What glaucoma is, why the eye's drainage system matters, how it's diagnosed, and the full range of treatments — from drops to laser to microsurgery.
Glaucoma is a group of diseases that damage the optic nerve — the cable of over a million nerve fibers that carries images from your eye to your brain. It is usually, though not always, related to eye pressure that is too high for that particular nerve to tolerate.
Vision loss typically starts at the edges of your sight and creeps inward, which is why most people notice nothing is wrong until real damage has already occurred.
Leading cause of irreversible blindness worldwide
Of optic nerve fibers can be lost before a change in vision is even noticeable
Symptoms, in the most common forms, until damage is already advanced — regular exams are how it's caught early
Having a parent or sibling with glaucoma raises your own risk significantly.
Risk rises steadily after 60, and even earlier for some higher-risk groups.
The single most important, and the only modifiable, risk factor.
Obstructive sleep apnea, high nearsightedness, and certain ethnic backgrounds also raise risk.
Eye pressure (IOP) is the only risk factor we can currently modify — which is why every glaucoma treatment, from drops to surgery, focuses on lowering it. There is no cure, and vision already lost cannot be recovered, but consistently controlling IOP is what slows or stops further damage.
Your eye continuously produces a clear fluid called aqueous humor. It flows through the pupil and exits through a drainage angle, where the iris meets the cornea. When that drainage slows or stops, pressure builds inside the eye.
This is a completely internal system, separate from the tear film on the surface of your eye — so it has nothing to do with external eye watering or tearing.
Normal drainage angle
The angle is wide open without resistance, so fluid reaches the drain (trabecular meshwork) and leaves the eye freely.
Not everything that looks like glaucoma is glaucoma yet — and among the true glaucomas, the underlying cause of the drainage problem varies.
The optic nerve or eye pressure looks slightly unusual, but there's no confirmed damage — watched closely over time.
Eye pressure runs higher than average, but the optic nerve and visual field remain healthy.
The drainage angle is anatomically narrow and at risk of closing, even though it hasn't caused damage.
Glaucoma is identified and tracked through a combination of in-office exam findings and specialized imaging, repeated at regular intervals to watch for any change.
Tonometry measures the pressure inside your eye — the main modifiable risk factor.
A dilated look at the optic nerve, checking its color, shape, and any pattern suggesting damage.
A specialized mirrored lens lets your doctor directly view the drainage angle to see if it's open or narrow.
Ancillary baseline testing in clinic is performed to assess starting peripheral vision and health of the optic nerve. These tests are repeated annually or biannually to check for any worsening of glaucoma.
Maps your peripheral vision to detect and track the specific pattern of vision loss glaucoma causes. This test is particularly difficult, so do not be discouraged if you're having a tough time — you're not alone.
Hover or click to see example ↻BaselineFull peripheral vision; sensitivity is even throughout.
A quick, painless scan measuring the thickness of nerve fiber layers — often catching change before you'd ever notice it.
Hover or click to see example ↻BaselineAll four quadrants are healthy and even.
Every treatment works toward the same goal — lowering eye pressure, the only proven way to slow glaucoma. Most patients start with the least invasive option and step up only if needed.
Considered in place or in conjunction with eye drops
Considered when laser and drops aren't enough to control pressure on their own
Minimally Invasive Glaucoma Surgery — small incisions and fast recovery, with a modest pressure-lowering effect.
A larger pressure-lowering effect for more advanced or harder-to-control glaucoma, with a longer recovery.
Whether you're newly diagnosed, a glaucoma suspect, or looking into surgical options, we'll walk through where you stand and what makes sense next.
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