Glaucoma is often called the “silent thief of sight” for good reason. It typically causes no pain and produces no visible symptoms until a significant portion of peripheral vision has already been lost — vision that cannot be recovered. It is the leading cause of irreversible blindness worldwide, affecting millions of people who do not yet know they have it. The encouraging news is that when detected early through regular eye exams, glaucoma can almost always be managed effectively enough to preserve functional vision for life.
What Is Glaucoma?
Glaucoma is a group of conditions that damage the optic nerve, which carries visual signals from the eye to the brain. In most cases, damage is related to elevated pressure inside the eye (intraocular pressure), which gradually destroys nerve fibers over time. In normal-tension glaucoma, nerve damage occurs even when eye pressure is within the normal range, suggesting that blood flow and nerve vulnerability also play important roles.
The most common form, primary open-angle glaucoma, progresses slowly and painlessly. Patients often do not notice any change in their vision until the disease is advanced. Acute angle-closure glaucoma, by contrast, can develop suddenly with severe eye pain, headache, nausea, and blurred vision — this is a medical emergency that requires immediate treatment.
Who Is at Risk?
Several factors increase the likelihood of developing glaucoma. Elevated intraocular pressure (ocular hypertension) is the most well-established risk factor. Having a first-degree relative with glaucoma raises your lifetime risk significantly. African Americans develop glaucoma at higher rates and at younger ages than other groups. People with thin corneas, those who are very nearsighted, and individuals with diabetes or hypertension also face higher risk.
Age is a universal risk factor — the chances of developing open-angle glaucoma increase after age 40 and rise steeply after 60. If you fall into any of these categories, annual eye exams with glaucoma screening are strongly recommended.
How Glaucoma Is Detected
Diagnosing glaucoma requires more than a standard vision screening. A comprehensive glaucoma evaluation includes tonometry (measuring intraocular pressure), gonioscopy (examining the drainage angle of the eye), visual field testing (to detect any peripheral vision loss), optical coherence tomography (OCT) of the optic nerve fiber layer, and detailed examination of the optic disc.
No single test is sufficient on its own. Your eye doctor looks at the whole picture — pressure, nerve appearance, drainage anatomy, and any functional vision changes — to determine whether glaucoma is present and how far it has progressed.
Treatment and Management
Glaucoma cannot currently be reversed, but it can be controlled. First-line treatment is usually prescription eye drops that lower intraocular pressure by reducing fluid production or increasing fluid drainage. When drops are insufficient or not tolerated, laser treatment (selective laser trabeculoplasty, or SLT) is often highly effective at improving drainage. Surgical options, including minimally invasive glaucoma surgery (MIGS) and traditional trabeculectomy, are available for more advanced cases.
Consistent monitoring is just as important as treatment. Glaucoma management is a lifelong commitment — pressure can fluctuate, and the optic nerve must be reassessed regularly to ensure disease progression has been halted.
Our team provides regular glaucoma monitoring and management as part of our comprehensive eye care services. To check your risk, try our free eye health tools and schedule a screening if you have not had one recently.