I needed general anesthesia for cataract surgery, and other providers couldn’t help. Dr. Callahan got it approved. After my first surgery, I have 20/20 vision! Amazing results—she’s worth the wait!
Therese Silvent
Can Glaucoma Be Cured?
Catching Glaucoma Before More Vision Is Lost
Most forms of glaucoma develop without any pain or obvious warning signs in the early stages. Knowing which symptoms require urgent attention and which risk factors apply to you can help you act quickly when it matters most.
Your brain is remarkably good at filling in gaps in your visual field. When glaucoma begins damaging your peripheral, or side, vision, your brain compensates by using information from your other eye and making educated guesses about what should be there. You may not realize you have blind spots until a large portion of your vision is already gone. Regular comprehensive eye exams are the only reliable way to detect glaucoma before you notice any vision loss.
While early glaucoma is usually silent, certain changes over time may signal that something is wrong. These include gradual loss of peripheral vision in one or both eyes, tunnel vision in more advanced stages, and subtle difficulty with night driving or low-light situations. Because these changes happen slowly, they are easy to overlook or attribute to aging.
Acute angle-closure glaucoma is a medical emergency that occurs when the eye's drainage system becomes suddenly blocked, causing pressure to spike rapidly. Without immediate treatment, it can lead to permanent blindness. If you experience any of the following, seek emergency care right away.
- Severe eye pain that comes on suddenly
- Intense headache with nausea or vomiting
- Sudden blurred vision or rainbow-colored halos around lights
- A red eye with a cloudy or hazy cornea
- A fixed, mid-dilated pupil that does not respond to light
Certain medications, including some decongestants, anticholinergic drugs, and topiramate, can trigger or worsen angle-closure in eyes that are already at risk. Always tell your eye doctor about any new medications you are taking.
Certain factors make glaucoma more likely. Age is among the most significant, with people over 60 facing a considerably higher risk. Family history is also important, since glaucoma tends to run in families. Other factors that increase your risk include the following.
- Being over age 60, particularly over 70
- Having a parent or sibling with glaucoma
- Being of African, Hispanic, or Asian descent
- Diabetes, thin corneas, or low nighttime blood pressure
- Previous eye injuries or certain prior eye surgeries
- High myopia, or nearsightedness; significant farsightedness increases risk for angle-closure
- Long-term or high-dose steroid use, including eye drops, inhalers, injections, or skin creams
- Obstructive sleep apnea or circulation conditions like Raynaud syndrome
- A prior history of elevated eye pressure or being told you are a glaucoma suspect
Risk can also differ by ancestry and glaucoma type. Open-angle glaucoma is more common in people of African and Hispanic ancestry, while angle-closure glaucoma is more common in some Asian populations.
Tests We Use to Diagnose and Track Glaucoma
Diagnosing glaucoma requires more than a single pressure reading. We use a combination of tests to get a full picture of your eye health and to track any changes over time.
We use a test called tonometry to measure the pressure inside your eye, a value referred to as intraocular pressure. The Goldmann applanation method, in which we numb the eye surface and gently touch it with a small instrument, is the reference standard in clinical practice. Normal pressure typically falls between 10 and 21, but some people develop glaucoma even within this range, so pressure alone does not tell the whole story. Because pressure can vary throughout the day, we may ask you to come in at different times to capture a more complete picture.
Gonioscopy uses a special mirrored contact lens to view the drainage angle inside your eye, the area where fluid flows out. This exam helps us determine whether your angle is open, narrow, or blocked, which directly guides what type of treatment is most appropriate. It is quick and generally well tolerated.
- Identifies narrow angles at risk for angle-closure attacks
- Detects secondary causes such as pigment dispersion or pseudoexfoliation
- Helps guide decisions about laser or surgical treatment
We measure the thickness of your cornea using a test called pachymetry. Corneal thickness affects how accurately we interpret pressure readings and is itself an independent risk factor for glaucoma. A thin cornea can make pressure appear lower than it truly is, while a thick cornea can make it appear higher. Knowing your corneal thickness allows us to set a more accurate target pressure and refine your overall risk assessment.
We examine your optic nerve during a dilated eye exam, using drops to widen your pupils so we can see the nerve at the back of the eye. We look for signs of damage such as cupping, where the center of the nerve appears hollowed out, as well as changes in color or shape and the presence of disc hemorrhages, which can signal disease progression. We routinely photograph the optic nerve to document its condition and compare it to future exams, helping us detect even subtle changes over time.
A visual field test creates a detailed map of your full field of vision, including your peripheral vision. You look straight ahead into a machine and press a button each time you see a small flashing light in different locations. The computer then identifies any blind spots or areas of vision loss. We use different testing patterns, including wider maps for earlier disease and more detailed central maps for advanced glaucoma, and we repeat this test regularly to track whether your condition is stable or progressing.
