Glaucoma – Causes, Signs and Symptoms

Glaucoma – Causes, Signs and Symptoms

What is glaucoma?

Glaucoma, often termed the “silent thief of sight”, is an eye disease that affects your eye’s optic nerve, usually caused by a pressure buildup in the eye due to poor drainage. Each eye has an optic nerve that relays information on things we see to our brain. Glaucoma is a serious eye disease that is often asymptomatic and should be treated as soon as possible to slow down or even halt its progression.

There are two types of glaucoma:

1. Open-angle glaucoma

This is the most common type of glaucoma that occurs when the eye is not draining as well as it should be. This type of glaucoma progresses gradually. It is painless and has no symptoms at first. However, this type of glaucoma can be detected early with regular eye exams.

2. Angle-closure glaucoma

This type of glaucoma occurs when the iris is too close to the drainage angle of the eye, so the iris ends up blocking the drainage angle. When the drainage angle is completely blocked, eye pressure rises rapidly, resulting in sudden and severe symptoms. Such cases are considered an emergency and an ophthalmologist should be consulted immediately.

Causes of glaucoma

Our eyes constantly produce fluid called aqueous humour. New aqueous should flow in while the same amount flows out to maintain normal eye pressure. However, if the drainage angle is not correct, the fluid cannot flow out and will build up in the eye. This results in eye pressure increasing, which may damage the optic nerve.

Some people are at higher risk of getting glaucoma than others. Such risk factors include:

  • Age (Risk of glaucoma increases from 50 years of age onwards)
  • Asian, Hispanic or African descent (due to genetic predisposition)
  • Existing medical conditions eg. diabetes, hypertension
  • Eye conditions eg. previous eye injury, high myopia (nearsightedness)
  • Long-term use of steroid medications

There are no specific lifestyle activities or diets that are linked to glaucoma, nor are there any definite ways to prevent glaucoma. The best thing that can be done in cases of glaucoma is early detection and treatment.

Signs and symptoms of glaucoma

The two types of glaucoma have differing signs and symptoms.

1. Open-angle glaucoma

One may not notice any vision loss until glaucoma is in its advanced stage. As the disease progresses, blind spots develop in one’s peripheral (side) vision. As this type of glaucoma tends to not show symptoms until damage is severe, it is important to go for regular eye exams, as eye exams are able to pick up on the abnormal eye pressure or any damaged optic nerve before you experience any symptoms.

2. Angle-closure glaucoma

One typically does not experience symptoms before an attack. Early symptoms of an oncoming attack include blurred vision, halos, mild headaches or eye pain.

During an attack, one may experience:

  • Severe eye pain, typically associated with headache 
  • Redness of eye
  • Blurry vision
  • Nausea and vomiting

People with such symptoms should see an ophthalmologist immediately.

How often does glaucoma lead to blindness?

Statistically, about 15% of glaucoma patients lose ability to read in one eye. However, glaucoma progresses at different rates for different individuals, the majority of glaucoma patients never reach blindness. If left untreated, glaucoma causes  one’s peripheral vision to start becoming blurry. Overtime, their central vision will be blurred as well, which leads to the person going blind.

Early detection of glaucoma is crucial in preventing any adverse consequences. With early detection, glaucoma is highly treatable. However, if glaucoma is left untreated until the optic nerve is damaged, the damage cannot be reversed, although further possible damage can still be prevented by visiting an ophthalmologist. Hence, it is important to go for regular eye exams to detect such eye diseases as early as possible, especially if you are at higher risk for them.

Treatment of glaucoma

Glaucoma is a progressive disease. While it cannot be completely cured, its progression can be slowed down or even halted through treatment.

1. Medication

Glaucoma is usually controlled with eyedrop medication. Some of these eyedrops help by reducing the amount of fluid (aqueous humour) your eye produces, while others may help fluid flow better through the drainage angle, thereby reducing your eye pressure.

As these eyedrop medicines are absorbed into the bloodstream , they may cause some side effects, such as stinging or itching sensations. Any side effects should be reported to your ophthalmologist.

