Glaucoma Symptoms: When to Seek Medical Attention

About glaucoma?

Today I visited the doctor.
Currently, the intraocular pressure in both eyes is at 20 mmHg, and I have myopia of -7.75 diopters in both eyes, but I can still see clearly.
Recently, I've been experiencing occasional stiffness in my neck, slight pressure in my head, and sometimes my eyes feel pressured as well.
I've noticed a faint yellow halo around streetlights that started a few days ago.
My pupils tend to dilate gradually when I'm outside or when I open my eyes.
I also feel discomfort in my stomach and have a sensation of nausea, but I don't actually vomit.
After examining me, the doctor said that my symptoms do not indicate glaucoma and that the nausea is simply due to gastrointestinal issues.
The doctor mentioned that the pupil dilation is a normal phenomenon and attributed my symptoms to corneal problems.
However, I clearly feel that these are symptoms of glaucoma.
I'm still a bit scared, especially since I have many reports to complete for university, and I'm worried about losing my grades.

Kunhuo de daxuesheng, 10~19 year old female. Ask Date: 2019/03/30

Dr. He Jianxian reply Ophthalmology

The symptoms of glaucoma you mentioned likely refer to acute glaucoma, which is almost impossible to occur in eyes with a refractive error of -775 diopters.
If the doctor has examined and found no issues, there is no need to worry.

Reply Date: 2019/03/30

More Info

It sounds like you're experiencing a range of concerning symptoms, and it's understandable to feel anxious about the possibility of glaucoma, especially given your high myopia and the recent changes in your vision. Let's break down your situation and clarify some important points regarding glaucoma symptoms and when to seek medical attention.

Understanding Glaucoma Symptoms
Glaucoma is often referred to as the "silent thief of sight" because it can progress without noticeable symptoms until significant damage has occurred. Common symptoms of glaucoma can include:
1. Peripheral Vision Loss: This is often one of the first signs of glaucoma. It may not be noticeable until the condition has progressed significantly.

2. Halos Around Lights: Seeing halos or rainbows around lights, especially at night, can be a symptom of increased intraocular pressure (IOP).

3. Eye Pain or Discomfort: Some individuals may experience pain or discomfort in the eyes, which can be associated with acute glaucoma attacks.

4. Headaches: Frequent headaches, particularly around the eyes, can be a symptom of elevated eye pressure.

5. Nausea and Vomiting: In acute glaucoma, nausea and vomiting can occur due to the severe pain and pressure in the eye.

Your Symptoms
From your description, you mentioned experiencing:
- Eye pain and a sensation of pressure.

- A halo effect around lights.

- Occasional neck pain and headaches.

- Gastrointestinal discomfort with a feeling of nausea.

While your doctor has indicated that these symptoms are not indicative of glaucoma, it's essential to consider the following:
1. Intraocular Pressure (IOP): Your IOP readings of 20 mmHg are on the higher side of normal. While this alone does not confirm glaucoma, it warrants monitoring, especially given your high myopia.

2. Visual Symptoms: The halo effect around lights can be associated with several conditions, including glaucoma, but it can also be related to corneal issues or even dry eyes, particularly in high myopia.

3. Headaches and Nausea: These symptoms can be multifactorial. While they can be associated with eye strain or pressure, they can also stem from other causes, such as tension headaches or gastrointestinal issues.

When to Seek Further Medical Attention
Given your symptoms and the potential for glaucoma, consider the following steps:
1. Follow-Up with an Eye Specialist: If your symptoms persist or worsen, it may be beneficial to seek a second opinion from a glaucoma specialist. They can perform comprehensive testing, including visual field tests and optical coherence tomography (OCT), to assess the health of your optic nerve and the presence of any visual field loss.

2. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur and their severity. This information can be helpful for your healthcare provider.

3. Discuss Your Concerns: Don't hesitate to express your fears and concerns with your healthcare provider. A good doctor will take your symptoms seriously and work with you to find the underlying cause.

4. Consider Lifestyle Factors: Stress, fatigue, and prolonged screen time can exacerbate eye strain and discomfort. Ensure you are taking regular breaks from screens and managing stress effectively.

Conclusion
While your doctor has assessed your symptoms and determined they are not indicative of glaucoma at this time, it is crucial to remain vigilant. If you continue to experience discomfort, visual changes, or if your symptoms escalate, seeking further evaluation is warranted. Remember that early detection and management are key in preventing vision loss from glaucoma or any other ocular condition. Your health and academic performance are important, so prioritize your well-being and seek the care you need.

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