Clinical

Glaucoma testing at your address

Pressure, the optic nerve and visual fields, assessed at home, at work or in aged care.

The condition

What is glaucoma?

Glaucoma is damage to the optic nerve, the nerve that carries what you see from your eye to your brain. It is usually caused by pressure inside the eye being higher than that nerve can tolerate.

Damage starts at the edges of your vision and works inwards, and it is permanent.

Sudden severe eye pain with a red eye, blurred vision, haloes around lights, headache or nausea can be acute angle closure glaucoma. That is a medical emergency. Go to a hospital emergency department.3

Symptoms

What are the symptoms?

Glaucoma has no symptoms in its early stages. There is no pain, no blurring and no redness.

Vision goes from the outer edges first, and your other eye fills the gap, so most people notice nothing until a large amount of nerve is already gone.

In the Australian National Eye Health Survey, around half of the participants found to have glaucoma had no known history of it.1

Types

Types of glaucoma

Open angle

The most common type. The drainage angle stays open but fluid leaves too slowly, and pressure builds over years.

Angle closure

The drainage angle narrows or shuts. It can happen suddenly, with severe pain, a red eye, blurred vision, haloes and often nausea. That is a medical emergency.

Normal tension

The optic nerve is damaged even though eye pressure measures within the normal range.

Secondary

Pressure rises because of another condition, an eye injury, or long term steroid use.

Risk

Who is at higher risk?

  • Anyone over 50. Risk climbs steadily with age
  • A parent, brother or sister with glaucoma. The strongest predictor after age
  • African or Asian ancestry. Open angle glaucoma is more common and often earlier in people of African descent, and angle closure is more common in people of Asian descent
  • Long term steroid use, including inhaled and topical steroids, not only tablets
  • A significant past eye injury, even decades earlier
  • Short sightedness, and diabetes

Tell your optometrist if anyone in your family has glaucoma. It changes how often you should be examined, and how much weight a borderline finding carries.

Testing

How is glaucoma tested?

Glaucoma is not diagnosed on eye pressure alone. Pressure is a risk factor. The optic nerve and the visual field are what confirm it.

Eye pressure

Measured by tonometry. We use two methods, including one that needs no drops.

The optic nerve

Examined through a slit lamp biomicroscope with a diagnostic lens. The shape and colour of the nerve head is where early damage shows.

Visual fields

An automated visual field tester maps where sensitivity has been lost. Field loss is what confirms the diagnosis.

Slit lamp photography

Images of the nerve kept on file, so each visit is compared against the last.

The drainage angle

Assessed at the slit lamp, to tell open angle glaucoma from angle closure.

Your history

Family history, ancestry, steroid use, past eye injury, short sightedness and diabetes.

Results

What happens if we find something?

01

Normal

Your images and field results go on file as a baseline, so the next visit has something to compare against.

02

Suspect

A borderline nerve, raised pressure, or family history without field loss. Monitored at a shorter interval.

03

Diagnosed

Treatment lowers the pressure, usually with drops. Optometrists with a scheduled medicines endorsement prescribe and monitor, often alongside an ophthalmologist.

04

Advanced

Referred to ophthalmology for laser or surgery, with the referral written on the day.3

In residential care

Glaucoma in aged care

Glaucoma is recorded in 13.6% of Australians entering residential aged care.2

Eye pressure, the optic nerve and photography can all be assessed at the bedside. Visual fields need the resident to press a button in response to a light, so where that is not possible it is recorded as not assessed.

Tell us before a clinic day if a resident is already on glaucoma drops.

Where we test

Where does testing happen?

Testing happens in the clinic vehicle at your address, at your workplace, or at your village or aged care home. The instruments are installed and calibrated, and the examination is the same one you would have in a shopfront practice.

Glaucoma monitoring continues for life, at an appointment every 6 or 12 months.

Questions

Questions about glaucoma

Would I know if I had glaucoma?
Almost certainly not until it is advanced. Glaucoma takes the outer edges of the vision first, and the other eye fills the gap, so nothing looks missing. In the Australian National Eye Health Survey, around half of the participants found to have glaucoma had no known history of it.
Is a pressure check on its own enough?
No. Pressure is a risk factor, not a diagnosis. A significant number of people develop glaucoma at pressures inside the normal range, and plenty of people with raised pressure never develop it. The optic nerve and the visual field are what settle the question.
What equipment do you use?
Eye pressure by tonometry, the optic nerve assessed through a slit lamp biomicroscope with a diagnostic lens, slit lamp photography so the nerve can be compared over time, and an automated visual field tester.
Who is at higher risk?
Anyone over 50, anyone with a parent, brother or sister who has glaucoma, people of African or Asian ancestry, anyone who has taken steroids long term, and anyone who has had a significant eye injury. Short sightedness and diabetes also raise the risk.
Can glaucoma be cured?
No. Vision already lost to glaucoma does not come back. Treatment, usually drops, lowers the pressure and slows or stops further loss. Found early, most people keep useful sight for life.
Do I need to see an ophthalmologist?
Not always. Optometrists monitor and, with a scheduled medicines endorsement, treat glaucoma, and many people are co-managed between an optometrist and an ophthalmologist. Advanced disease, poor control on drops, and anyone likely to need laser or surgery is referred.
How often should it be checked?
Every 12 months for anyone 65 and over, which is what Medicare funds, and every 2 years under 65 unless you have a risk factor or a suspicious finding, in which case more often. If you are already being monitored for glaucoma the interval is set by whoever is managing it.
Can this be done in an aged care home?
Yes. Pressure, the optic nerve and slit lamp photography are all straightforward at the bedside or in a room. Visual fields need the resident to be able to press a button in response to a light, so it is not always possible, and where it is not, that is written into the report.

Written and reviewed by

Ali Selman, Bachelor of Vision Science, Master of Optometry. AHPRA registered optometrist. Last reviewed 23 August 2026.

Sources

  1. Keel S, Xie J, Foreman J, Lee PY, Alwan M, Fahy ET, van Wijngaarden P, Fan Gaskin J, Ang GS, Crowston J, Taylor HR, Dirani M. Prevalence of glaucoma in the Australian National Eye Health Survey. British Journal of Ophthalmology 2019;103(2):191-195. Around half of the participants found to have glaucoma had no known history of it. doi.org/10.1136/bjophthalmol-2017-311786
  2. Khadka J, Ratcliffe J, Caughey GE, Wesselingh SL, Inacio MC. Prevalence of eye conditions, utilization of eye health care services, and ophthalmic medications after entering residential aged care in Australia. Translational Vision Science & Technology 2021. Cohort of 409,186 people aged 65 and over; glaucoma recorded in 13.6%.
  3. Royal Victorian Eye and Ear Hospital. Primary Care Referral Guidelines, Ophthalmology, March 2026. Acute angle closure glaucoma is an emergency requiring immediate referral. Uncontrolled glaucoma with intraocular pressure above 26 mmHg is urgent, 1 to 30 days. eyeandear.org.au
  4. Medicare Benefits Schedule, items 10910, 10911 and 10931. mbsonline.gov.au
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