2. Surgery

This option is usually undertaken if medical treatment with the eyedrops are not effective. The most common surgery is trabeculectomy, where an opening is created for the fluid in the eye to drain out. The fluid is absorbed by tissue around your eye and eye pressure is relieved.

There are other types of surgery used to treat more complicated cases of glaucoma.

3. Laser treatment

This is usually used for patients with angle-closure glaucoma. Iridotomies involve using a laser to create a tiny hole in the iris to help fluid flow to the drainage angle.

Book an eye exam to make sure your eyes are safe from the “silent thief of sight”.


Age-related Eye Problems

Age-related Eye Problems

Not only does ageing contribute to vision problems such as presbyopia, it also increases risk for eye health problems.

What eye problems are associated with ageing?

Age increases risk for many eye diseases and conditions, including:

  • Age-related macular degeneration

Based on research by Singapore Eye Research Institute in 2009, age-related macular degeneration is one of the leading causes of blindness in people over 50 years of age.

Glaucoma is the cause of about 40% of blindness in Singapore. Based on research by Singapore Eye Research Institute in 2009, around 3% of people above 50 years old have glaucoma, while this figure is higher at 10% for those above 70 years of age.

Cataracts are the leading cause of blindness worldwide.

  • Retinal detachment

Those over the age of 40 are at higher risk of retinal detachment.

Normal, harmless floaters are often caused by age-related changes to the vitreous fluid in our eyes. Sudden onset of or increase in floaters can be indicative or retinal detachment.

As we age, our tear production decreases, resulting in dry eyes.

How to counter age-related eye problems

Comprehensive eye exams should be taken every 1-2 years for people 40-64 years old and annually for those 65 years old and above. If you have other risk factors for eye diseases, such as diabetes or family history of eye diseases, you should get a comprehensive eye exam more often.

This allows your optometrist/ophthalmologist to monitor your eye health and detect any eye diseases early. Early detection of eye diseases is important in treating the condition before it has irreversible consequences or results in blindness.

Have not had a comprehensive eye exam in the past year?


Comprehensive Eye Exam: Why It Is Important and What To Expect

Comprehensive Eye Exam: Why It Is Important and What To Expect

Why is it important to have a comprehensive eye exam regularly?

Keeping an eye on your vision requires different care and attention at different stages of life. Even when we are young, we should do a comprehensive eye check-up regularly as eye problems can be present at any age. 

Did you know some eye diseases such as glaucoma have no symptoms? Having a regular eye check-up gives you the best chance to diagnose any underlying eye diseases. Your eye doctor can also help to evaluate your eyes as an indicator of your general well-being.

What is the difference between a vision screening and an eye exam?

Vision screenings are basic eye tests to help recognize any issues with your vision, but it does not test for any underlying eye diseases. Usually, it checks for basic refractive errors such as myopia, astigmatism, and hyperopia.

A comprehensive eye exam performed by an optometrist or ophthalmologist involves a thorough examination of all aspects of your vision. Your eye doctor will be able to diagnose visual health issues and ocular conditions that are otherwise unable to be determined by vision screening.

What to expect from a comprehensive eye exam?

History Taking

Your eye care professional will ask for your background and health history as existing medical conditions may increase the potential risk of developing certain eye diseases.

Visual Acuity Test

This is a test to measure how well you can see in different distances by asking you whether you can see numbers and letters of varying sizes using an eye chart.


This is a test to measure your type and degree of refractive error to determine your exact eyeglasses prescription.

Eye Pressure Test

Usually done with a tonometer, this test measures your eye pressure that checks for glaucoma: an eye condition that can cause vision loss due to built-up eye pressure damaging the eye’s optic nerve.

Check the front of your eyes: Slit Lamp Test

The front part of your eyes will be examined under high magnification to detect any abnormalities such as cataracts and macular degeneration.

Check the back of your eyes: Retinal Imaging / Fundus Examination

A high resolution, wide-angle picture of your retina will be captured to detect any abnormalities such as retinal detachment in the back part of your eyes.

A perfectly healthy retina.

Assessment and Management

After the eye exam, your eye care professional will advise you on the test results and steps needed if abnormalities are detected.

