Glaucoma Resources 2019-2020

Glaucoma is a disease that damages the eye’s optic nerve. It is the second leading cause of blindness around the world, and people who are over age 60 are at a greatly increased risk for glaucoma.¹

In this guide, we’ll examine the causes, signs, symptoms, complications and treatments for glaucoma and provide a list of state and national resources for those suffering from or at risk of glaucoma. 

What Are the Types of Glaucoma?

Glaucoma is not just a single condition. It refers to a group of conditions that can happen when the optic nerve of your eye becomes damaged.

The optic nerve ­– or cranial nerve – is located in the back of the eye and serves as the main transmitter of visual information from your eye to your brain.  

There are several different types of glaucoma.

Open-Angle Glaucoma 

Also called chronic or primary glaucoma, open-angle is the most common form of glaucoma, accounting for around 90 percent of all cases.² “Open angle” means there is a wide open angle between the iris and cornea.

This type of glaucoma develops slowly and usually includes symptoms and damage that are not easily noticed.

Angle-Closure Glaucoma

Also called acute or narrow-angle glaucoma, this type of glaucoma develops very quickly with noticeable signs and symptoms and requires immediate medical attention.

In this type of glaucoma, the angle between the iris and cornea is closing.    

Normal-Tension Glaucoma

The causes of this type of glaucoma, also called low-tension or normal-pressure glaucoma, are still unknown.

People of Japanese ancestry, those with a family history of normal-tension glaucoma and those with a history of systemic heart disease have been shown to be at an increased risk for this type of glaucoma.³

Congenital Glaucoma

This rare type of glaucoma occurs in babies and may be inherited.

Also called childhood glaucoma, pediatric glaucoma or infantile glaucoma, this condition is caused by an incorrect development of the eye’s drainage system prior to birth. 

Secondary Glaucoma

Secondary glaucoma refers to any other form of glaucoma in which there is an identifiable cause, such as injury, certain drugs or medications, diabetes, cataracts or inflammation.

Secondary glaucoma can be grouped into several different categories:

• Exfoliative glaucoma
  A flaky material peels off from the outer layer of the eye and collects between the cornea and iris.
  
  
• Neovascular glaucoma
  New blood vessels form on the iris and over the eye’s drainage channels.
  
  
• Pigmentary glaucoma
  Pigment granules in the back of the iris break into the clear fluid that is produced inside the eye.
  
  
• Traumatic glaucoma
  Injuries bruise or penetrate the eye.
  
  
• Uveitic glaucoma
  Swelling and inflammation of the middle layer of the eye called uveitis can lead to glaucoma.

What Causes Glaucoma?

Glaucoma is caused by a buildup of pressure in the eye.

A normal level of ocular pressure ranges from 12 to 22 millimeters of Mercury. Anything above that level could lead to glaucoma. 

There is fluid that flows naturally between the iris and the cornea of the eye which cleanses other parts of the eye and provides a necessary lubricant. If that fluid is unable to then escape the eye at its normal rate, pressure can build up and glaucoma can begin to form as a result.

The problem causing the buildup can be something that is blocking the fluid from escaping, or it can be traced to too much fluid being produced in the first place.

The blockage of fluid or release of excess fluid do not have a known cause, though doctors know it can be inherited and have identified certain genes that present an increased risk.

People with any of the following traits may be at an increased risk for developing glaucoma:

• Age 40 and over, and especially those age 60 and over
• Family history of glaucoma
• Asian, Hispanic or African heritage
• Elevated eye pressure
• Thin corneas
• Farsightedness or nearsightedness
• Have suffered an eye injury
• Long-term use of steroid medications
• Have diabetes, migraines, high-blood pressure, poor blood circulation or other health problems 

What Are the Signs and Symptoms of Glaucoma?

The signs and symptoms of glaucoma can depend partly on the type of glaucoma that is present.

Some of the symptoms sometimes associated with glaucoma can include:

• Pain in the eye or forehead
• Redness of the eye
• Blurred or decreased vision
• Seeing a halo or rainbow effect
• Headaches 
• Nausea
• Vomiting

Spotty vision or blind spots can affect your peripheral vision and lead to tunnel vision, which is when you can no longer see to the side, above or below without turning your head. Tunnel vision can eventually progress to total blindness, which occurs during the final stages of glaucoma. 

Glaucoma often doesn’t cause any pain, especially in the early stages. And because the symptoms can come on slowly, studies estimate that only around 50 percent of people with glaucoma are even aware that they have the disease.⁵

Many people don’t experience any real glaucoma symptoms until the disease has progressed into the later stages. 

How Is Glaucoma Diagnosed?

