What Is Usually the First Sign of Glaucoma? A Guide for Bangladeshi Patients

Glaucoma is a serious eye condition that develops gradually, often without symptoms until vision damage has already begun. Early diagnosis is essential to prevent irreversible vision loss. For Bangladeshi patients seeking reliable care, recognising the early signs of glaucoma can help ensure timely treatment and protect long-term vision.

This guide explains what is usually the first sign of glaucoma, why early diagnosis matters, and how to access trusted treatment options.

What is Glaucoma?

Glaucoma is a progressive eye disease that damages the optic nerve, often due to increased pressure inside the eye. If left untreated, it can cause permanent vision loss, often without noticeable symptoms in the early stages.

Because the condition develops silently, many people remain unaware until significant damage has already occurred. Recognising the first warning signs and seeking regular eye exams are the best ways to prevent irreversible vision loss.

What Is Usually the First Sign of Glaucoma?

The first sign of glaucoma is often loss of peripheral vision, commonly described as tunnel vision. This gradual loss typically occurs without pain or noticeable symptoms, making it difficult for patients to identify the condition in its early stages.

In some cases, patients may experience:

• Blurred Vision in one or both eyes.
• Increased Eye Pressure (although this may not always cause discomfort).
• Halos Around Lights, especially at night.

Since these symptoms can be subtle, routine eye examinations are vital to detect glaucoma before major damage occurs.

Types of Glaucoma and Associated Symptoms

Different types of glaucoma present with distinct symptoms. Recognising these can help identify potential warning signs early.

Open-Angle Glaucoma

This is the most common type of glaucoma, developing slowly over time. The early signs include:

• Gradual loss of peripheral vision.
• Difficulty adjusting to dim lighting.
• Blind spots that expand gradually if untreated.

Acute Angle-Closure Glaucoma

This form is more aggressive and requires urgent medical attention. Symptoms may include:

• Sudden Eye Pain or headache.
• Blurred Vision or foggy eyesight.
• Halos Around Lights.
• Nausea and Vomiting (in severe cases).

Normal-Tension Glaucoma

In this condition, optic nerve damage occurs even with normal eye pressure. Early signs may include:

• Blurred or hazy vision.
• Mild but persistent eye discomfort.

Secondary Glaucoma

This type results from injury, inflammation, or other medical conditions. Symptoms vary based on the underlying cause but may include eye redness, pain, or reduced vision clarity.

Diagnosing Glaucoma

Diagnosing glaucoma early is key to managing the condition effectively. Common diagnostic procedures include:

• Tonometry: Measures eye pressure to detect abnormal increases. Modern tonometry devices provide accurate readings with minimal discomfort, making the process quick and easy.
• Visual Field Test: Assesses peripheral vision to identify early signs of vision loss. This test helps doctors map blind spots and track how glaucoma is affecting your vision over time.
• Optic Nerve Imaging: Advanced imaging techniques such as OCT (Optical Coherence Tomography) provide detailed images of the optic nerve, enabling specialists to detect even subtle changes.
• Pachymetry: Measures corneal thickness, as thinner corneas may increase glaucoma risk and affect pressure readings.
• Gonioscopy: Examines the drainage angle of the eye to assess the risk of angle-closure glaucoma.

Routine eye exams are essential, particularly for individuals with a family history of glaucoma, those over the age of 40, or individuals with conditions such as diabetes and hypertension. Early detection offers the best chance of slowing or preventing vision loss.

Treatment Options for Glaucoma

Glaucoma treatment focuses on reducing intraocular pressure and protecting the optic nerve from further damage. The choice of treatment depends on the type and severity of the condition. Effective treatment options include:

• Medications: Prescription eye drops or oral medications are commonly used to reduce intraocular pressure. These must be used consistently as directed to maintain stable eye pressure.
• Laser Therapy: Procedures such as laser trabeculoplasty help improve fluid drainage and reduce pressure. Laser treatment is often recommended when medications are insufficient or as an additional step to manage pressure effectively.
• Surgical Interventions: For advanced or aggressive glaucoma cases, procedures like trabeculectomy or minimally invasive glaucoma surgery (MIGS) may be required to create new drainage pathways and protect the optic nerve.
• Drainage Implants: In some cases, specialists may insert drainage devices to help regulate fluid buildup within the eye.
• Lifestyle and Home Care: While not a standalone solution, practices such as reducing screen strain, stress management, and following prescribed medication schedules can improve long-term outcomes.

Preventing Vision Loss from Glaucoma

While glaucoma cannot always be prevented, certain measures can reduce the risk of vision loss:

• Routine Eye Exams: People over 40, those with a family history of glaucoma, or individuals with conditions like diabetes or high blood pressure should undergo comprehensive eye exams at least once every year. Early detection is crucial for successful treatment.
• Know Your Risk Factors: People with a family history of glaucoma or those over 40 should be particularly cautious.
• Healthy Lifestyle Choices: Eating a balanced diet, exercising regularly, and avoiding smoking can help protect overall eye health.
• Manage Underlying Conditions: Controlling conditions such as diabetes, hypertension, and heart disease can reduce the risk of developing glaucoma and slow its progression.
• Limit Screen Time and Eye Strain: Prolonged screen use can increase eye strain and dry eyes. Follow the 20-20-20 rule — look at something 20 feet away for 20 seconds every 20 minutes to relax your eyes.
• Stress Management: Elevated stress can increase eye pressure. Techniques such as meditation, deep breathing exercises, or yoga can help reduce stress and support overall eye health.