Optical coherence tomography, or OCT, takes precise cross-sectional images of your retina and optic nerve. This technology measures the thickness of the nerve fiber layer with high accuracy, detecting thinning that may appear before changes show up on visual field testing. Macular ganglion cell analysis can add additional detail. OCT complements visual field testing but does not replace it; both are needed to properly monitor glaucoma over time.
- Quick, painless, and non-invasive
- Highly precise measurements that can be compared across visits
- Helps detect subtle progression at an early stage
Monitoring Your Glaucoma Over Time
Glaucoma care is not a one-time event. Consistent monitoring is essential because the disease can change without producing any symptoms. We tailor your follow-up schedule to your individual situation.
The frequency of your glaucoma appointments depends on the severity of your condition and how well your eye pressure is controlled. After starting or adjusting treatment, we typically recheck pressure within four to eight weeks. People with early glaucoma and stable pressure may come in every three to six months, while those with more advanced or unstable disease may need monthly visits. Every visit generally includes a pressure check and optic nerve exam, with visual field tests and OCT imaging performed once or twice a year.
We set an individualized target eye pressure based on your stage of disease and risk factors, then monitor whether that target is being met. If your pressure is not at goal or if your condition is progressing despite treatment, we will adjust your plan. This may mean adding a medication, changing a laser treatment, or discussing a surgical option. We may also use short-term oral medications during pressure spikes while planning the next step. Our goal is always to find the approach that protects your optic nerve while fitting your daily life.
Treatments That Help Prevent Vision Loss
While there is no cure for glaucoma, several effective treatments can lower eye pressure and protect your remaining vision. We match the right treatment, or combination of treatments, to your specific type and stage of disease.
Medicated eye drops are usually the first treatment we recommend. These medications work either by reducing the amount of fluid the eye produces or by improving how fluid drains out of the eye, both of which lower eye pressure. Most people need to use their drops every day for the long term.
- Prostaglandin analogs improve fluid drainage and are often the first choice
- Beta blockers reduce fluid production inside the eye
- Alpha agonists both reduce production and improve drainage
- Carbonic anhydrase inhibitors decrease fluid production
- Rho kinase inhibitors enhance drainage through the trabecular pathway
- Miotics such as pilocarpine are used in selected cases, often for angle-closure
- Combination drops deliver two medications in a single bottle for added convenience
Each class of medication has specific side effects and precautions. For example, beta blockers can slow heart rate and worsen asthma. Prostaglandin analogs may cause eyelash changes or subtle darkening of the eyelid skin. Tell your eye doctor about any bothersome effects so your treatment can be adjusted appropriately.
Selective laser trabeculoplasty, or SLT, is an in-office laser procedure that uses gentle energy to enhance the eye's natural drainage pathways and lower eye pressure. Most patients feel little to no discomfort, and the procedure takes only a few minutes. SLT is often considered a first-line treatment option and can reduce or even eliminate the need for daily eye drops in some patients.
- Effect typically builds over several weeks after treatment
- Results can diminish over time, but repeat treatment is often possible
- Temporary mild inflammation or a brief pressure spike can occur after the procedure
- A follow-up pressure check is scheduled after treatment to confirm the response
For angle-closure glaucoma, we may recommend a laser peripheral iridotomy. This procedure creates a tiny opening in the iris, the colored part of the eye, to allow fluid to flow more freely and reduce the risk of a future angle-closure attack. It is a well-established procedure with a long safety record, though some risks exist.
- Can prevent future acute angle-closure attacks in appropriate eyes
- Some patients notice mild glare or ghost images after the procedure
- A brief pressure spike or inflammation may occur; follow-up is scheduled afterward
- Additional treatment may be needed if angles remain narrow or scarring develops
Minimally invasive glaucoma surgery, or MIGS, uses tiny instruments to improve the eye's drainage with less trauma and faster recovery than traditional surgery. Our team performs goniotomy, a MIGS procedure that opens the eye's natural drainage channel to allow fluid to escape more easily. MIGS is well suited for mild to moderate glaucoma and can often be performed at the same time as cataract surgery.
- Provides meaningful pressure reduction with a lower risk profile than traditional surgery
- Recovery is typically faster than conventional glaucoma procedures
- May reduce or eliminate the need for some eye drops
- Not a substitute for traditional surgery in advanced or severe glaucoma
When medications and laser treatments are not enough to control eye pressure, traditional surgery may be needed. Trabeculectomy creates a new drainage channel to allow fluid to leave the eye, while tube shunt surgery places a small drainage device inside the eye to regulate pressure. These procedures can provide excellent long-term pressure control in cases that have not responded to other treatments. More complex surgical cases may be referred to a specialist for the best outcome. As with any surgery, risks include infection, bleeding, scarring, or changes in vision, and we review these thoroughly with you before proceeding.
