Fan Xianqun. Ophthalmology [M]. 9th ed., Beijing: People’s Medical Publishing House, 2018.

[5] Janey, L, Wiggs, et al. Genetics of Glaucoma [J]. Human Molecular Genetics, 2017.