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Condition Focus · Optic Nerve Health
Glaucoma
A clear, reassuring guide to glaucoma — why it so often goes unnoticed, what an eye test actually looks for, and how sight is protected once it's found.
Source: UCL Institute of Ophthalmology and Moorfields Eye Hospital, British Journal of Ophthalmology, January 2026 — commissioned by Glaucoma UK.
Guidance you can trust, from a UK optometry team
Understanding the condition
What is glaucoma?
Glaucoma is not one disease but a group of conditions that damage the optic nerve — the bundle of around a million fibres carrying everything you see from your eye to your brain.
In most cases the damage is linked to raised pressure inside the eye (intraocular pressure, or IOP). Your eye continuously makes a clear fluid called aqueous humour and drains it away again. If drainage slows, pressure builds, and over time that pressure presses on the optic nerve.
Crucially, glaucoma usually takes your peripheral vision first, working slowly inwards. Your brain fills in the gaps so convincingly that most people notice nothing at all until a significant amount of nerve has already been lost. Damage that has happened cannot be reversed — which is why finding it early matters so much.
Sight is lost from the outside in
Unlike macular degeneration, glaucoma spares central vision until late. You can still read the bottom line of a letter chart while significant peripheral field is already gone.
The main types
Open-angle and angle-closure glaucoma
The two most common forms behave very differently — one is silent and slow, the other can be a medical emergency. Knowing which is which changes how urgently you need to act.
The drainage angle stays open but becomes gradually less efficient, so pressure creeps up over years. It is painless and symptomless in its early stages.
- Develops slowly, often over decades
- Usually affects both eyes, rarely equally
- Almost always found at a routine sight test
The drainage angle closes suddenly and pressure rises fast. This causes severe pain and rapid sight loss, and needs treatment within hours.
- Sudden, severe eye pain and headache
- Nausea or vomiting, halos around lights
- A red eye with blurred vision — go to A&E
Normal-tension glaucoma
Optic nerve damage occurs even though eye pressure measures within the normal range. Poor blood flow to the nerve is thought to play a part, so pressure alone is never the whole picture.
Secondary glaucoma
Raised pressure caused by something else — an eye injury, inflammation such as uveitis, advanced diabetes, or long-term steroid use, including inhalers, drops and tablets.
Sudden severe eye pain with headache, nausea, halos around lights or a red, blurred eye should be treated as an emergency — go to your nearest eye casualty or A&E immediately. Acute angle-closure glaucoma can damage sight permanently within a day if left untreated.
Know your risk
What increases the risk of glaucoma?
Some factors can't be changed, but knowing yours tells your optometrist how closely to watch — and how often you should be seen.
Age over 60
Risk climbs with each decade. In people of African or Caribbean heritage it rises earlier, from around 40.
Family history
A parent, brother, sister or child with glaucoma raises your risk several times over. Tell your optometrist — and tell your relatives.
Diabetes & blood pressure
Both diabetes and high blood pressure are associated with a higher risk, and affect the blood supply the optic nerve depends on.
Long-term steroid use
Steroid tablets, inhalers, creams and especially eye drops can raise eye pressure when used over long periods.
Severe short-sightedness
High myopia stretches the eye and the optic nerve head, making the nerve more vulnerable to pressure.
Previous eye injury
A past blow to the eye or eye surgery can damage the drainage system, sometimes causing raised pressure years later.
Signs to watch for
Symptoms & warning signs
The hardest thing about open-angle glaucoma is that there is usually nothing to notice. It is painless, it starts at the edges, and one eye compensates for the other. This is precisely why it is found at eye tests rather than at home.
No symptoms at all, early on — the most common presentation, and the reason regular sight tests matter more here than in almost any other eye condition.
Gradual loss of peripheral vision — you might catch door frames, miss a step, or bump into things on one side.
Patchy or hazy blind spots that your brain smooths over, so they rarely appear as obvious gaps.
Halos around lights, or aching eyes — less common, but worth mentioning to your optometrist if they're new.
Your best protection
There is no home test for glaucoma
Macular degeneration has the Amsler grid. Glaucoma has nothing equivalent, because the vision it takes is the vision your brain is best at filling in. By the time you could notice it yourself, nerve has already been lost permanently.
The only reliable detection is a routine sight test, where four quick checks build a picture no self-check can. A standard eye examination takes about 20–30 minutes.
In England you're entitled to a free NHS sight test if you're 60 or over, or if you're 40 or over and have a parent, brother, sister or child diagnosed with glaucoma. If that's you, book one — and tell your relatives to do the same.
