Glaucoma is a disease of the optic nerve — the part of your eye that carries visual informa-tion to your brain. When the optic nerve is progressively damaged over time, it leads to permanent vision loss. In many cases, elevated pressure inside the eye (called intraocular pressure, or IOP) contributes to this damage. However, glaucoma can also develop in peo-ple whose eye pressure is within the normal range, which is why regular eye exams are so important even if you have never been told your pressure is high.
Glaucoma is one of the leading causes of blindness world¬wide. It is often called the “silent thief of vision” because it damages your sight slowly and without warning — most people notice nothing wrong until significant vision has already been lost.
The two major types of glaucoma
Open-angle glaucoma
This is by far the most common form of glaucoma. It devel¬ops gradually when the eye’s drainage system becomes less efficient over time — think of it like a slow drain that never quite fully clears. As fluid builds up, pressure inside the eye can rise and begin damaging the optic nerve. Because this process is painless and causes no noticeable vision changes in the early stages, many people are unaware they have it until significant damage has occurred.
Some people have optic nerves that are sensitive to even normal eye pressure, putting them at higher risk. This is another reason why routine eye exams are essential — your eye doctor can detect early signs of optic nerve damage long before you would notice any change in your vision.
Angle-closure glaucoma
Also called closed-angle or narrow-angle glaucoma, this type occurs when the iris (the colored part of your eye) sits very close to the eye’s drainage angle and can shift to block it completely — similar to a piece of paper sliding over a drain. When the drainage angle is suddenly blocked, eye pressure spikes rapidly. This is called an acute attack, and it is a true eye emergency.
Signs of an acute angle-closure attack include:
If you experience these symptoms, seek emergency eye care immediately. Prompt treatment is essential to prevent permanent vision loss.
Many people with angle-closure glaucoma develop it slowly over time — this is known as chronic angle-closure glaucoma. Like open-angle glaucoma, it causes no symptoms in the ear¬ly stages, so it often goes undetected until damage is already severe or an acute attack occurs.
Your eye continuously produces a clear fluid called aqueous humor. Under normal circumstances, the same amount that is produced drains out through the eye’s drainage angle, keeping pressure inside the eye stable. When the drainage system is not working properly — whether due to blockage, narrowing, or other factors — fluid accumulates and pressure builds. Over time, elevated pressure (and in some cases other mechanisms not yet fully understood) damages the delicate fibers of the optic nerve, leading to vision loss.
In the early stages of open-angle glaucoma, there are typically no noticeable symptoms at all. As the disease pro¬gresses, you may begin to notice blind spots in your side (peripheral) vision. If left untreated, central vision is eventually affected as well.
Angle-closure glaucoma may also develop without warning signs, until an acute attack strikes suddenly with blurred vision, halos around lights, eye pain, headache, nausea, and vomiting (see above). Chronic angle-closure glaucoma, like open-angle, progresses silently in many people.
Several factors can increase your risk of developing glau¬coma:
Of these, elevated IOP is the only risk factor we can direct¬ly treat. That said, having normal eye pressure does not mean you are free from risk — which is why a comprehen¬sive eye exam looks at much more than pressure alone.
The best way to detect glaucoma is through a comprehen¬sive annual eye exam. Your eye doctor will measure your eye pressure, carefully examine your optic nerve, test your central and peripheral vision, assess your drainage angle, and measure the thickness of your cornea. Together, these findings help identify early changes that may indicate glau¬coma — often before you are aware of any problem.
There is currently no cure for glaucoma, and any vision already lost cannot be restored. However, with early detec¬tion and treatment, we can slow or even halt its progres¬sion and protect the vision you have.
The right treatment for you will depend on the type and stage of your glaucoma, your eye pressure, and other indi¬vidual factors. Options include:
When surgery is performed, the goal is typically to create or restore a drainage pathway so that fluid can leave the eye more easily and pressure is kept at a safe level.
SLT is a safe, gentle light treatment for open-angle glaucoma. It works by targeting specific cells in the eye’s drainage tissue to stimulate improved fluid outflow, lowering eye pressure. SLT can be an effective first-line treatment and may reduce or eliminate the need for daily eye drops. It can also be repeated if needed over time.
Because glaucoma so often develops without any symptoms, regular comprehensive eye exams are your most important defense. If you have risk factors or concerns, please don’t wait — schedule an appointment with our team today.
