Glaucoma: the silent thief of sight

Glaucoma is often referred to as the “silent thief of sight” because it can progress without warning. In the video podcast Hablemos de Salud, Dr Néstor Ventura, ophthalmologist at Hospital Clínic, together with Vanessa, a patient with glaucoma, share an open and honest conversation about this common eye condition and discuss what steps can be taken to slow its progression.

What exactly is glaucoma?

Glaucoma is a degenerative condition that affects the optic nerve and is often associated with high intraocular pressure. It leads to progressive loss of the visual field, particularly peripheral vision.

In its early stages, the condition is typically asymptomatic. By the time visual loss becomes obvious, the damage is already irreversible. However, early detection can slow or even halt the progression of the disease.

As Dr Ventura explains, the optic nerve functions like a “cable” connecting the eye to the brain, transmitting visual information. As the fibres within this cable deteriorate, vision gradually declines. Unlike other eye conditions that can be corrected surgically, the damage caused by glaucoma cannot be reversed.

Why didn’t I notice any symptoms earlier?

In most cases, glaucoma remains asymptomatic in its initial stages. Vision loss usually starts in the peripheral field, while central vision remains unaffected for a long time.

Moreover, the brain has a remarkable ability to compensate for these gaps, effectively “filling in” missing areas of the visual field and giving the impression that everything is functioning normally.

Vanessa explains that when she first noticed slightly blurred vision, she assumed it was simply a change in her prescription: “I thought it was myopia. I didn't think much of it.” This delay in recognising symptoms is one of the major challenges of glaucoma.

If I have glaucoma, will I go blind?

Glaucoma can lead to complete vision loss in some people, but not everyone will go blind. Its progression depends on several factors, including the aggressiveness of the specific type of glaucoma, the individual’s response to treatment, and the medical follow-up.

This is why early detection and regular check-ups are so important. The goal is to slow progression so that vision can be preserved for as long as possible.

Although the damage already done cannot be reversed, the progression of the disease can be slowed down. All available treatments focus on lowering intraocular pressure, the main modifiable factor associated with glaucoma. This is usually achieved with eye drops and, in some cases, with laser treatment or surgery.

Will I need to use eye drops forever?

Glaucoma is a chronic disease. In many cases, treatment is long-term and may be lifelong, although this depends on how the disease progresses in each patient.

For many years, the standard treatment has been eye drops to lower intraocular pressure. More recently, laser treatment has also been used as an initial treatment in selected cases.

Vanessa explains that, at first, she only used one drop at night and had follow-up appointments spaced out over time. Later on, when managing the condition became more complex, she had to use drops every three hours. She relied on alarms and the support of those around her to help her remember.

It is also worth noting that certain surgical interventions can stabilise intraocular pressure for many years. However, as Dr Ventura underlines, this is not considered a cure, as the optic nerve cannot recover once it has been damaged.

Can I lead a normal life?

Living with glaucoma may involve certain changes, especially if there is visual field loss. Vanessa explains that, for safety reasons, she has stopped riding her motorbike and avoids wearing headphones in the street so she can stay more aware of her surroundings.

Even so, many people can continue to lead active lives with proper monitoring. Vanessa continues to work, keeps to her usual routines and has gradually adapted to the changes.

“It's not like you wake up one day and everything has changed. You adapt, change certain habits, and carry on.” The key is medical support, adherence to treatment and support from those around you.

An episode you won’t want to miss

Talking about glaucoma helps us understand that it is a common, chronic disease that can be effectively managed if detected early. In the episode of Hablemos de Salud video podcast dedicated to glaucoma, Dr Néstor Ventura and Vanessa share their clinical knowledge and personal experience to explain why this disease often goes unnoticed, how it is diagnosed, and what it is like to live with it. A conversation that focuses on the importance of having your eyes checked regularly and not normalising vision loss.

Early detection is key to preserving vision. Having regular check-ups is the first step.