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Glaucoma

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Protect your sight. Detect glaucoma early. We are committed to empowering your life through early detection and compassionate glaucoma care.

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Glaucoma

Glaucoma is a group of eye conditions that damage the optic nerve, the cable that carries visual information from your eye to your brain. It is often linked to higher than normal eye pressure, but not always. Glaucoma matters because it can develop quietly, with no obvious symptoms in the early stages, and any vision loss that occurs is permanent. The good news is that with early diagnosis and the right treatment plan, glaucoma can often be controlled and progression can be slowed significantly.

What is glaucoma

Glaucoma is diagnosed based on optic nerve changes and functional vision testing, not just a single eye pressure reading. Understanding how glaucoma affects vision helps explain why regular screening and ongoing monitoring are so important.

How glaucoma affects the optic nerve

Glaucoma damages the optic nerve fibres over time. Because the nerve fibres responsible for peripheral vision are often affected first, many people do not notice any change early on. Central vision can stay clear until the disease is more advanced, which is why regular testing is so important. Without treatment, the field of vision can gradually narrow.

Is glaucoma the same as high eye pressure

Not exactly. High eye pressure is called ocular hypertension, and some people with ocular hypertension never develop glaucoma. On the other hand, some people develop glaucoma even when their eye pressure is in the normal range. This is known as normal tension glaucoma. Glaucoma is diagnosed based on optic nerve damage and/or characteristic visual field changes, not on pressure alone.
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glaucoma1

Types of glaucoma we 
diagnose and treat

Primary open angle glaucoma

This is the most common form. The drainage angle is open, but the fluid does not drain efficiently enough, so pressure can build over time and slowly damage the optic nerve.

Angle closure glaucoma

Angle closure happens when the drainage angle becomes narrow or blocked, preventing fluid from leaving the eye.

  • Acute angle closure can cause a sudden spike in pressure and severe symptoms. This is an emergency.
  • Chronic angle closure develops more gradually and can be picked up during an eye examination before an attack occurs.

Secondary glaucoma

Secondary glaucoma is caused by another factor affecting drainage or pressure. Examples include inflammation inside the eye, previous trauma, pigment dispersion, and a steroid response (from steroid drops, tablets, or inhalers).

Glaucoma symptoms and warning signs

Many people expect glaucoma to cause pain or noticeable blur early, but that is not usually the case. Knowing the difference between slow, symptom-free glaucoma and an acute attack is important.

Early glaucoma symptoms

In many cases, there are no symptoms at the start. Any changes tend to be subtle and may include gradual loss of peripheral vision that is easy to miss day to day.

Symptoms of acute angle closure

Acute angle closure can cause:

  • Sudden eye pain and redness
  • Blurred vision and halos around lights
  • Headache, nausea, or vomiting

If these symptoms occur, seek urgent care immediately.

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Glaucoma risk factors

Lens choice is one of the most important parts of planning because it influences how often you may still use glasses afterwards. No lens is “best” for everyone. The goal is to match lens choice to your eyes and how you live.

Who is more likely to develop glaucoma

Risk is higher if you have one or more of the following:

  • Increasing age
  • Family history of glaucoma
  • Higher eye pressure
  • Thinner corneas
  • Certain ethnic backgrounds (risk can vary by glaucoma type)
  • Higher levels of short-sightedness
  • Diabetes or vascular factors in some patients

If you have diabetes, it is also worth understanding retina-related risks such as diabetic retinopathy, which can affect vision in different ways.

Medications and conditions that can increase eye pressure

Steroids are a common trigger for raised pressure in susceptible people, including steroid eye drops, tablets, injections, creams used around the eyes, and some inhalers. Previous eye injury, inflammation, and certain eye conditions can also increase risk.
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glaucoma

Glaucoma testing and diagnosis

Glaucoma diagnosis is built from several pieces of information collected over time. The goal is to confirm whether glaucoma is present, establish a baseline, and then track for change.

Eye pressure checks

Eye pressure is measured with tonometry. One reading is not enough to diagnose glaucoma because pressure can vary throughout the day and from visit to visit. Trends over time matter.

Optic nerve assessment

Your specialist will examine the optic nerve closely and may use imaging to document its shape and nerve fibre appearance. This helps detect early damage and track changes over time

Visual field testing

Visual field testing checks how well you see in your peripheral vision. It is one of the most important tools for monitoring glaucoma because it measures functional vision, not just structure.

OCT and imaging for glaucoma

OCT imaging can measure the retinal nerve fibre layer and ganglion cell complex. This can help detect early glaucoma changes and confirm whether treatment is keeping things stable.

Angle assessment and corneal thickness

Gonioscopy checks whether the drainage angle is open or narrow, which guides diagnosis and treatment decisions. Pachymetry measures corneal thickness because it can influence pressure readings and help inform a realistic target pressure.

