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How Is Glaucoma Diagnosed?

To diagnose glaucoma, an eye doctor will test your vision and examine your eyes through dilated pupils. The eye exam typically focuses on the optic nerve, which has a particular appearance in glaucoma. In fact, photographs of the optic nerve can also be helpful to follow over time as the optic nerve appearance changes with the progression of the disease. The doctor will also perform a procedure called tonometry to check for eye pressure, and a visual field test, if necessary, to determine if there is loss of side vision. Glaucoma tests are painless and take very little time.

How Is Glaucoma Treated?

Glaucoma treatment may include prescription eye drops, laser surgery, or microsurgery.

  • Eye drops for glaucoma. These either reduce the formation of fluid in the front of the eye or increase its outflow. Side effects of glaucoma drops may include allergy, redness of the eyes, brief stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect the heart and lungs. Be sure to tell your doctor about any other medications you are currently taking or are allergic to.
  • Laser surgery for glaucoma. Laser surgery for glaucoma slightly increases the outflow of the fluid from the eye in open-angle glaucoma or eliminates fluid blockage in angle-closure glaucoma. Types of laser surgery for glaucoma include trabeculoplasty, in which a laser is used to pull open the trabecular meshwork drainage area; iridotomy, in which a tiny hole is made in the iris, allowing the fluid to flow more freely; and cyclophotocoagulation, in which a laser beam treats areas of the middle layer of the eye, reducing the production of fluid.
  • Microsurgery for glaucoma. In an operation called a trabeculectomy, a new channel is created to drain the fluid, thereby reducing intraocular pressure that causes glaucoma. Sometimes this form of glaucoma surgery fails and must be redone. For some patients, a glaucoma implant is the best option. Other complications of microsurgery for glaucoma include some temporary or permanent loss of vision, as well as bleeding or infection.

Open-angle glaucoma is most commonly treated with various combinations of eye drops, laser trabeculoplasty, and microsurgery. Traditionally in the U.S., medications are used first, but there is increasing evidence that some people with glaucoma may respond better with early laser surgery or microsurgery.

Infant or congenital glaucoma -- meaning you are born with it -- is primarily treated with surgery, because the cause of the problem is a very distorted drainage system.

Talk to your eye doctor to find out which glaucoma treatment is right for you.