Glaucoma is a group of chronic eye diseases that cause damage and degeneration of the optic nerve, resulting in a decline in visual function. It is one of the leading causes of blindness worldwide and the leading cause of irreversible blindness. Therefore, early detection and appropriate treatment are essential to prevent damage and preserve quality of life.
How Does Glaucoma Develop?
Glaucoma results from chronic damage to the nerve fibers that form the optic nerve and the cells from which these fibers originate. The mechanism of destruction is not fully understood but is likely related to a combination of mechanical pressure on the fibers, impaired blood flow to this layer of the retina, and possibly secondary inflammatory processes. In most cases, the changes develop slowly over years and progressively worsen with age.
"The Silent Thief of Sight"
As noted above, the damage caused by glaucoma typically develops gradually and slowly. Naturally, the brain learns to compensate for the deficit — especially when damage begins in only one eye — and patients do not notice the change until relatively late stages when significant damage has already occurred. Additionally, in many cases the damage starts more prominently in the periphery of the visual field, which is less noticeable in daily functioning. Therefore, by the time patients notice vision changes, significant and irreversible damage may have already occurred, earning glaucoma its nickname 'the silent thief of sight.'
Who Is At Risk?
Glaucoma has numerous risk factors including: family history of glaucoma (especially first-degree relatives), ethnicity, high myopia (nearsightedness) or hyperopia (farsightedness), thin corneas, chronic steroid use, history of eye trauma, intraocular inflammation, previous eye surgeries, low blood pressure, and more. Currently, the only treatable risk factor is intraocular pressure, and treatment focuses on lowering intraocular pressure to levels that slow and even halt disease progression. Regular eye exams are critical for early detection, especially if you have one or more risk factors.
Symptoms and Warning Signs
It is important to emphasize that the absence of symptoms or a sensation of vision disturbance does not rule out glaucoma. Furthermore, in most cases, elevated intraocular pressure cannot be felt even when very high. Therefore, routine monitoring that allows tracking of the disease is essential. An attack of acute angle-closure glaucoma is an exceptional case where a sharp rise in intraocular pressure can lead to sudden eye pain, headache, nausea, blurred vision, and halos around lights — this is a medical emergency requiring immediate treatment.
Why Early Detection Matters
Currently, there is no treatment that can repair damage to the optic nerve caused by glaucoma, and vision loss cannot be restored. However, there is a wide range of treatments that help slow the rate of disease progression and even stop it, so the disease can be managed effectively, especially when detected early. Comprehensive eye examinations that include intraocular pressure measurement, optic nerve evaluation with OCT imaging, and visual field testing are the best defense against vision loss. Prof. Leshno recommends baseline screening starting at age 40, with more frequent exams based on risk factors. In cases of strong family history or early onset, genetic testing should also be considered.