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Glaucoma treatment options

Treatment focuses on lowering eye pressure to a level that is safer for the optic nerve. The best option depends on glaucoma type, severity, and how stable the optic nerve and visual fields are over time.

Glaucoma eye drops

Eye drops are commonly used to lower eye pressure by reducing fluid production or improving drainage. Consistent daily use matters. Side effects vary depending on the drop type and can include stinging, redness, or dry eye symptoms, so it is important to tell your doctor if anything feels off.

Laser treatment for glaucoma

Laser options may be used to lower pressure or reduce the need for drops.

  • SLT (Selective Laser Trabeculoplasty) is commonly used for open angle glaucoma to improve drainage.
  • Laser iridotomy can be used if the angle is narrow or at risk of closure.

Minimally invasive glaucoma surgery (MIGS)

MIGS procedures are designed to lower eye pressure with a smaller surgical footprint than traditional glaucoma surgery. They are often considered at the time of cataract surgery in suitable patients, depending on glaucoma type and target pressure needs.

Glaucoma surgery

When drops and laser are not enough, surgery may be recommended. This can include trabeculectomy or drainage implants (tubes). These procedures aim to create a new pathway for fluid to leave the eye and protect the optic nerve from further damage.
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What to expect from 
glaucoma treatment

Glaucoma care is a long-term plan, not a one-time fix. The focus is stability, protecting the optic nerve, and catching progression early if it occurs.

Setting a target eye pressure

A “safe” pressure is different for each person. Your target is based on optic nerve health, visual field results, rate of change (if any), and individual risk factors. The goal is stability over time.

Ongoing monitoring and follow-up

Glaucoma care is long-term. Follow-up usually includes repeat pressure checks, optic nerve review, OCT imaging, and visual field testing at intervals based on your level of risk and stability. Regular reviews help catch change early.

Can glaucoma be cured

There is no cure, and vision that has been lost cannot be restored. Treatment is focused on preserving the vision you have and reducing the risk of further loss.
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Living with glaucoma

Most people with glaucoma live full lives, but success depends on daily habits and ongoing reviews. Small practical steps can make treatment easier and more effective.

Using eye drops correctly

A few practical habits can make drops easier and more effective:

  • Use the drop at the same time each day
  • If you use more than one drop, leave a gap of a few minutes between them
  • Try gentle eyelid closure after instilling drops to reduce runoff
  • If you miss doses often, tell your doctor so the plan can be simplified where possible

Driving and vision

Glaucoma can affect peripheral vision, which matters for driving safety. If you notice changes, or if you are unsure about your vision standards, discuss it early so you can get clear advice and appropriate testing.

Protecting your long-term eye health

Keep your appointments, stick with your treatment plan, and report side effects rather than pushing through them. Glaucoma is often manageable, but it relies on consistent follow-up.
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Glaucoma and cataract surgery

It is common for glaucoma and cataracts to overlap, especially as people get older. If both are present, planning can involve pressure goals as well as vision goals

How cataract surgery can affect eye pressure

Cataract surgery can lower eye pressure in some people, particularly if the drainage angle is narrow. In others, glaucoma treatment is still needed before and after surgery. If cataracts are also part of your picture, you can read more about cataract assessment and surgery.

Combining cataract surgery with MIGS

For suitable patients, combining cataract surgery with MIGS can reduce pressure and may reduce reliance on drops. Whether this is appropriate depends on glaucoma severity, eye anatomy, and your target pressure.
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Why choose City Eye Surgeons for glaucoma care

Comprehensive glaucoma assessment and monitoring

Glaucoma is a condition where details matter. A thorough baseline assessment and consistent monitoring plan help protect vision long-term.

Full range of medical, laser and surgical options

We can discuss medical therapy, laser options, and surgical pathways when appropriate, based on the glaucoma type and your individual risk profile.

Long-term management and continuity of care

Glaucoma care is not a one-off visit. Ongoing follow-up and a clear plan make a big difference in staying stable over time.
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FAQs

What is the difference between glaucoma and high eye pressure?
High eye pressure (ocular hypertension) means the pressure is elevated but there is no proven optic nerve damage. Glaucoma means there is optic nerve damage and/or characteristic visual field loss, which can occur with high or normal pressure.
Most chronic glaucoma does not cause headaches. Acute angle closure can cause severe headache with eye pain and nausea, and needs urgent treatment.
Usually no. Drops control pressure but do not “fix” the underlying tendency. Any change should be made with your specialist so pressure remains safe.
It depends on your risk level and stability. Some people need more frequent checks early on or if progression is suspected, then less often once stable.
Untreated glaucoma can lead to progressive, permanent vision loss, often starting with peripheral vision and potentially affecting central vision later.

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