What Is Glaucoma?

Glaucoma is often called "the silent thief of sight" because most people have no symptoms in the early stages. Glaucoma is a group of eye diseases that gradually damage the optic nerve, the vital connection between your eye and your brain. Vision loss begins at the periphery and progresses so slowly that many patients don't notice anything is wrong until significant, irreversible damage has already occurred.

Glaucoma is the leading cause of irreversible blindness worldwide, yet with early detection and proper treatment, the vast majority of patients can preserve their vision for life.

Types of Glaucoma

Open-angle glaucoma

• This is the most common form of glaucoma and produces no noticeable symptoms. The drainage system of the eye remains open, but becomes less efficient over time, causing eye pressure to slowly rise. As the disease progresses, blind spots develop in your peripheral vision. These often go undetected until significant damage has already occurred, causing tunnel vision. This is why routine screening matters.

Angle closure glaucoma

• In this type, the drainage angle between the iris and cornea becomes physically blocked, preventing fluid from draining properly. It can occur slowly (chronic angle-closure) or suddenly (acute angle-closure episode).

• Watch out for these symptoms: sudden severe eye pain with blurring of vision and halo around lights, eye redness, brow ache, headache, nausea, and vomiting. Seek care immediately.

Normal tension glaucoma

• Glaucoma occurs despite eye pressure readings within the normal range. Causes could be poor blood flow to the optic nerve, vascular disease, or increased nerve sensitivity. It is more common in individuals of Japanese descent and those with a history of low blood pressure or migraines.

• It is important to treat obstructive sleep apnea in patients with normal tension glaucoma

Secondary glaucoma

• This form of glaucoma develops as a result of another underlying condition, such as:

  • Pseudoexfoliation glaucoma — flaky protein material deposits throughout the body and in the drainage system of the eye. Compared to primary open-angle glaucoma, PXG tends to cause higher IOP spikes, wider pressure fluctuations, and much faster disease progression.

  • Pigment dispersion glaucoma — pigment rubs off the back of the iris and clogs the eye's drainage system. Commonly affects young, nearsighted men. Some patients may experience brief episodes of blurry vision or halos around lights, particularly after strenuous exercise or pupil dilation.

  • Neovascular glaucoma — abnormal blood vessel growth secondary to diabetes or retinal vascular disease blocking the eye’s drainage system.

  • Steroid-induced glaucoma — prolonged use of corticosteroid medications (eye drops, inhalers, or oral steroids) causes elevated intraocular pressure.

  • Angle recession glaucoma — injury to the eye disrupts normal drainage of the eye.

Congenital and childhood glaucoma

• Glaucoma can affect infants and children, either present at birth or early in childhood. Often associated with Sturge-Weber syndrome or port-wine stain facial birthmark. Signs in infants include excessive tearing, sensitivity to light, and enlarged, cloudy eyes.

How Is Glaucoma Monitored?

Because glaucoma is a progressive disease, monitoring is just as important as treatment. We will use a combination of the following tests to track your condition over time:

• Intraocular Pressure (IOP) Measurement - this is checked at every visit. It is an important benchmark and treatment target.

• Visual Field Testing - this checks your peripheral vision and monitors for potential loss over time. You will respond to light signals appearing in different parts of your visual field.

• Optical Coherence Tomography (OCT) - this measures the thickness of the optic nerve fiber layer and ganglion cell layer, detecting early loss in glaucoma. Changes in thickness over time can signal progression even before you notice any vision changes yourself.

• Optic Nerve Photo - This is a color photo of your optic nerve to detect subtle structural changes like widening of the central cup, thinning of the rim tissue, or small hemorrhages on the nerve.

Treatment

Treatment depends on the type of glaucoma you have, how advanced it is, and how well it responds to therapy. The goal is to lower eye pressure and preserve the vision you have.

• Medication. Prescription eye drops are the most common first-line therapy. They work either by reducing the amount of fluid the eye produces or by improving the fluid's drainage.

• Laser Treatment. Selective Laser Trabeculoplasty (SLT) uses a targeted laser to improve outflow through the eye's natural drainage system (the trabecular meshwork), lowering pressure without surgery. This is an in-office procedure.

• Surgery. When drops and laser treatment aren't enough, surgical procedures can create new or improved drainage pathways to bring pressure down and protect the optic nerve from further damage.

Protect Your Vision

Glaucoma cannot be reversed, but with early detection, it can almost always be managed. If you have any risk factors or if it has simply been a while since your last eye exam, call to schedule an appointment. We'll determine your individual risk and set a follow-up schedule tailored to you.