Glaucoma and ocular hypertension
Glaucoma and ocular hypertension are two terms that are often linked, but it is important to understand the difference. Ocular hypertension simply means that the pressure inside the eye (intraocular pressure or IOP) is higher than normal. However, ocular hypertension does not automatically mean that glaucoma is present.
Glaucoma, on the other hand, is an eye disease that damages the optic nerve, the nerve that connects the eye to the brain. In most cases of glaucoma, this damage to the optic nerve is caused by excessively high intraocular pressure. However, there are forms of glaucoma in which eye pressure remains within the normal range (normal-tension glaucoma).
In summary: ocular hypertension is a risk factor for glaucoma, but not everyone with ocular hypertension will develop glaucoma. It is also possible to have glaucoma even with normal eye pressure.
Glaucoma is an insidious disease because it is often asymptomatic in its early stages. Vision loss caused by glaucoma is progressive and irreversible. If glaucoma is not detected and treated in time, it can lead to loss of peripheral vision and, at an advanced stage, blindness.
Symptoms of glaucoma and ocular hypertension: warning signs (often absent)
This is what makes the condition particularly challenging: ocular hypertension usually causes no symptoms.
Similarly, early-stage glaucoma is most often asymptomatic. Central vision remains normal for a long time, and loss of peripheral vision may go unnoticed at first.
When symptoms do appear, they are often late and may include:
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- Progressive loss of peripheral vision: you may feel that you see less well on the sides, bump into objects, or experience “tunnel vision”
- Blurred vision (in certain types of glaucoma)
- Eye pain and redness (in acute angle-closure glaucoma, an ophthalmologic emergency)
- Colored halos around lights (in certain types of glaucoma)
Glaucoma progresses silently at first. This is why regular ophthalmologic examinations are important, even in the absence of symptoms.
Risk factors for glaucoma and ocular hypertension
Several factors increase the risk of developing glaucoma or ocular hypertension:
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- Age: the risk of glaucoma increases with age, especially after 40
- Family history of glaucoma: a genetic factor is involved
- People of African and Asian origin, who have a higher risk of certain types of glaucoma
- High myopia (for open-angle glaucoma)
- Hyperopia (for angle-closure glaucoma)
- Diabetes, high blood pressure, and cardiovascular diseases
- Prolonged use of corticosteroids (eye drops or systemic treatment)
- Eye trauma
The diagnosis of glaucoma is based on a series of ophthalmologic examinations. These tests are painless and allow your ophthalmologist to make an accurate diagnosis of glaucoma or ocular hypertension, assess the stage of the disease, and implement appropriate treatment.
Treatment of glaucoma and ocular hypertension
The goal of glaucoma treatment is to slow or stop the progression of the disease and preserve vision. Treatments primarily aim to lower intraocular pressure.
Treatment options include:
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- Pressure-lowering eye drops: this is the first-line treatment in most cases of glaucoma and ocular hypertension
- Laser treatments
- Glaucoma surgery: if eye drops and laser treatment are insufficient, or in certain forms of glaucoma, surgery may be necessary to create a new drainage pathway for intraocular fluid and reduce pressure. Several surgical techniques are available.
The choice of the most appropriate treatment depends on the type of glaucoma, its stage, the target eye pressure, and the individual situation. Regular follow-up with your ophthalmologist is essential to adjust treatment and monitor disease progression.
If you have questions about glaucoma or ocular hypertension, if you would like to undergo screening, or if you have been diagnosed with glaucoma and are seeking care in Geneva, our ophthalmology clinic is at your disposal. We perform all examinations necessary for glaucoma screening and follow-up, and we offer treatments tailored to your specific situation.
