Glaucoma: The Silent Thief of Sight

Glaucoma is often called the “silent thief of sight,” and with good reason. It’s one of the leading causes of irreversible blindness worldwide, yet most people have no idea they have it until permanent damage has already occurred. This eye condition damages the optic nerve, which transmits visual signals from the eye to the brain. Once this nerve is compromised, the damage cannot be reversed. However, early detection and treatment can help preserve your vision and prevent further deterioration.

In this blog, we’ll explore glaucoma, who is at risk, the symptoms to look out for, how it is diagnosed, and what treatments are available to manage the condition.

What is Glaucoma?

Glaucoma is not a single disease but a group of eye conditions leading to progressive optic nerve damage. The most common contributing factor is increased intraocular pressure (IOP), which results from fluid buildup in the eye. However, depending on the individual and the specific type of glaucoma, glaucoma can also occur with normal or even low eye pressure.

Glaucoma damage is typically slow and painless. It first affects peripheral vision before advancing to central vision in more severe cases. Because the disease develops gradually, many people are unaware that they have it until significant vision loss has already occurred.

Types of Glaucoma

There are several types of glaucoma, each with its own causes, risk factors, and progression patterns. The main categories include:

Primary Open-Angle Glaucoma

This is the most common form of glaucoma, particularly in African populations. It develops slowly over time and is usually asymptomatic until vision is significantly affected. The drainage angle within the eye remains open, but the trabecular meshwork becomes less efficient, increasing eye pressure.

Angle-Closure Glaucoma

This type occurs when the drainage angle in the eye becomes blocked or closed, causing a sudden rise in intraocular pressure. It is a medical emergency and can lead to rapid vision loss if not treated promptly. Symptoms may include eye pain, headaches, nausea, blurred vision, and seeing halos around lights.

Normal-Tension Glaucoma

In this type, optic nerve damage occurs despite normal eye pressure. The exact cause is not fully understood, but it is believed to be related to poor blood flow to the optic nerve.

Secondary Glaucoma

This form results from another condition or eye injury. Causes can include inflammation, trauma, certain medications like corticosteroids, or diseases such as diabetes or cataracts.

Congenital Glaucoma

A rare type that affects babies and young children. It is typically present at birth due to abnormal eye drainage system development.

Who Is at Risk of Developing Glaucoma?

Glaucoma can affect anyone, but some people are more likely to develop the condition. Common risk factors include:

• Age over 60, though younger individuals can also be affected
• Family history of glaucoma
• African, Asian, or Hispanic ancestry
• High intraocular pressure
• Myopia (short-sightedness)
• Thin corneas
• Chronic diseases such as diabetes and high blood pressure
• Prolonged use of corticosteroid medications
• Previous trauma or injury to the eye

People with multiple risk factors are encouraged to have regular comprehensive eye exams, even without symptoms.

Symptoms of Glaucoma

One of the biggest challenges in managing glaucoma is that it often causes no noticeable symptoms until it has progressed. In its early stages, vision remains normal, and there is no pain. That’s why it is so important to attend regular eye screenings, especially if you fall into one of the higher-risk categories.

When symptoms do appear, they may include:

• Blind spots or patchy vision in your peripheral (side) vision
• Tunnel vision in advanced stages
• Blurred vision
• Severe eye pain or pressure (more common in angle-closure glaucoma)
• Halos around lights
• Headaches, nausea, and vomiting in acute cases

By the time these signs become noticeable, significant and irreversible damage may have already occurred.

How Is Glaucoma Diagnosed?

Glaucoma is diagnosed through a series of eye tests conducted by an optometrist or ophthalmologist. These tests are quick, painless, and crucial for detecting the disease early. They include:

1. Tonometry

Measures intraocular pressure using a device called a tonometer.

2. Ophthalmoscopy

Assesses the shape and colour of the optic nerve to identify any visible signs of damage.

3. Visual Field Test

Checks for blind spots or loss of peripheral vision.

4. Gonioscopy

Examines the eye’s drainage angle to determine whether it is open or closed.

5. Pachymetry

Measures the thickness of the cornea, which can influence pressure readings and help assess your risk.

Sometimes, when the diagnosis is unclear, your doctor may request follow-up assessments to monitor changes over time before confirming the condition.

Can Glaucoma Be Cured?

Unfortunately, glaucoma cannot be cured, and any vision loss already sustained cannot be restored. However, further damage can be prevented or slowed significantly with early detection and proper management.

Treatment Options for Glaucoma

The goal of treatment is to lower intraocular pressure to a safe level for the eye. The right treatment option will depend on the type and severity of the disease, as well as the patient’s age, lifestyle, and general health. Treatments include:

1. Eye Drops

Prescription eye drops are the most common initial treatment. They work by reducing fluid production in the eye or helping it drain more effectively.

2. Laser Therapy

Selective Laser Trabeculoplasty (SLT) is a common laser procedure used to improve fluid drainage in open-angle glaucoma. It is often used when eye drops are not enough or to reduce medication reliance.

3. Surgical Options

In cases where eye drops and laser therapy are ineffective, surgery may be recommended. Options include:

• Minimally Invasive Glaucoma Surgery (MIGS) – Small implants are used to improve fluid outflow. This option is typically used in early to moderate cases.
• Trabeculectomy – A surgical procedure to create a new drainage pathway for the fluid.
• Drainage implants – Small devices are inserted to help fluid drain out of the eye effectively.

4. Cataract Surgery

Removing the cataract lens can help open the drainage angle and lower eye pressure in patients with narrow or closed-angle glaucoma.

Living with Glaucoma

Glaucoma is a lifelong condition that requires consistent monitoring and management. Adhering to your prescribed treatment plan and attending regular eye check-ups are essential to maintaining your vision. The following lifestyle tips may also support eye health:

• Take prescribed eye drops exactly as instructed
• Monitor and control blood pressure and blood sugar levels
• Avoid smoking and excessive alcohol consumption
• Maintain a balanced diet rich in antioxidants
• Exercise regularly, but avoid activities that increase eye pressure
• Protect your eyes from injury

Living with glaucoma does not mean you will go blind. Many patients retain good vision for life with early intervention and ongoing care.

Why Choose iSurgeon?

At iSurgeon, we offer advanced diagnostic tools, personalised treatment plans, and expert surgical care for patients with glaucoma. Our team is dedicated to preserving your vision and enhancing your quality of life. Whether you’re at risk or have already been diagnosed, we are here to guide you every step of the way.

We understand how worrying it can be to hear the word “glaucoma.” But you’re not alone, and with the right team, early detection, and consistent treatment, you can stay ahead of the condition and continue enjoying the world around you.