Glaucoma: The Silent Thief of Sight

Glaucoma damages the optic nerve, usually because pressure inside the eye is higher than that nerve can tolerate. What makes it dangerous is the pattern of loss: peripheral vision goes first, and the brain fills in the gaps so convincingly that patients routinely lose half their visual field without noticing.

Who should be screened

• Everyone over 40, every two years.
• Anyone with a parent or sibling who has glaucoma — risk rises several-fold.
• People with high myopia, diabetes, or a history of long-term steroid use.
• Anyone who has had significant eye trauma.

What a glaucoma work-up involves

Pressure measurement alone is not enough, because a third of patients have normal-tension glaucoma. A proper assessment adds corneal thickness measurement, gonioscopy to check the drainage angle, automated visual field testing and OCT imaging of the optic nerve fibre layer.

Treatment

The aim is always the same: lower the pressure enough to stop further damage. Most patients are controlled with daily drops. Where drops are insufficient or poorly tolerated, SLT laser or filtering surgery such as trabeculectomy is offered.

An important caveat

Vision already lost to glaucoma cannot be recovered. Everything in glaucoma care is about protecting the sight you still have — which is why the screening appointment is the part that matters most.