What is glaucoma?
In short A group of eye conditions that damage the optic nerve, usually from eye pressure that’s too high for your nerve. Vision loss is often silent at first, starting at the edges (peripheral vision) — so regular screening matters.
Goal: Lower eye pressure and protect the optic nerve to keep vision stable over the long term.
Urgent red flags
- Severe eye pain with headache, nausea, halos around lights
- Sudden vision loss or very blurred vision
- Red, hard eye with worsening pain
These can signal acute angle-closure. Seek urgent eye care.
Typical symptoms
- Often none early on (open-angle type)
- Slowly narrowing side vision; bumping into objects
- Needing more light; glare or halos (especially at night)
Who’s at higher risk?
- Age ≥60, family history, certain ethnic backgrounds
- High eye pressure, thin corneas, severe nearsightedness/farsightedness
- Long-term steroid use, diabetes, vascular issues
Main types
| Type | What happens | Notes |
|---|---|---|
| Primary open-angle | Drainage becomes less efficient → slow pressure rise | Most common; painless and gradual |
| Angle-closure (narrow angle) | Drain angle closes; pressure can rise quickly | Can be sudden & painful; needs urgent care |
| Normal-tension | Optic nerve damage even at “normal” pressures | Blood flow and nerve vulnerability may play roles |
| Secondary | From other causes (inflammation, trauma, steroids) | Treat the trigger plus pressure control |
How it’s diagnosed & monitored
Key tests
- Eye pressure (tonometry)
- Optic nerve exam + photos/OCT imaging
- Visual field testing for side vision
- Gonioscopy (checks the drain angle)
- Corneal thickness (pachymetry)
Follow-up schedule
- New diagnosis: visits every 1–3 months until stable
- Stable: typically every 3–6 months with periodic fields/OCT
- After treatment change: earlier re-check to confirm pressure goal
Treatment options
Eye drops (first-line)
- Prostaglandin analogs (once nightly)
- Beta-blockers, alpha-agonists, carbonic anhydrase inhibitors
- Often combined for target pressure; watch for side effects
Laser
- SLT (selective laser trabeculoplasty) for open-angle
- Peripheral iridotomy for narrow/angle-closure
- May reduce or delay need for drops
Procedures
- MIGS (minimally invasive glaucoma surgery) often with cataract surgery
- Trabeculectomy or tube shunt for advanced cases
Eye drop technique
Step-by-step
- Wash hands; tilt head back, look up
- Pull lower lid to make a small pocket
- One drop only; don’t touch the bottle tip to eye/lashes
- Press inner corner of eye (punctal occlusion) for 1–2 minutes to keep medicine in
- Wait 5–10 minutes between different drops
Make it easier
- Use a mirror or lie down
- Color-code caps or use a checklist
- Ask about once-daily options or combination bottles
Daily care & safety
- Take drops exactly as prescribed; set phone reminders
- Bring all bottles to each visit; note any side effects (wheezing, slow pulse with beta-blockers)
- Protect eyes from injury; wear sunglasses for glare
Driving & low-vision help
- Ask about legal vision requirements where you live
- Avoid night driving if glare/halos are significant
- Use larger mirrors; scan side-to-side more often
Low-vision aids
- High-contrast labels, magnifiers, task lighting
- Orientation & mobility training if fields are reduced
Questions for your eye doctor
- What type of glaucoma do I have and what is my target pressure?
- How often should I have pressure checks, OCT, and visual fields?
- Are drops, laser, or surgery best for me right now?
- Could any of my other medicines affect eye pressure?
- What side effects should I watch for with my drops?
- Can we simplify my drop schedule?
Glaucoma — quick answers
Can glaucoma be cured?
There’s no cure yet, but controlling pressure can slow or stop further damage and preserve sight.
If my pressure is normal, can I still have glaucoma?
Yes — normal-tension glaucoma exists. Nerve testing and visual fields guide treatment even when pressure numbers look “normal.”
Do cataracts affect glaucoma?
Cataract surgery can sometimes lower pressure and improve vision quality. In some cases, MIGS can be added at the same time.
What happens if I miss drops?
Pressure can drift up. Use reminders; if doses are frequently missed, ask about laser or simpler regimens.
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