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Symptoms, Treatment and Research

Two people seen clearly in a circle of light, surrounded by darkness, to mimic glaucoma's narrowing of sight

Glaucoma slowly and silently clouds vision, without any pain.
Photo courtesy of NEI

Glaucoma Symptoms

At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. Glaucoma can develop in one or both eyes.

Without treatment, people with glaucoma slowly lose their peripheral vision. They may miss objects to the side and out of the corner of their eye. They seem to be looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains.

Glaucoma Treatment

Glaucoma treatment includes medicines, laser and conventional surgery, or a combination of these. While these treatments may save remaining vision, they do not restore any lost sight.

Eye drops are the most common early treatment for glaucoma. Taken regularly as directed, they can lower eye pressure, which can help prevent further damage to the nerve. Before beginning treatment, tell your eye care professional about your other medicines and supplements because the drops sometimes can interfere with them.

Because glaucoma often has no symptoms, people may be tempted to stop taking, or forget to take, their medicine. Regular use is very important.

Promising Research

Contact Lens for Glaucoma

A tiny donut-shaped wafer containing a common glaucoma medicine is sandwiched inside this specially designed contact lens. In laboratory experiments, the lens, which can also correct vision, releases the eyesight-saving medication at a steady rate for up to a month. Its design offers numerous potential advantages over standard glaucoma treatments and may have additional applications, such as delivering anti-inflammatory drugs or antibiotics to the eye.

An experimental contact lens releases a glaucoma medicine at a steady rate for up to a month.
Photo courtesy of: Peter Mallen, Massachusetts Eye and Ear Laboratory/ Kohane Laboratory, Boston Children's Hospital

What makes the new lens different from other prototypes is the many-layered construction that places a ring of drug-releasing film in standard, FDA-approved contact lens materials. Other designs most often use a pre-made lens dipped in a drug solution, which then leaches out into the eye rapidly and inconsistently.

During testing in an animal model, the new lens delivered glaucoma medication safely and consistently for four weeks, at concentrations comparable to those achieved with daily eye drops.

Potential Cause of Glaucoma Identified

A multi-institution research team has found that glaucoma appears to result from defects in the cells that control the flow of aqueous humor—the fluid that nourishes the eye and maintains its proper pressure. These cells are called endothelial cells. They line a canal-like structure that controls the flow of aqueous humor out of the eye.

The researchers found that endothelial cells from eyes with glaucoma are stiffer than those from healthy eyes. They theorized that this limits the amount of aqueous humor that can flow from the eye. Pressure would then increase and eventually cause damage to the optic nerve at the back of the eye.

"There is no cure for glaucoma, which affects more than two million Americans," observes Mark Johnson, professor of biomedical and mechanical engineering at Northwestern University's McCormick School of Engineering and Applied Science. Johnson led the research, supported by NIH and other institutions. "Our work shows that cells of this endothelial layer act as mechanical gates. Therapeutic strategies that alter the stiffness of these cells potentially could lead to a cure for this debilitating disease."

Questions to ask your eye care professional

You can protect yourself against vision loss by working in partnership with your eye care professional. Ask questions and get the information you need about glaucoma to take care of yourself and your family.

  • What is my diagnosis?
  • What caused my condition?
  • Can my condition be treated?
  • What is the treatment for my condition?
  • When will the treatment start and how long will it last?
  • What are the benefits of this treatment and how successful is it?
  • What kinds of tests will I have?
  • What can I expect to find out from these tests?
  • When will I know the results?

See more questions to ask here:

Read More "Glaucoma" Articles

Watch Out for Glaucoma / Symptoms, Treatment and Research / Eye-to-Eye with Dr. Rachel Bishop

Spring 2015 Issue: Volume 10 Number 1 Page 14-15