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Eye Atlas
Optic nerveglaucoma

Glaucoma: a disease you have to look for, not wait for

The most common form of glaucoma doesn’t hurt or get in the way for years while the optic nerve loses fibers. What’s lost can’t be restored, but glaucoma caught in time can almost always be stopped.

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When to see a doctor the same day
NormalGlaucomaSimulation

The field of vision closes in from the edges while the center stays sharp for a long time, which is why the loss is often noticed only once it is advanced.

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Unaware of the diagnosis
~50%
of people with glaucoma — there are no symptoms until late stages
Screening
after 40
eye pressure and optic nerve every 1–3 years
Lost vision
can’t be restored
treatment preserves what’s left

What’s happening

Damage to the optic nerve

Glaucoma is a group of diseases in which optic nerve fibers gradually die. The main factor that can be controlled is intraocular pressure, but glaucoma can also occur with normal pressure. Peripheral vision goes first; central vision is affected last.

  1. Open-angle — slow and painless, the most common type
  2. Angle-closure — can start with a sudden, painful attack
  3. Normal-tension — nerve damage with “normal” pressure readings
cupnerve fiber rim

Optic nerve head
cup-to-disc ratio: 0.3

Visual field
full

Normal. The optic nerve fibers are intact: the disc rim is wide and the visual field is full.

What is lost does not come back. But treatment — drops, laser or surgery — almost always stops the disease at the stage where it was found.

Glaucoma

What it feels like

  • In the early stages — nothing
  • Later — a narrowing visual field: bumping into things at your side
  • Trouble at dusk and when moving from light into darkness
  • In an acute attack: severe pain, a red eye, rainbow halos around lights, nausea

Who’s at risk

Tick what applies to you

Matches: 0 of 5

This isn’t a diagnosis. Tell your doctor what matched — it affects how often you should be checked.

Eye exams explained

How it’s diagnosed

  1. Measuring eye pressure (tonometry) and corneal thickness

  2. Examining the optic nerve head with the pupil dilated

  3. OCT of the nerve fiber layer — shows loss before the patient notices it

  4. Automated perimetry — a map of the visual field

  5. Gonioscopy — checks whether the drainage angle is open

Who treats it

An ophthalmologist; complex cases are managed by a glaucoma specialist.

What you can check at home

All tests →
Eye exams explainedUltrasound, OCT, visual fields — what they show

Glaucoma

What can be done

Options are listed from simplest to most serious. The “doesn’t work” label goes to remedies with no proven benefit.

Start here

  1. Pressure-lowering eye dropsWorksThe foundation of treatment. They only work when used every day, for life.
    • Prostaglandin analogs — usually the first choice, once a day in the evening
    • Beta blockers, carbonic anhydrase inhibitors, alpha agonists — added when needed
    • Missed doses are the most common reason glaucoma progresses
  2. Selective laser trabeculoplasty (SLT)WorksThe laser improves fluid drainage. It can be the first treatment instead of drops, or an add-on.
    • Done in the office in a few minutes
    • The effect may wear off over the years — the procedure can be repeated
  3. Laser iridotomyWorksFor a narrow or closed angle: a tiny opening in the iris prevents an acute attack.
    • Done preventively for narrow angles
    • Lens replacement surgery also widens the angle
  4. SurgeryWhen indicatedWhen drops and laser can’t keep pressure under control.
    • Minimally invasive glaucoma surgery (MIGS) — often combined with cataract surgery
    • Trabeculectomy and drainage implants — a stronger effect, but higher risks

Beyond this — your doctor decides

Glaucoma often coexists with cataracts and diabetes, and its visual field loss can be simulated.

CataractDiabetic retinopathyVision builder

Glaucoma

Frequently asked questions

If my eye pressure is normal, does that mean I don’t have glaucoma?

Not necessarily. Normal-tension glaucoma exists, and a single measurement can miss fluctuations. That’s why doctors check not just pressure but also the optic nerve and visual field.

Can glaucoma be cured?

No, but it can be controlled. With regular treatment, most patients keep useful vision for life.

Can I drink coffee and exercise?

Normal amounts of coffee are fine. Exercise is good for you, but with pigmentary glaucoma or inverted yoga poses, it’s worth discussing your routine with your doctor.

How often should I get checked?

Without risk factors, after 40 — every 2–4 years; after 65 — every 1–2 years. With glaucoma in the family — earlier and more often.

This material is for general information and doesn’t replace an in-person exam. Diagnosis and treatment are decided by a doctor after an examination.

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