Glaucoma can be detected with a visual field test, in which a doctor will ask you to spot flashing lights around the rim of your field of vision.

There are also a few more technical approaches to diagnosing glaucoma. 

• Tonometry
  Eye drops are used to numb the eye, and then a machine directs a puff of air into the eye which measures the internal pressure.
  
  
• Gonioscopy
  This type of test measures the width of the angle between your iris and your cornea.
  
  
• Ophthalmoscopy
  Eye drops are used to dilate the pupils, and then a doctor uses a magnifying device to examine the back of your eye to check the health of your optic nerve.        

One way to catch glaucoma in its early stages is to have your vision checked on an annual basis. 

How Can Glaucoma Affect Your Health?

Deteriorating vision can have a greater effect on your overall health.

For example, vision loss can greatly increase the risk of falls, especially among senior adults.

Poor vision can also contribute to senior isolation or depression, as it can become more difficult to socialize, partake in hobbies and do things outside of the house.

Glaucoma may also affect your ability to complete activities of daily living (ADLs), such as bathing, dressing and preparing food.

How Is Glaucoma Treated?

There are a few different ways to treat glaucoma. The type of treatment used generally depends on the type of glaucoma that is present.

Eye Drops

Eye drops are an easier form of glaucoma treatment. The type of drops used are designed to reduce pressure in the eye and increase the flow of fluid.

Some people experience side effects of these eye drops, including dizziness, asthma attacks, cardiovascular disease, nausea and fatigue. 

Prescription Medication

Prescription drugs may be used to address the amount of fluid buildup in the eye or the rate that it is flowing back out.

Medication may also be used to address some secondary causes of glaucoma such as diabetes, high or low blood pressure or heart conditions. 

Medical Marijuana

Medical marijuana has been shown to reduce pressure in the eyes and has been used to treat glaucoma.

Medical marijuana is legal in only 33 states (as of 2020), so not everyone has access to this type of treatment.⁶

Surgery

Surgery is often a last resort after other treatments don’t work, or if the glaucoma has been left untreated and is in its final stages.

Laser surgery offers a quick and painless solution to unclogging the path for fluid to properly flow through the eye. Traditional glaucoma surgery involves a doctor manually entering the eye to open up new drainage areas.  

Does Medicare Cover Glaucoma Treatment?

Medicare Part B provides some coverage of glaucoma tests and treatment. 

• Tests are covered once every 12 months if you are deemed to be at high risk for glaucoma.
  
  Those considered to be high-risk for Medicare purposes include those with diabetes, those with a family history of glaucoma, African Americans age 50 and over and Hispanic Americans age 65 and over. 
  
  You’ll typically pay 20 percent of the Medicare-approved amount for the test (or a flat fee copayment, if the test is performed in a hospital outpatient setting) after you meet your annual Part B deductible. 
  
  
• Outpatient glaucoma surgery is covered by Medicare Part B.
  
  
• Eye drops and prescription medication may be covered by a Medicare Part D prescription drug plan or a Medicare Advantage (Medicare Part C) plan that includes drug coverage.
  
  Medicare Part D or Part C plan benefits and availability may vary based on where you live.

Speak with your doctor or health care provider to find out more about how much your glaucoma test or treatment may cost.

The national and state resources listed below can help support you or your loved ones who may be suffering from glaucoma and other vision problems.

National Resources

Prevent Blindness

Prevent Blindness is a volunteer eye health and safety organization that has been fighting blindness through awareness, advocacy and education for more than 100 years. 

EyeCare America

EyeCare America provides comprehensive eye exams and eye care to eligible people age 65 and older, often with no out-of-pocket expenses.  

Lions Club International

Financial assistance for eye care can often be found through a local Lions Club chapter. Lions Club International is a charitable organization that serves communities through a variety of different programs and initiatives.

Knights Templar Eye Foundation

Sponsored by the Grand Encampment of Knights Templar, this charity organization aims to improve vision through research, education and supporting access to care.

SEE International

SEE International provides eye care to people all over the world using volunteer doctors and clinics. 

New Eyes for the Needy

This not-for-profit organization collects, recycles and distributes donated eyeglasses to people who cannot afford them. 

Glaucoma Research Foundation

The Glaucoma Research Foundation is a national non-profit organization dedicated to finding a cure for glaucoma.

National Federation of the Blind

The National Federation of the Blind coordinates programs, services and resources for blind people throughout the U.S. 

BrightFocus

BrightFocus is a non-profit organization that supports research in the fight against glaucoma. 

The Glaucoma Foundation

The Glaucoma Foundation is a non-profit organization supporting research and collaboration in working toward a cure for glaucoma. 

State Resources for Glaucoma

Select your state