Glaucoma

Glaucoma is a group of eye diseases that damage the optic nerve, the structure responsible for sending visual information from your eye to your brain. In many cases, this damage happens slowly and without noticeable symptoms at first — which is why glaucoma is often called the silent thief of sight.

Inside the eye, a clear fluid is constantly produced and drained to maintain healthy pressure. When this drainage system doesn’t work properly, fluid can build up, increasing pressure inside the eye. Over time, this pressure can damage the optic nerve fibers. Once optic nerve damage occurs, vision loss is permanent.

In the early stages, glaucoma often causes no pain and no obvious vision changes. As the disease progresses, peripheral (side) vision is usually affected first, creating a tunnel-like view. If left untreated, central vision can also be lost, leading to blindness.

Routine comprehensive eye exams allow glaucoma to be detected early, when treatment is most effective at preserving vision.

A glaucoma evaluation is part of a comprehensive eye exam and may include:

• Visual acuity testing – Measures how clearly you see at different distances
• Visual field testing – Evaluates your side (peripheral) vision
• Dilated eye exam – Allows your doctor to closely examine the optic nerve and retina
• Eye pressure measurement (tonometry) – Checks pressure inside the eye
• Gonioscopy – Examines the eye’s drainage angle to identify blockages or abnormalities

Your eye doctor will recommend how often you should be tested based on your risk factors.

During specialized glaucoma evaluation appointments, your doctor may also perform advanced diagnostic testing, including:

• Visual field testing – Measures subtle changes in peripheral vision
• Pachymetry – Measures corneal thickness, which helps interpret eye pressure readings
• Optic nerve head (ONH) OCT – Provides detailed imaging of the optic nerve to detect early damage and monitor progression
• Angle assessment (angle scan) – Evaluates the eye’s drainage angle to identify narrowing or blockage

These tests help your doctor diagnose glaucoma accurately and track changes over time.

Anyone can develop glaucoma, but your risk may be higher if you:

• Have elevated eye pressure
• Are over age 60
• Are Black or Hispanic
• Have a family history of glaucoma
• Have diabetes or high blood pressure
• Are very nearsighted
• Have had an eye injury or eye surgery
• Use steroid medications

While glaucoma cannot be cured, it can be managed. Treatment focuses on lowering eye pressure to slow or prevent further vision loss.

Common treatment options include:

Medications

Prescription eye drops or oral medications help reduce eye pressure. It’s important to use them exactly as directed. Let your doctor know if you experience side effects — adjustments can often be made.

Laser treatment

Laser procedures are performed by an ophthalmologist and help improve fluid drainage from the eye, reducing pressure safely and effectively.

Surgical options

If medications and laser treatment aren’t enough, surgery may be recommended to create a new drainage pathway for fluid.

Cataract surgery & micro-bypass stents

Cataract surgery alone often lowers eye pressure. In some patients, tiny microstents placed during cataract surgery can further improve drainage and help control glaucoma.

• Primary open-angle glaucoma – The most common form; drainage slows over time, causing gradual pressure buildup
• Normal-tension glaucoma – Optic nerve damage occurs despite normal eye pressure
• Angle-closure glaucoma – Sudden blockage of drainage that causes a rapid pressure increase (medical emergency)
• Congenital glaucoma – Present at birth due to abnormal drainage system development
• Secondary glaucoma – Caused by other conditions such as diabetes, cataracts, eye surgery, tumors, or steroid use

Seek immediate care if you experience:

• Severe eye pain
• Headache or brow pain
• Redness of the eye
• Blurred vision
• Seeing halos or rainbow-colored rings around lights

Prompt treatment is critical to prevent permanent vision loss.