You may be seeing clearly, reading comfortably and going about your day as usual while glaucoma is quietly affecting your vision. Here’s why regular eye checks matter, even when your eyes seem perfectly fine.
Imagine discovering that your vision has been gradually changing without you ever noticing it. This is what makes glaucoma particularly concerning. Often called the silent thief of sight, glaucoma is a group of eye conditions that damage the optic nerve, which carries visual information from the eye to the brain.
The biggest challenge? Glaucoma may not cause noticeable symptoms in its early stages. By the time a person realises that something is wrong, some vision may already have been permanently lost.
Most types of glaucoma are largely asymptomatic in the early and moderate stages, causing no pain or irritation which could prompt a doctor’s visit. As the condition damages the optic nerve it typically affects peripheral vision first gradually progressing towards the centre. Since we primarily use central vision for most of our daily activities such as reading, working and watching television, these early changes in our peripheral vision easily go unnoticed.
Additionally, our brain is remarkably good at filling the gaps in what we see. One eye may compensate for changes in the other making it even harder to recognise that vision is getting affected. Over time, glaucoma can cause increasing loss of peripheral vision and gradually affect central vision too. So, being able to see clearly doesn’t always mean that our eyes are completely healthy
Let us take a simple, easy to understand analogy; the way there is blood in the body that circulates and delivers oxygen and nutrients there is a fluid inside the eye called the intra-ocular fluid which circulates within the eye. This is produced in the eye and drains out of the eye continuously. For various reasons if this fluid is produced in excess, or its outflow path is too small it can result in an increase in the eye pressure, and this can affect the optic nerve within the eye and is, therefore, an important risk factor. There are some people who are susceptible to eye pressure in normal ranges too. However, having high eye pressure does not necessarily mean you have glaucoma, and some people can develop glaucoma even when their eye pressure is within the normal range.
Thus, having normal eye pressure alone does not mean that one is free from glaucoma and having high pressure does not mean that one surely has glaucoma.
This is why a glaucoma evaluation involves more than just checking the eye pressure, but it is a detailed evaluation.
Glaucoma can affect anyone, but the risk increases with increasing age. People who have a family history of glaucoma have a higher risk and should be particularly mindful. Other risk factors include long-term use of steroid medications, very high plus or minus powers, previous eye injuries, presence of diabetes, other eye conditions like uveitis, retinal artery and vein occlusions.
Having a risk factor for glaucoma does not mean that you will develop glaucoma. It just means that regular eye examinations are especially important for you.
A comprehensive eye examination can help detect glaucoma before noticeable vision loss occurs.
This will include measurement of the eye pressure, gonioscopy which assesses the area of the eye which drains the fluid from inside the eye and assessment of the optic nerve. Depending on the individuals risk factors, examination findings and age, additional tests like visual field assessment and optical coherence tomography amongst others may also be recommended.
This is why an eye examination should not be viewed only as a way to update your glass prescription. It can also help identify eye diseases that may have no obvious symptoms.
There is good news: Glaucoma can most often be managed effectively when detected early.
Treatment may include prescription eye drops, laser treatment or surgery; depending on the type and severity of glaucoma. While existing vision loss from glaucoma cannot be restored, treatment can help slow or prevent further damage.
For those prescribed glaucoma medication, following the treatment regularly is important, even if their vision feels perfectly normal. Following the appropriate review schedule is important for anyone with glaucoma- even after laser or after glaucoma surgery. The treatment is primarily about protecting the existing vision.
While glaucoma is often silent, some forms can develop suddenly. Severe eye pain, red eye, blurred vision, nausea or sudden changes in vision can be signs of acute attack of angle-closure glaucoma and require immediate medical attention.
Don’t wait for your vision to change.
Perhaps the most important thing to remember about glaucoma is simple: don’t wait for symptoms to get your eyes checked.
If you have a family history, risk factors or are due for an eye examination, speak to an eye specialist about how frequently you should be screened.
Your eyes may feel perfectly normal and that is exactly why regular checks matter.
With glaucoma, the goal isn’t to wait until you notice something is wrong. It is to find the problem early, while there is still vision to protect.
(The views expressed are personal)
This article is authored by Dr Shoruba Dinakaran, consultant, cataract & glaucoma services, Happiest Netralaya, Happiest Health.