1 · Eye pressure (tonometry)
A brief puff of air or a gentle probe measures the pressure inside the eye. Quick, painless, and the check most people remember.
2 · Visual field test
You press a button each time you see a faint light appear off to the side. This maps your peripheral vision and finds gaps you'd never notice.
3 · Optic nerve examination
Your optometrist looks directly at the optic disc for the characteristic 'cupping' that glaucoma causes.
4 · OCT scan
A painless scan measures the thickness of the nerve fibre layer, picking up thinning years before a field test would.
Treatment & monitoring
How glaucoma is treated
Treatment cannot restore sight already lost, but it is very effective at protecting what remains. The goal is always the same: lower the pressure enough to stop the nerve deteriorating further.
Prescription eye drops
The usual first step, used once or twice daily to reduce fluid production or improve drainage. They only work if used every single day — most sight lost to glaucoma is lost because drops were stopped.
Laser treatment
Selective laser trabeculoplasty (SLT) improves the eye's natural drainage in a short outpatient appointment, and is increasingly offered as a first-line option.
Surgery
Where drops and laser aren't enough, procedures such as trabeculectomy or a drainage implant create a new route for fluid to leave the eye.
Lifelong monitoring
Regular pressure checks, field tests and scans track whether treatment is holding, so it can be adjusted before further damage occurs.
- You have sudden, severe pain in or around one eye
- Your eye is red and your vision has gone blurry or foggy
- You see rainbow-coloured halos around lights
- You feel sick or are vomiting alongside eye pain or headache
Together these can indicate acute angle-closure glaucoma, where pressure rises sharply over hours. Go to your nearest eye casualty unit or A&E straight away — do not wait for a routine appointment.
Taking control
Living well with glaucoma
A glaucoma diagnosis is not a sentence to sight loss. The overwhelming majority of people diagnosed and treated in time keep useful vision for life.
Use your drops, every day
The single most important thing you can do. Tie them to an existing habit, set a phone alarm, and tell your optometrist if side effects make them hard to keep up — there are alternatives.
Never skip an appointment
Glaucoma gives no feedback of its own. Your appointments are the only way anyone, including you, can tell whether treatment is working.
Tell your family
First-degree relatives have a substantially higher risk and qualify for free NHS sight tests from 40. Telling them is one of the most useful things you can do with your diagnosis.
Stay active, avoid strain
Regular moderate exercise supports healthy eye pressure. It's worth asking your specialist about activities involving prolonged head-down positions.
Nutrition & the optic nerve
Nutrients studied for optic nerve health
Glaucoma has no dietary cure, and no supplement lowers eye pressure the way prescribed drops do. Research interest instead centres on the oxidative stress and blood flow around the optic nerve, which may influence how well nerve cells cope with the pressure they're under.
These nutrients are the ones most often studied in that context. The evidence is early and none of them replaces treatment.
| Resveratrol | A polyphenol antioxidant studied for its role in defending cells against oxidative stress |
| Omega-3 fatty acids | Associated with healthy blood flow, which the optic nerve depends on |
| Vitamins C & E | Antioxidants that contribute to the protection of cells from oxidative stress |
| B vitamins & NAD+ precursors | Involved in cellular energy production in nerve tissue — an active area of research |
| Magnesium | Studied in relation to blood vessel function around the optic nerve |
Nutritional supplements are not a treatment for glaucoma and are not suitable for everyone. They do not lower intraocular pressure and must never replace prescribed drops or scheduled appointments. Always speak to your optometrist, ophthalmologist or GP before starting a supplement, particularly if you take other medication.
From our range · Optional support
GlaucoGuard — daily nutritional support alongside your treatment
If you and your optometrist decide a supplement has a place alongside your prescribed care, GlaucoGuard brings together resveratrol and supporting antioxidants in one daily capsule, formulated by the team at Ocular Express.
GlaucoGuard is a food supplement, not a medicine. It does not treat, prevent or cure glaucoma and is not a substitute for prescribed eye drops or medical treatment. Always follow your optometrist's or ophthalmologist's guidance.
Common questions
Frequently asked questions
Will I go blind from glaucoma?
Can damage from glaucoma be reversed?
Is glaucoma hereditary?
Can I have glaucoma with normal eye pressure?
How often should I have my eyes tested?
Can a supplement replace my glaucoma drops?
Does Ocular Express provide medical advice?
This page is for general information and awareness only and does not constitute medical advice or a diagnosis. It is not a substitute for a professional eye examination. If you have concerns about your vision, please consult a GOC-registered optometrist or your GP. Content clinically reviewed by the Ocular Express optometry team — last reviewed July 2026.