Written by Nishika Reddy, MD | Reviewed by Patricia Pinto-Garcia, MD, MPH
Key takeaways:
Glaucoma is the second leading cause of blindness worldwide. Glaucoma damages the optic nerve, which leads to vision loss, starting with peripheral (side) vision loss.
There’s no way to stop glaucoma from starting. But there are steps you can take to stop glaucoma from getting worse and causing significant vision loss or blindness.
If you have glaucoma, stay up to date with your eye exams, use your glaucoma eye drops, and don’t smoke. These things can keep your glaucoma from advancing.
Glaucoma is a group of eye diseases that cause damage to the optic nerve, the part of the eye that sends light signals to the brain. People who develop glaucoma can develop permanent vision loss and low vision. In fact, glaucoma is the second leading cause of blindness worldwide.
There’s no cure for glaucoma. And there’s no way to reverse glaucoma or prevent it from starting. But the good news is that there are ways to keep glaucoma from progressing and causing vision loss. If you have glaucoma, here are six things you can do to protect your vision.
Get regular eye exams
Getting regular eye exams is the most important thing you can do to protect your vision if you have glaucoma.
Glaucoma doesn’t usually cause any symptoms. By the time you start noticing vision changes, glaucoma has already started to permanently damage your optic nerve. So you can’t rely on vision changes or other symptoms to tell you if your glaucoma is getting worse.
Make sure you follow up with your ophthalmologist for regular eye exams. During these exams, your ophthalmologist will check your:
Eye pressure
Visual fields
Visual acuity (seeing shapes at a distance)
Retina health
Corneal thickness
Drainage angle (where the fluid in the inner eye drains)
Each of these items gives important information on how your glaucoma is progressing. With this information, your ophthalmologist can develop a plan to keep your glaucoma from getting worse and damaging your vision. Regular eye exams can be time consuming, but they can also save your vision. Most people with glaucoma need eye exams every 3 months. But you may need more frequent eye exams until your glaucoma is under control.
Stick with your glaucoma eye drops
If you have glaucoma, you will need to use eye drops every day, possibly several times a day, for the rest of your life. This can be daunting and discourage people from using their eye drops. Many people stop using their glaucoma eye drops because the drops don’t make them feel different or improve their vision.
Eye drops aren’t the easiest medications to use, and they can’t cure or reverse glaucoma. But glaucoma eye drops can save your vision. It’s clear from decades of research that glaucoma eye drops stop glaucoma from getting worse and causing vision loss.
Treating glaucoma with several types of drops slows glaucoma more than treatment with only one type of glaucoma eye drop. This is why most people need combination therapy for their glaucoma.
So, don’t give up on your glaucoma eye drops. Keep using them every day, because they are working and keeping your vision safe.
Stop smoking
If you smoke and you have glaucoma, consider quitting.
Studies show that people who smoke are more likely to develop glaucoma. But what if you already have glaucoma?
People with glaucoma who continue to smoke are twice as likely to have their glaucoma progress, even with treatment. Also, the more you smoke, the faster your glaucoma is likely to progress.
Smoking also increases your risk of developing other eye conditions that can lead to vision loss like macular degeneration and cataracts.
Tell your ophthalmologist about all your medications
Some medications can worsen glaucoma, so it’s important to tell your ophthalmologist about all the medications you take. Make sure to tell them about any over-the-counter (OTC) medications you take, such as cough and cold medications. Also, tell them about cosmetic medications, such as Botox. This is true even if you only take these medications sometimes. Some of these medications can worsen glaucoma too.
Some medications that can worsen glaucoma include:
Allergy medications including diphenhydramine (Benadryl), loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec)
Asthma / Chronic obstructive pulmonary disease (COPD) medications like ipratropium bromide (Atrovent) and tiotropium bromide (Spiriva)
Depression and anxiety medications like fluoxetine (Prozac), paroxetine (Paxil), and duloxetine (Cymbalta)
Heartburn / Gastroesophageal reflux disease (GERD) medications like cimetidine (Tagamet) and ranitidine (Zantac)
Migraine medications like botulinum toxin (Botox) injections, sumatriptan (Imitrex), amitriptyline, and topiramate (Topamax)
Steroids like prednisone, prednisolone, and dexamethasone. Nasal sprays and inhalers that contain steroids can also worsen glaucoma.
Choose glaucoma-friendly activities
Regular exercise and staying active is great for your physical and mental health. But some exercises and activities can worsen glaucoma. Some activities can lead to rapid changes in eye pressure and worsen glaucoma like:
It’s not just adrenaline-releasing activities that can worsen glaucoma. Other activities that can worsen glaucoma include:
Weight lifting, including bench pressing and squat maneuvers
Certain yoga positions where your head is below the level of your heart
Breathing exercises that involve holding your breath
Handstands, gymnastic moves, or other activities where you might be upside down
Playing woodwind or brass instruments
Talk with your ophthalmologist about your exercise and activity routines. They can make suggestions on how to adjust your routines so you can keep doing the things you love while keeping your eyes safe.
Wear eye protection
Protecting your eyes from injury is obviously important for your vision. But if you have glaucoma, eye protection offers you an added layer of protection.
Eye injuries can lead to a specific type of glaucoma called traumatic glaucoma. One type of glaucoma can already be tough to treat. Adding on another type can make getting glaucoma under control even more difficult.
Make sure to wear eye protection if you’re doing activities that put you at risk for eye injuries. Most eye injuries are sports related. If you’re playing a sport that involves a ball, wear eye protection, especially if that ball is small and traveling at high speed.
Some jobs also increase your chances of getting an eye injury. Always wear eye protection if your job requires, encourages, or recommends it.
It’s not just flying debris, chemicals, and projectiles that can cause eye injury. Ultraviolet (UV) light can also worsen glaucoma. Wear sunglasses with UV-blocking lenses when you’re outdoors. This can also lower your risk of developing cataracts.
The bottom line
Glaucoma is a group of conditions that damage the optic nerve. People with glaucoma can develop permanent vision loss and blindness. There’s no cure for glaucoma, and it can’t be reversed. But treatment can slow glaucoma and keep your vision safe. Steps you can take to keep your glaucoma in check include getting regular eye exams, consistently using glaucoma eye drops, and quitting smoking.
References
American Academy of Ophthalmology Preferred Practice Pattern Glaucoma Panel, Hoskins Center for Quality Eye Care. (2022). Glaucoma summary benchmarks — 2022.
Bengtsson, B., et al. (2022). The glaucoma intensive treatment study: Interim results from an ongoing longitudinal randomized clinical trial. Acta Ophthalmologica.
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