Glaucoma
Glaucoma damages the optic nerve slowly and silently. It takes peripheral vision first, which the brain compensates for without the person noticing, and by the time the patient becomes aware of it the loss is already permanent. What is lost cannot be recovered, but what remains can be protected.
Why it is called silent
In its most common form, open-angle glaucoma, there is no pain, no red eye and no blurred vision in the early stages. The visual field narrows from the edges inward. Many patients first come in having already lost a significant share of their optic nerve fibers.
That is why detection depends on the exam, not on symptoms.
Who is at higher risk
- People over 40.
- A parent or sibling with glaucoma. This is the single most important risk factor.
- Raised intraocular pressure.
- A thin cornea.
- High myopia.
- Diabetes, long-term steroid use, or previous eye trauma.
If a parent or sibling has glaucoma, you should be checked even if your sight is perfect.
How it is diagnosed and monitored
The diagnosis is never made on one number. It brings together:
- Intraocular pressure, read together with corneal thickness measured by pachymetry.
- Gonioscopy, to see whether the drainage angle is open or closed.
- Optic nerve OCT, which measures the nerve fiber layer and detects loss before it shows up in the visual field.
- Visual field testing, which maps the field of vision and is the follow-up test above all others.
Glaucoma is a chronic disease: monitoring is lifelong, with periodic tests compared against each other to tell whether the disease is stable or progressing.
Treatment
- Pressure-lowering drops. First line in most cases. They work only if they are used every day at the same time.
- YAG laser iridotomy. Opens a channel in the iris in narrow-angle glaucoma and prevents an angle-closure attack.
- Filtering surgery. When pressure cannot be controlled with medication, an alternative drainage route is created.
The goal of treatment is not to improve vision, it is to stop the loss. Successful treatment is treatment after which your visual field looks the same year after year.
Frequently asked questions
If I have surgery or use the drops, will I get back what I lost?
No. Optic nerve damage is irreversible. The whole point of treatment is to preserve the vision you have today.
Can I stop the drops if I feel fine?
No. Because glaucoma produces no symptoms, feeling fine does not mean it is controlled. Stopping the drops on your own is one of the most common reasons the disease progresses.
Does high eye pressure always mean glaucoma?
Not always. There is ocular hypertension without nerve damage, which needs watching, and there is also glaucoma with pressure in the normal range. That is why the diagnosis combines several tests.
How often are the check-ups?
It depends on severity and stability. Typically every three to six months, with periodic visual fields and OCT as your specialist advises.
This information is educational
What is described here is the usual approach and does not replace a medical assessment. The diagnosis and treatment for your case are decided by your treating specialist.
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