What is Glaucoma?
Cats experiencing vision loss may not show any immediate symptoms. If the vision deteriorates gradually, it is likely that the cat will be able to continue normal activities. This makes it difficult for owners to notice that anything is wrong until the condition has become severe. If a cat begins to display symptoms of vision loss, a prompt veterinary consultation is recommended. If symptoms develop suddenly, this should be considered an emergency requiring immediate attention.
Glaucoma is a condition that occurs when the aqueous humor fluid in the eye fails to drain adequately, resulting in unusually high intraocular pressure. Feline glaucoma is similar to the human condition. The pressure causes the retina and the optic nerve leading from the eye into the brain to deteriorate. This nerve damage results in vision disorders and can lead to swelling of the eyeball, lens displacement, and destruction of the membranes located within the cornea. Glaucoma is an extremely painful condition and, if left untreated, it will cause partial or total blindness.
Symptoms of Glaucoma in Cats
Depending on the cause of glaucoma, symptoms may progress slowly over time or appear suddenly. The condition may affect one or both eyes. Symptoms may include:
- Cloudy eyes
- Redness of blood vessels in the eye
- Eyeball swelling or bulging
- Rubbing of eyes
- Rapid blinking
- Watery discharge
- Dilated pupils that fail to respond to light
- Vision loss
- Loss of appetite
- Behavior changes
- Headaches (indicated by head pressing)
Primary glaucoma is a rare inherited condition that is more commonly found in Burmese and Siamese cats than in other breeds. It is the result of an anatomical anomaly in an otherwise healthy eye. Primary glaucoma almost always affects both eyes.
Secondary glaucoma is a more common condition and may occur in one or both eyes. Eye disease, injury, or uveitis are the primary causes of secondary glaucoma. Uveitis is a severe inflammation of the eye caused by a blockage of the drainage ducts, usually from scar tissue and other debris. It is commonly found in cats with serious diseases including feline immunodeficiency virus (FIV), feline infectious peritonitis (FIP), feline leukemia (FeLV), or a parasite known as toxoplasmosis. In some cases, secondary glaucoma occurs without a known cause. The condition is more common in older cats.
Causes of Glaucoma in Cats
Primary glaucoma is caused by an improper development of the drainage angle in the eye.
Secondary glaucoma may be caused by several conditions, including:
- Severe eye infections
- Lens dislocation
- Inflammation of eye tissues
- Intraocular bleeding
- Eye tumors
- Injury to the eye
Diagnosis of Glaucoma in Cats
When a cat is brought into the veterinarian’s office with symptoms of vision loss, the first step will be for the vet to review its complete medical history. Owners should provide a detailed description of the symptoms including the onset and severity. Any thoughts regarding other possible causes of the symptoms, previous injuries, or other relevant information should be shared.
A thorough physical examination will be performed, including an eye exam. A tonometer is a diagnostic tool that blows a puff of air into the eyeball to measure intraocular pressure. The presence of high pressure in conjunction with a loss of vision will lead to a diagnosis of glaucoma. A gonioscopy may be used to measure the drainage of fluid from the eye, and in some cases, an electroretinography may be used to determine the permanence of vision loss. X-rays or an ultrasound may be performed to check for other eye abnormalities.
Treatment of Glaucoma in Cats
When a cat presents with glaucoma, the vet should immediately take steps to reduce the pressure in the eye in an attempt to save the cat’s vision. Unfortunately, by the time symptoms arise significant vision impairment has often already occurred. Once vision loss has occurred, it cannot be reversed. When only one eye is affected, treatment may also focus on protecting the healthy eye. Depending on the complexity of the case, a referral to a veterinary ophthalmologist may be necessary.
If the condition is not severe enough to require surgery, it can often be treated with prescription eye drops. Pain medication will be prescribed, as well as dorzolamide and/or timolol for a reduction of intraocular pressure, and steroids for inflammation. When glaucoma is treated with medications only, there is a high likelihood that blindness will eventually occur.
