Being diagnosed with glaucoma can be worrying, and one of the first questions many people ask is:
“Am I going to go blind?”
The answer is that most people with glaucoma do not go blind. With early diagnosis, regular monitoring and appropriate treatment, most people keep useful vision throughout their lifetime.
However, glaucoma can cause permanent irreversible sight loss, so it is important that it is monitored regularly and treated appropriately.
What is glaucoma?
Glaucoma is an eye condition where there is damage to the optic nerve, which carries visual information from the eye to the brain.
Eye pressure is an important risk factor, but glaucoma is not simply a disease of high eye pressure. Some people develop glaucoma even when their eye pressure is within the normal range. This is known as normal-tension glaucoma.
Sight already lost through glaucoma cannot currently be restored. The aim of treatment is to protect the vision you have and reduce the risk of further damage.
How likely am I to lose my sight?
The risk varies considerably from person to person.
Some people’s glaucoma changes extremely slowly over many years, while others have a form of the disease that progresses more quickly.
Your individual risk depends on factors such as:
How advanced the glaucoma was when it was diagnosed?
How quickly it is progressing?
Your eye pressure.
Your age
The type of glaucoma you have
How well your glaucoma responds to treatment?
This is why glaucoma treatment should be individualised. Two people with the same eye pressure may have very different levels of risk and may require different treatment.
How do I know if my glaucoma is getting worse?
Eye pressure is important, but it is only one part of the picture.
Several tests are used to determine whether your glaucoma is stable, including:
Visual field tests – to look for changes in your peripheral and central vision.
OCT scans – detailed scans that can detect changes in the optic nerve and retinal nerve fibres.
Optic nerve examination and photographs – to look for structural changes over time.
Eye pressure measurements – to help determine whether your pressure is at an appropriate level for your individual eyes.
A useful question to ask at your appointment is therefore not simply “What is my eye pressure?”, but:
“Is my glaucoma stable?”
Can glaucoma get worse even if my eye pressure is normal?
Yes.
People with normal-tension glaucoma develop characteristic glaucoma damage despite having eye pressures within the traditionally normal range.
There is also no single “safe” eye pressure that applies to everybody. An eye pressure that is acceptable for one person may be too high for someone whose glaucoma is progressing.
An individual target eye pressure will be set based on your glaucoma and its risk of progression.
Can treatment prevent sight loss?
Although treatment cannot restore vision already lost through glaucoma, lowering eye pressure can reduce the risk of further damage.
Depending on the type and severity of glaucoma, treatment may include:
- Eye drops to lower eye pressure
- Selective laser trabeculoplasty (SLT) to improve drainage from the eye
- Cataract surgery with MIGS to improve the drainage from the eye
- Glaucoma surgery when a lower eye pressure is required or glaucoma continues to progress
The best treatment is not necessarily the same for every patient.
What can I do to protect my sight?
There are several simple but important things you can do:
Attend your glaucoma appointments.
Use prescribed eye drops regularly.
Attend visual field and OCT tests when requested.
Ask whether your glaucoma is stable or progressing.
Tell close relatives that you have glaucoma, as some forms of glaucoma run in families.
If you notice a significant change in your vision, seek appropriate eye-care advice rather than waiting for your next routine appointment.
Should I be worried?
A diagnosis of glaucoma should be taken seriously, but having glaucoma does not mean that you will inevitably go blind.
The important things are identifying the disease, monitoring whether it is progressing and lowering eye pressure appropriately when treatment is required.
The aim of glaucoma care is simple:
To preserve useful vision throughout your lifetime.
Further information and support
Glaucoma UK provides independent information and support for people living with glaucoma, including patient information, support groups and a glaucoma helpline.
