About Glaucoma
Glaucoma — commonly known as high eye pressure — is an insidious disease that damages the optic nerve, the cable that carries vision to the brain. It usually progresses without symptoms, which is why it is often discovered late.
The damage and visual-field loss it causes are permanent, so the goal of treatment is to halt or slow progression. Regular eye examinations are vital for early diagnosis and for protecting sight.
What Is Glaucoma?
In most types of glaucoma the pressure inside the eye rises because fluid cannot drain properly. This raised pressure gradually damages the optic-nerve fibres, narrowing the field of vision from the edges inward.
Because central vision is preserved until late, many people do not notice the loss until it is advanced. This makes screening essential, especially after age 40 and in those with a family history.
Types of Glaucoma
The main forms of glaucoma are:
- Open-angle glaucoma: The most common type; slow, painless and symptom-free for years.
- Angle-closure glaucoma: A sudden, painful pressure rise that is an emergency.
- Normal-tension glaucoma: Optic-nerve damage despite pressures in the normal range.
- Secondary glaucoma: Caused by other conditions, injury or certain medications.
Symptoms
Glaucoma is usually silent; warning signs include:
- Visual-field narrowing: Gradual loss of peripheral (side) vision.
- Reduced night vision: Difficulty seeing in dim conditions.
- Serious loss in advanced stages: Marked vision loss once the disease is advanced.
- Often no early symptoms: Many people feel nothing until damage has occurred.
- Acute attack (angle-closure): Sudden pain, redness, halos and blurred vision — seek care urgently.
Diagnosis
Diagnosis and follow-up rely on several measurements:
- Intraocular pressure (tonometry): Measures the pressure inside the eye.
- Optic-nerve examination: The nerve head is assessed for glaucoma damage.
- Visual-field test (perimetry): Maps and tracks peripheral vision loss.
- OCT of the nerve fibre layer: Detects thinning before field loss appears.
- Gonioscopy: Examines the drainage angle to classify the glaucoma.
Treatment
Drops & Laser
Lowering eye pressure protects the optic nerve; most patients start with drops and/or laser.
Drops
Daily drops reduce intraocular pressure and protect the nerve.
Laser
Laser improves fluid drainage in suitable patients.
Follow-up
Pressure, field and OCT are tracked over time.
Pressure Under Control
When Needed
When pressure cannot be controlled, surgery creates a new drainage pathway.
Assessment
Surgery is planned when drops/laser are insufficient.
Surgery
A new outflow pathway or device lowers pressure.
Monitoring
Pressure is monitored for life to protect vision.
Long-term Pressure Control
When did you last check your eye pressure?
Early diagnosis is decisive; a follow-up schedule is set to your risk level.