What is glaucoma?
Glaucoma is a group of conditions that gradually damage the optic nerve and may lead to irreversible vision loss. The most challenging aspect is that glaucoma often develops without noticeable symptoms in the early stages—many people feel no changes until vision has already begun to deteriorate.
That is why the best protection is a regular comprehensive eye exam that includes glaucoma screening. When detected early, glaucoma can be effectively controlled and the risk of vision loss can be significantly reduced. However, it is important to understand that even with proper treatment the disease may progress in some cases, so glaucoma requires long-term, systematic monitoring.
Causes of glaucoma
In most cases, optic nerve damage is associated with elevated intraocular pressure (IOP). The eye constantly produces fluid that must drain through the eye’s drainage system. If outflow is impaired, fluid builds up, pressure rises, and this can gradually affect the optic nerve.
There is also normal-tension glaucoma: intraocular pressure may remain within the normal range, yet optic nerve damage still occurs. The mechanisms can be complex, so diagnostics must be as accurate and comprehensive as possible.
Why glaucoma is called the “silent thief of sight”
Glaucoma is one of the leading causes of blindness worldwide. Because early manifestations are often minimal or absent, glaucoma is frequently referred to as the “silent thief of sight.” Many people learn about the condition during a routine eye exam, when changes can already be detected objectively.
For this reason, everyone is advised to undergo glaucoma screening as part of a comprehensive eye check-up—especially if risk factors are present.
Glaucoma risk factors
Risk factors vary depending on the type of glaucoma, but the general rule is the same: if you have at least one risk factor, you should be examined more regularly.
Primary open-angle glaucoma
This is the most common form. The drainage system gradually becomes less effective, fluid outflow decreases, and intraocular pressure may increase.
Risk factors:
age (risk increases over time);
family history of glaucoma;
long-term or uncontrolled use of steroid medications (especially eye drops or systemic forms);
coexisting conditions (for example, blood pressure issues—under certain circumstances may be associated with optic nerve risk).
Angle-closure (narrow-angle) glaucoma
This occurs when the eye’s anatomy predisposes the drainage angle to become blocked. In some situations it can lead to a rapid and dangerous rise in intraocular pressure, requiring urgent medical care.
Risk factors:
hyperopia/farsightedness (anatomical features may increase risk);
age (risk increases over time);
sex (some forms are more common in women).
Secondary glaucoma
Secondary glaucoma develops as a consequence of other conditions or influences that disrupt aqueous outflow.
Possible causes include:
eye injuries (blunt or penetrating);
inflammatory processes;
certain diseases (e.g., diabetes) and conditions that alter intraocular structures;
in some cases—medications that may affect intraocular pressure or drainage.
How to protect your vision
Even without obvious risk factors, glaucoma can still develop. The basic protection strategy is scheduled eye exams and targeted glaucoma screening. This is especially important after age 40, and for anyone with hereditary predisposition or coexisting conditions.
Glaucoma treatment
The goal of treatment is to stop or максимально slow optic nerve damage. The best outcomes occur when glaucoma is diagnosed before noticeable vision loss develops.
Main treatment options include:
eye drops to control intraocular pressure;
laser procedures, including selective laser trabeculoplasty (SLT), to improve fluid outflow;
surgery, when stronger or more stable pressure control is needed.
Glaucoma typically requires lifelong monitoring. If drops or other treatments are prescribed, it is crucial to follow the regimen—consistency often determines long-term stability.
“Signs” vs “symptoms”: an important distinction
With glaucoma, a person may have no symptoms for a long time. Symptoms are what the patient feels (e.g., discomfort, blurred vision).
Signs are what the doctor detects during examinations—objective changes that can be identified before the patient notices anything.
That is why glaucoma is a condition where prevention and regular screening are essential.