In summary
Glaucoma is a silent disease: it often has no symptoms in its early stages. Regular checks of eye pressure and of the visual field are essential, especially after the age of 40 or if there is a family history. Treatment can slow progression and protect the vision you still have.
- Risk factors
- High intraocular pressure (the main modifiable factor), family history, age over 40, high myopia, African origin.
- Diagnosis
- Tonometry, visual field test, optic nerve OCT, gonioscopy.
- Treatment
- Pressure-lowering eye drops, laser (selective laser trabeculoplasty SLT, iridotomy), surgery (trabeculectomy, valves, MIGS).
- Prevention
- Regular check-ups, monitoring of eye pressure, healthy lifestyle.
What is glaucoma
How the eye works
The eye is like a camera: the cornea acts as the lens, the retina as the film, the pupil as the aperture, the iris as the filter and the optic nerve as the cable that carries visual information to the brain.
Learn more about eye anatomyWhat is glaucoma?
Glaucoma damages the optic nerve, which connects the retina to the brain and carries the visual message. High eye pressure is the main risk factor: it can impair the flow of blood and nutrients to the optic disc, the point where the optic nerve joins the back of the eye. However, damage can also occur with pressure in the normal range.
Learn more about what glaucoma isWhat to do if you have glaucoma
- Follow the treatment plan you have been given, consistently and diligently.
- Rely on an ophthalmologist who is experienced in the condition.
- Make sure you understand your diagnosis and the type of glaucoma.
- Ask what stage the disease is at and which treatment is most suitable.
- Agree with your treating ophthalmologist the type and frequency of check-ups suited to the stage.
Symptoms and signs
Early stageAsymptomatic
In the most common form (chronic open-angle glaucoma), symptoms are absent or minimal. Patients do not feel any pain or notice an obvious drop in vision until the damage is already advanced, affecting the peripheral visual field.
Middle stagePeripheral blind spots
As the disease progresses, small areas of the peripheral visual field where you cannot see (scotomas) appear. The brain 'fills in' the gaps and the other eye compensates, which is why you usually notice nothing.
Advanced stageTunnel vision
The visual field narrows to "tunnel vision". Only in the late stages is central vision also lost, up to blindness. Damage to the optic nerve cannot be reversed.
Diagnosis
Glaucoma, which often has no symptoms, mainly affects older adults and can be diagnosed during a routine eye check-up. Only a specialist doctor can properly assess eye pressure and identify signs and risk factors.
- Tonometry
- measuring intraocular pressure.
- Gonioscopy
- examination of the iridocorneal angle.
- Computerised visual field test
- a map of functional damage.
- Optic nerve OCT
- quantifies the loss of nerve fibres.
Treatment options
Three types of treatment, chosen and combined based on the stage of the disease and the patient's individual response.
Medicines
Pressure-lowering eye drops and gels regulate the production and drainage of aqueous humour. Taking them consistently and following your ophthalmologist's instructions is essential to control the disease.
Learn about medicines
Laser
Selective laser trabeculoplasty (SLT) acts on the trabecular meshwork to improve drainage. It is an outpatient procedure lasting a few minutes: it can be the first treatment, instead of eye drops, or be added to them.
Laser treatments
Surgery
Trabeculectomy, valve implants and minimally invasive techniques (MIGS) create or improve a drainage route for the aqueous humour. Surgery is used when eye drops and laser are not enough to control the disease.
Surgical proceduresPrevention
Important
Early diagnosis is the best form of prevention. Regular check-ups after the age of 40 are essential.
- 01
Early diagnosis
Glaucoma cannot be prevented in an absolute sense, but early diagnosis is the best form of prevention against loss of vision. Regular check-ups with an ophthalmologist, especially after the age of 40 or if you have risk factors, help to detect the disease at an early stage.
- 02
Healthy lifestyle
Regular exercise, a balanced diet and controlling blood pressure contribute to overall eye health. Avoiding smoking and protecting your eyes from injury are further useful precautions.
- 03
Sticking to treatment
Once glaucoma has been diagnosed, sticking to treatment and attending regular check-ups are essential to monitor progression and adjust the treatment.