What is Glaucoma? Here Are the 10 Most Frequently Asked Questions

Glaucoma is one of the leading causes of vision loss worldwide, but it often goes unnoticed until the damage is already advanced. This eye disease can in fact progress without obvious symptoms in its early stages, making regular eye exams essential for early diagnosis.

But what exactly is glaucoma? What are the warning signs? And how is it treated?
In this article, we answer the 10 most frequently asked questions to help you better understand this condition and take care of your visual health.

1) What is glaucoma?

Glaucoma is a disease of the optic nerve that causes the progressive loss of retinal ganglion cells, leading to irreversible vision damage. It can affect one or both eyes.
The main risk factor is elevated intraocular pressure, which, when it exceeds physiological levels, compresses the fibers of the optic nerve.
The first-line treatment is pharmacological and aims to lower intraocular pressure and prevent visual damage.
Glaucoma is a slow-progressing disease, often asymptomatic, and for this reason, it is typically diagnosed during routine eye exams.

2) What are the normal values of intraocular pressure?

The main risk factor for developing glaucoma is increased intraocular pressure, which should ideally remain within a range of 10 to 20 mmHg to avoid damage to the optic nerve.

3) How is glaucoma treated?

The first-choice treatment for glaucoma is topical, based on the daily instillation of eye drops that aim to lower intraocular pressure.
Adherence to therapy is essential to prevent visual deterioration.
In all cases where drug therapy is not sufficient, the ophthalmologist may opt for laser treatments (iridotomy) or surgical procedures (trabeculectomy).

4) How can I tell if I have glaucoma?

Open-angle glaucoma is a deceptive disease because it is often asymptomatic: in most cases, elevated intraocular pressure is not associated with visual disturbances or eye pain until advanced stages, where blurred vision and the appearance of dark shadows in the peripheral visual field are reported.
Conversely, angle-closure glaucoma, characterized by obstruction of the iridocorneal angle, is an acute condition described as causing intense, sudden pain that requires urgent treatment.

5) What is a visual field test and why is it important in glaucoma?

Computerized visual field testing (or perimetry) is an essential exam for diagnosing and monitoring glaucoma.
During this test, the patient sits with their face resting on a chinrest and, keeping one eye at a time fixed on a central point, must press a button to signal the perception of light stimuli of varying intensity.
This test is fundamental for detecting sensitivity loss or scotomas (areas of vision loss) caused by optic nerve damage.

6) Is glaucoma hereditary?

Glaucoma is a multifactorial disease, meaning it is influenced by genetic, environmental, and behavioral factors.
Although a genetic predisposition may exist in some cases, this increases the risk but does not guarantee the development of the disease.
On the other hand, glaucoma can occur in individuals with no family history.
For this reason, prevention is always necessary and should be implemented through regular eye exams.

7) Is an eye exam at the optician enough to diagnose glaucoma?

No, an eye test at an optical store cannot replace a full ophthalmologic exam: only an eye doctor can assess the health of our eyes and diagnose glaucoma or other eye diseases.

8) How long will I need to continue glaucoma treatment?

Glaucoma is a chronic condition that can damage the optic nerve and, in most cases, requires lifelong drug treatment.
However, in certain circumstances, the ophthalmologist may decide to reduce or completely stop the drug therapy.

9) Can taking cortisone affect glaucoma?

Yes, cortisone therapy in any form (eye drops, tablets, injections, etc.) can increase intraocular pressure and, in some patients known as “steroid responders,” cause greater damage to the optic nerve.
The effects of short-term cortisone use disappear within a few days, but long-term use (months or years) can alter the trabecular meshwork—the eye’s drainage system—leading to a chronic increase in intraocular pressure.

10) Is there a link between systemic blood pressure and intraocular pressure?

There are no significant correlations between intraocular pressure and blood pressure.
Therefore, people with systemic hypertension are not necessarily at risk of developing glaucoma, and vice versa.

Dr. Alessia Bottoni
Biotecnologa e Ortottista esperta in Dry Eye