glaucoma

Overview
Glaucoma is a group of eye conditions that damage the optic nerve, the vital connection between the eye and the brain. This damage is often caused by increased pressure in the eye (intraocular pressure), but not always. It typically develops slowly and painlessly, which means many people don’t realize they have it until significant vision loss occurs. There are several types, with open-angle glaucoma being the most common.

Why It’s Important
Glaucoma is a leading cause of irreversible blindness worldwide. Because it often has no early symptoms, it’s known as the “silent thief of sight.” Regular eye exams are critical for early detection. If caught early, vision loss can often be slowed or prevented, but lost vision cannot be restored.

Quick Facts

  • Most common in people over age 60, but can affect younger adults and even infants

  • Over 3 million Americans are affected, many unknowingly

  • Often chronic and progressive

  • Main types include:

    • Primary open-angle glaucoma (most common)

    • Angle-closure glaucoma (sudden and severe)

    • Normal-tension glaucoma (optic nerve damage with normal eye pressure)

    • Congenital glaucoma (present at birth)

What Happens in the Body
Normally, a clear fluid called aqueous humor flows through the eye and drains out, keeping pressure balanced. In glaucoma, this fluid doesn’t drain properly, causing increased intraocular pressure that damages the optic nerve. In some types, nerve damage happens even without high pressure. As the nerve deteriorates, peripheral (side) vision fades first, followed by central vision in later stages.

Common Signs and Symptoms
Often no symptoms early on, especially with open-angle glaucoma.
As it progresses:

  • Gradual loss of peripheral vision

  • Tunnel vision in advanced stages

  • In acute angle-closure glaucoma:

    • Sudden eye pain

    • Blurred vision

    • Halos around lights

    • Nausea and vomiting

Diagnosis

  • Comprehensive eye exam including:

    • Tonometry (measures eye pressure)

    • Ophthalmoscopy (optic nerve inspection)

    • Visual field test (checks for blind spots)

    • Pachymetry (measures corneal thickness)

  • Early diagnosis is key—eye exams are recommended annually for high-risk individuals

See a doctor if:

  • You’re over 40 with a family history of glaucoma

  • You experience sudden vision changes, eye pain, or halos around lights

  • You have diabetes, high blood pressure, or are on long-term steroid medications

Treatment and Management

  • Eye drops (first-line treatment to lower eye pressure)

  • Oral medications (in some cases)

  • Laser therapy (to improve fluid drainage)

  • Surgery (to create new drainage pathways or relieve pressure)

  • No cure, but treatments can slow progression and preserve vision

Risks and Complications

  • Permanent vision loss or blindness

  • Falls and accidents due to vision loss

  • Emotional distress or loss of independence

  • Missed diagnosis if eye exams are not done regularly

Who Is at Risk

  • People over 60, especially African Americans (who are at higher risk earlier)

  • Family history of glaucoma

  • Diabetes, high blood pressure, or migraines

  • Long-term corticosteroid use

  • Eye injuries or surgeries

  • Thin corneas or high eye pressure

Related Conditions

  • Cataracts

  • Macular degeneration

  • Ocular hypertension

  • Diabetic retinopathy

When to See a Doctor

  • If you haven’t had an eye exam in over a year, especially if you’re over 40

  • If you notice vision loss, eye pain, or halos around lights

  • If you’re managing a condition like diabetes or are on steroids long-term

  • If glaucoma runs in your family

Last Updated: July 30, 2025