Surgical treatment may involve draining of the fluid to reduce pressure. A procedure known as cyclocryotherapy may be used to alter the fluid-producing cells in the eye. This may stop or slow the progression of glaucoma and works best for early treatment. When blindness has already occurred and there is continued pain and discomfort, it is often recommended that the eyeball be removed. After removal, the empty socket can be sewn shut or an orb may be used to retain the shape of the eye.
In addition to the treatment of glaucoma, any underlying diseases or conditions will also need to be addressed.
Recovery of Glaucoma in Cats
Following a glaucoma diagnosis, frequent veterinary visits will be necessary. Eye pressure must be regularly monitored and the vet will need to watch for drug interactions. Medications may need to be adjusted periodically. If only one eye is affected, preventative measures should be taken to protect the remaining eye.
If the glaucoma was caused by a lens dislocation or uveitis and the condition has been successfully treated, then the prognosis is positive.
If the cat has suffered vision impairment, owners will need to take measures to keep it out of harm’s way. Vision-impaired cats should always be kept indoors in a safe and quiet area. Contact with other animals and small children should be avoided. If possible, keep the cat away from stairs and be aware of sharp corners or other hazards. With a bit of patience, most cats eventually memorize their environment and adapt to life without sight.
Glaucoma Questions and Advice from Veterinary Professionals
Hello, my cat suffers from severe glaucoma. Unfortunately, he is already blind, we tried to cure the disease and used several prescribed eye drops for 10 days but they do not help at all. We are said that he needs an enucleation of the eye. However, we are very scared of surgery intervention because he has already experienced some anaesthesias so we don’t know how he will react to it one more time. He is also extremely sensitive. Please, could you probably recommend any medicament or an alternative to a general anaesthesia? Thank you very much for your answer in advance!
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April 2018 we were approached by a homeless man carrying (in a cardboard carrier) a 7 month old kitten. He said he could not care for her and asked us to take her. We did and fell in love with her. She is solid white with big round blue eyes. She is active and big (10 lbs.) I took her to the Vet shortly after and he did check her hearing (by clapping his hands) saying that white animals have a problem sometimes with hearing and vision. Just a couple of weeks ago I took her back to the Vet. b/c her left eye drained and by the end of each day she was squinting. This Vet. did pressure tests and looking at her forehead said there was a slight mound showing her there was fluid buildup. We were told she has glaucoma She was ordered Timolol Mal o.5% in left eye every 12 hours. To bring back for recheck in 2 to 4 weeks. I managed to get drops in her eye 3 times over the next couple of days and then she had had enough. She runs under the couch or a bed and is always 5 feet ahead of me. I have gotten her in my arms only for her to fight like a wild cat. She is very smart and watches my hands I have been told to hold the loose skin at back of neck. I managed to do that a couple of times but I am unable to hold her due to severe arthritic hands. My companion has early Alzheimers and is afraid he will hurt her. We are both handicapped and I honestly do not know if we are going to be good at getting this done. We do have a 10 year old dog and 8 year old rescue cat. Now she takes up so much of my time it is affecting the other pets. I am so anxious about getting a drop in her eye I'm becoming depressed thinking she is in pain and going blind. I will take her back to the Vet. this week but I do not believe they will see much if any change. I feel like a failure but I do not see myself being able to take care of her for the rest of my life (I'm 77). Do you have any advice or words of encouragement for me?
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on 25th dec my cats left eye was dilated so we took him straight to the vet. Glaucoma was diagnosed. He had to go on drops Trusopt 3 times a day on day one. 2nd visit he I was given steroids twice a day for uveitis. He has now been off steroids for 2 weeks & Trusopt reduced to twice a day. His eye has responded well, pressure came down within a day & is now 17 in both eyes he can see & his eye looks clear according to the vet Ophthalmoscope, the same colour as the right eye. His pupil responds the same as the right eye so responds to light. I wanted to know in cases like this if there is a chance he will recover. His blood tests were clear on day 2 & we think this all came about due to a cat toy that hit his left eye when playing with his brother 2 days before. If you need any more information please let me know.
Thank you for your reply. Its a mine field of knollage out there & most outcomes I read are not great. I will ask on our next visit on Thursday & hopefully will know more as we reduce the drops. I would really like to have a positive outcome to give hope to others
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