Glaucoma: The Silent Thief of Sight

by Monique Courtenay-Brown, MD, PhD, Lexington Medical Eye Care Associates

Glaucoma is a group of eye conditions that damage the optic nerve, which is vital for vision. The most common cause of glaucoma is high pressure inside the eye (intraocular pressure), which can lead to gradual vision loss if left untreated. Often called the "silent thief of sight," glaucoma typically develops slowly and painlessly, with no noticeable symptoms in the early stages.

Who is At Risk?
Certain factors increase the likelihood of developing glaucoma, including:

• Age: People over 60, especially those of African, Hispanic, or Asian descent, are at a higher risk.
• Family History: If glaucoma runs in your family, you are more likely to develop it.
• Eye Conditions: Conditions such as high intraocular pressure, thin corneas, or previous eye injuries can increase risk.
• Health Conditions: Individuals with diabetes, high blood pressure, and heart disease may also be at a higher risk.
• Ethnicity: African Americans are more likely to develop glaucoma at a younger age and experience more severe vision loss. If you have Hispanic or Asian heritage, you are also at higher risk for developing glaucoma. 

Warning Signs
In the early stages, glaucoma often presents no symptoms, making it hard to detect without regular eye exams. However, as the condition progresses, some signs may become noticeable:

• Peripheral vision loss: People with glaucoma may notice they have trouble seeing out of the corners of their eyes.
• Blurred or narrowing vision: As the condition worsens, a person may experience tunnel vision or blurred vision.
• Eye pain or discomfort: In certain types of glaucoma, such as acute angle-closure glaucoma, symptoms like severe eye pain, headaches, nausea, and vomiting can occur.

Diagnosing Glaucoma
Ophthalmologists typically diagnose glaucoma through a comprehensive eye exam, which may include:

• Tonometry: A test to measure intraocular pressure.
• Optic nerve imaging: Uses specialized tools to capture detailed optic nerve images.
• Visual field test: Checks for any loss of peripheral vision.
• Pachymetry: Measures the thickness of your cornea, which can affect eye pressure readings.
• Gonioscopy: Examines the angle of the eye where the iris meets the cornea to determine if it's open or closed.

Treatment Options
While there is no cure for glaucoma, there are treatments to help control the condition and prevent further vision loss:

• Medications: Eyedrops or oral medications can help lower intraocular pressure.
• Laser Therapy: In some cases, laser treatments can help open blocked drainage pathways or reduce fluid production in the eye.
• Surgery: For advanced cases, your ophthalmologist may recommend a surgical procedure to create a new drainage channel or implant a device to help control pressure.

Reduce Your Risk
While you can't eliminate the risk of developing glaucoma, there are steps you can take to reduce your chances:

• Regular Eye Exams: Routine checkups with an eye care professional are the best way to catch glaucoma early.
• Know Your Family History: If glaucoma runs in your family, be sure to get regular eye exams starting at an earlier age.
• Protect Your Eyes: Wearing safety glasses to prevent eye injuries can reduce the risk of developing secondary glaucoma.
• Maintain a Healthy Lifestyle: Eating a balanced diet, exercising regularly, and controlling your blood pressure and blood sugar levels may lower your risk.

Though glaucoma is one of the leading causes of blindness worldwide, with early detection and proper treatment, you can manage it effectively and preserve your vision. If you're at risk, don't wait for symptoms to appear—schedule regular eye exams to stay proactive about your eye health. Early detection is key to preserving your sight for years to come.


Monique Courtenay-Brown, MD, PhD, Lexington Medical Eye Care Associates