Glaucoma is a group of chronic eye diseases characterized by progressive damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain. It is one of the leading causes of irreversible blindness worldwide, primarily because it often progresses silently without noticeable symptoms until significant vision loss has occurred. The most common form, primary open-angle glaucoma, develops gradually and may go undetected for years.

The disease is most commonly associated with elevated intraocular pressure (IOP), although glaucoma can also occur with normal eye pressure, known as normal-tension glaucoma. Increased IOP results from impaired drainage of aqueous humor, the fluid that maintains eye pressure and nourishes ocular structures. Over time, sustained pressure damages the optic nerve fibers, leading to permanent visual field loss.

Risk factors for glaucoma include increasing age, family history of glaucoma, diabetes, hypertension, long-term steroid use, high myopia, and certain ethnic backgrounds. Secondary glaucoma can develop due to eye injuries, inflammation, tumors, or complications from other eye diseases or surgeries. Congenital glaucoma, though rare, affects infants and young children and requires early intervention to prevent severe vision loss.

Glaucoma is often referred to as the “silent thief of sight” because early stages typically present no symptoms. As the disease progresses, patients may experience gradual loss of peripheral vision, leading to tunnel vision in advanced stages. Acute angle-closure glaucoma, a less common but severe form, presents with sudden eye pain, headache, nausea, blurred vision, halos around lights, and requires immediate medical attention.

Diagnosis involves a comprehensive eye examination including measurement of intraocular pressure, optic nerve evaluation, visual field testing, gonioscopy to assess the drainage angle, and optical coherence tomography (OCT) to analyze optic nerve fiber thickness. Early detection through routine eye exams is critical, as vision loss from glaucoma is permanent but progression can be slowed or halted with timely treatment.

Management of glaucoma focuses on lowering intraocular pressure to prevent further optic nerve damage. Treatment options include medicated eye drops, oral medications, laser therapies such as selective laser trabeculoplasty (SLT), and surgical procedures including trabeculectomy and minimally invasive glaucoma surgeries (MIGS). The choice of treatment depends on disease severity, patient compliance, and response to therapy.

Glaucoma requires lifelong monitoring and adherence to treatment. While lost vision cannot be restored, early diagnosis and proper management allow most patients to maintain functional vision and quality of life. Education, regular follow-up, and personalized treatment plans are essential components of effective glaucoma care.