Managing Glaucoma Day to Day
Living well with glaucoma requires consistent habits between your office visits. The choices you make every day directly influence how well your treatment works and how much vision you preserve over time.
Taking your drops as prescribed is the single most important thing you can do to protect your vision. Missing doses allows pressure to rise and can cause more nerve damage. Setting reminders on your phone, linking drops to a daily habit like brushing your teeth, or asking a family member to help you remember can all make a real difference.
- Wash your hands before handling the bottle
- Tilt your head back, pull down your lower eyelid, and look upward
- Place one drop into the pocket of the lower eyelid
- Close your eye gently and press lightly against the inner corner for two minutes to reduce absorption into the body
- Wait at least five minutes between different eye drop medications
- Remove soft contact lenses before preserved drops and wait at least 15 minutes before reinserting
- Shake suspension drops before use; check whether your drops require refrigeration
A healthy lifestyle supports your overall eye health, even though no diet can cure glaucoma. Regular moderate exercise may help lower eye pressure slightly in some people. A diet rich in leafy greens and omega-3 fatty acids supports general wellbeing, which benefits your eyes.
- Avoid prolonged head-down positions, such as certain yoga poses, which can temporarily raise eye pressure
- Exhale during heavy exertion rather than holding your breath
- Stay well hydrated, but avoid drinking large amounts of liquid all at once, which can cause a temporary pressure spike
- Limit large amounts of caffeine, which may transiently raise eye pressure in some individuals
- If you snore heavily or feel excessively sleepy during the day, ask about evaluation for sleep apnea
Eye injuries can worsen glaucoma or trigger complications in already vulnerable eyes. Wearing protective eyewear during sports, yard work, or any activity involving flying debris is a simple but important precaution. Contact us right away if you experience any of the following between scheduled visits.
- Sudden decrease in vision or the appearance of new blind spots
- Severe eye pain or a significant headache
- Eye redness, discharge, or signs of infection
- Side effects from your medications that concern you
- Vision changes after starting a new medication, including non-eye prescriptions
If you are pregnant, planning a pregnancy, or breastfeeding, let your eye doctor know so your glaucoma medications can be reviewed. If you cannot reach our office for urgent symptoms, go to the nearest emergency department immediately.
Frequently Asked Questions
Here are answers to questions our patients most often ask about living with and managing glaucoma.
No treatment currently available can restore vision that has already been lost or repair damaged optic nerve fibers. This is true regardless of the treatment approach, whether drops, laser, or surgery. All current care is focused on slowing or stopping further damage. Research into nerve regeneration is ongoing, but these methods remain experimental and are not yet part of routine clinical practice.
Most people who follow their treatment plan consistently maintain useful vision for their entire lives. Outcomes depend heavily on how early the disease is detected, how well the eye pressure responds to treatment, and how reliably medications are used and appointments are kept. Many patients never progress beyond mild vision changes. The key is not to wait and not to stop treatment without guidance from your eye doctor.
Yes. Normal-tension glaucoma describes exactly this situation, where optic nerve damage occurs despite pressure readings that appear within the typical range. This is why pressure measurement alone is not enough to rule out glaucoma. Diagnosis in these cases relies on careful evaluation of the optic nerve and visual field, and treatment still focuses on lowering eye pressure below your personal baseline to reduce the risk of further damage.
Many patients still require some medication after SLT, MIGS, or even filtering surgery. The goal of these procedures is to reach and maintain your target pressure with the least number of treatments needed to keep you safe. For some patients, laser or surgery reduces the number of drops required. For others, a combination of approaches provides the best control. We monitor your pressure closely after any procedure to determine the right ongoing plan for you.
No type is curable, but some respond more predictably to specific treatments. Open-angle glaucoma often responds well to drops or SLT. Angle-closure disease may be managed with laser peripheral iridotomy or, in selected patients, early lens removal to widen the drainage angle. However, even when angle-closure is successfully treated, ongoing monitoring is still required. Any nerve damage that occurred before treatment begins remains permanent regardless of the glaucoma type.
No vitamin, supplement, or herbal remedy has been proven to stop glaucoma progression or replace medical treatment. While some products are marketed for eye health, the evidence does not support using them in place of prescribed therapy. Some supplements may interact with glaucoma medications or affect bleeding risk before a procedure. Always tell your eye doctor about any supplements you take so your full care plan can be considered safely.
Visit NewView Eye Center for Expert Glaucoma Care
Our team at NewView Eye Center is committed to providing personalized, thorough glaucoma care that fits your individual needs and lifestyle. We offer advanced diagnostic tools, in-office laser treatments including SLT and laser peripheral iridotomy, and minimally invasive surgical options to help protect your vision at every stage of the disease. If you have glaucoma, a family history of glaucoma, or any concern about your eye health, we encourage you to schedule a comprehensive exam with our eye doctors so we can develop a plan that is right for you.
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