A comprehensive eye exam may involve more tests depending on your ocular conditions but these are the most common and will help cover a wide spectrum of eye diseases.

Babies (Age 6 months onwards)

Ensure that your child’s eyes are screened during regular pediatric appointments and they are free from common childhood eye conditions and diseases.

Children and Teenagers (Age 3 to 19)

Ensure that your child has a thorough eye check every 1-2 years during routine health check-ups or when getting fitted for corrective eyewear, such as for myopia.

Young Adults (Age 20 to 39)

Have a comprehensive eye examination if you have a family history of eye disease or if you are suffering from an eye injury.

Adults and Seniors (Age 40 onwards)

Eye conditions such as age-related macular degeneration are more likely to occur as we grow older. To monitor vision changes, you should get a baseline eye disease screening when you are 40 and ask the doctor to assess how often you need to return for follow-up screenings.

For Anyone with Risk Factors

If you have a risk factor for eye disease (Diabetes, high blood pressure, family history of eye disease), you should see your eye doctor annually. Ask your eye doctor for the ideal interval between check-ups.

Have not had a comprehensive eye exam in the past year?


Cataracts – Early Signs and Symptoms

Cataracts – Early Signs and Symptoms

Have you often heard of cataract but are unsure of what exactly it is? Read on to find out more!

What is cataract?

Cataract is the most common cause of blindness in the world. In Singapore, cataract affects about 80% of people above the age of 60 and up to 95% of people above the age of 70. 

Simply put, cataract is the clouding of the lens of your eye that is normally clear. This results in impaired vision as not enough light is able to enter the eye. Having cataract would be akin to seeing the world through a frosted or fogged-up glass. Cataract affects everyday activities such as reading and driving.

Cataract often progresses slowly and may not interfere with eyesight in early stages. However, as it develops it will start to disturb your vision more and more.

Cataract Signs and Symptoms

Initially, cataract symptoms may not be that noticeable as only a small part of the eye may be affected by the cataract. However, over time, as the cataract develops the signs would become more obvious.

Extremely dense cataracts can be obvious when light is shone.

Symptoms of cataract include:

  • Cloudy, blurred or dim vision 
  • Difficulty in seeing at night that worsens over time
  • Sensitivity to light and glare
  • Needing brighter light for daily activities such as reading
  • Seeing “halos” around light sources
  • Fading or yellowing of colours
  • Double vision in one eye

A common sign of cataract would be blurred vision that cannot be corrected with the usual corrective visual aids such as glasses.

Upon noticing any change in your vision, it is important to see your eye doctor as soon as possible.

Causes of cataract

Cataract usually affects the elderly, however, it can occur in young people and even children as well. Cataract formation in the elderly is usually linked to ageing. For young people, cataract formation could be due to eye injury, other eye conditions or genetic predisposition. 

There are various risk factors that could contribute to cataract formation.

These include:

  • Age
  • Diabetes
  • Prolonged usage of corticosteroid medications
  • Excessive exposure to UV light
  • Diabetes
  • Previous eye injury or inflammation
  • Previous eye surgery
  • Smoking

Treatment of cataract

Cataracts cannot be cured with medication. Adjustments to your lifestyle can be adopted at earlier stages to help counteract the effects. Such changes include changing your spectacle lens power, using brighter lighting at home, wearing sunglasses outside during the day and avoiding night driving as far as possible.

However, when cataract starts to interfere with everyday activities, cataract surgery would be required. Cataract surgery is minimally invasive, painless and safe. During the surgery, the clouded lens is removed and replaced with a clear lens implant. After the procedure, your eye will fully heal in 1-2 months.

It is important to consult your eye doctor with regards to the progression of your cataract. If cataracts are left too long, they can become hyper-mature, making them slightly more challenging to remove in surgery, although they can still be removed safely.

Can cataract be prevented?

While there is no way to completely prevent formation of cataract, there are some things you can do to help prolong your healthy eyesight, such as:

  • Eating foods rich in antioxidants, vitamin A, C and vitamin E
  • Quitting smoking
  • Wearing sunglasses that block out UV rays and at least 75% of visible light

Book an eye exam to make sure your eyes are safe from the “silent thief of sight”.


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