Glaucoma is one of the leading causes of irreversible blindness worldwide. It's often called "the silent thief of sight" because it can progress for years without noticeable symptoms. By the time most people realize something is wrong, significant and permanent vision loss may have already occurred.
At Doctor Lili Optometry in Vancouver, we screen for glaucoma during every comprehensive eye exam. Early detection is the single most important factor in preserving your vision, and our advanced diagnostic technology allows us to identify signs of glaucoma before you experience any symptoms.
Glaucoma is a group of eye diseases that damage the optic nerve — the nerve that carries visual information from your eye to your brain. This damage is most often caused by abnormally high intraocular pressure (IOP), though glaucoma can also develop in people with normal eye pressure.
The eye continuously produces a clear fluid called aqueous humor, which nourishes the front structures of the eye and maintains its shape. In a healthy eye, this fluid drains at the same rate it is produced. When the drainage system doesn't function properly, fluid builds up, increasing the pressure inside the eye. Over time, this elevated pressure damages the delicate nerve fibers of the optic nerve, leading to gradual and irreversible vision loss.
The most common form, accounting for approximately 90% of all glaucoma cases. It develops slowly when the eye's drainage canals become less efficient over time, even though they appear structurally open. Pressure builds gradually, and vision loss begins with peripheral (side) vision — so subtle that most people don't notice it until the disease is advanced.
This is a chronic, lifelong condition. There is no cure, but with early detection and consistent treatment, the progression can be slowed or halted in most cases.
Occurs when the iris bulges forward and physically blocks the drainage angle, preventing fluid from leaving the eye. This can happen suddenly (acute angle-closure) or gradually (chronic angle-closure).
Acute angle-closure glaucoma is a medical emergency. Symptoms come on rapidly and include severe eye pain, headache, nausea, vomiting, blurred vision, and halos around lights. If you experience these symptoms, seek emergency care immediately — delayed treatment can result in permanent vision loss within hours.
Also called low-tension glaucoma. Optic nerve damage occurs even though intraocular pressure remains within the statistically normal range. This form is not fully understood and may be related to reduced blood flow to the optic nerve or an optic nerve that is unusually sensitive to pressure. It is diagnosed through careful examination of the optic nerve and visual field testing.
Results from another eye condition, injury, or medication. Causes include eye trauma, inflammation (uveitis), advanced cataracts, and long-term use of corticosteroid medications. Treatment focuses on both the underlying cause and managing the elevated eye pressure.
A rare condition present at birth, caused by incomplete development of the eye's drainage system. Signs in infants include unusually large eyes, excessive tearing, and sensitivity to light. Early surgical intervention is typically required.
While elevated intraocular pressure is the primary risk factor, glaucoma development is influenced by multiple factors. You may be at higher risk if you have:
The risk is significantly higher if a parent or sibling has the condition.
Or over 40 for certain ethnic groups.
Risk varies by ancestry, depending on the type of glaucoma.
Detected during an eye exam.
Severe nearsightedness or high farsightedness.
A history of trauma or previous eye surgery.
Eye drops, oral, or inhaled corticosteroids.
Heart disease, high blood pressure, or poor circulation.
Having one or more risk factors does not mean you will develop glaucoma, but it does mean more frequent monitoring is important. We adjust our screening schedule based on your individual risk profile.
One of the most dangerous aspects of glaucoma is that the most common form — open-angle glaucoma — produces no symptoms in its early stages. Vision loss begins at the edges of your visual field and progresses so slowly that many people compensate unconsciously and don't notice the change.
By the time symptoms become apparent, significant and irreversible damage has usually occurred. Symptoms of advanced glaucoma include:
Acute angle-closure glaucoma, by contrast, produces sudden and severe symptoms:
If you experience any of these acute symptoms, seek emergency medical care immediately.
Wondering what these symptoms actually look like day to day? Read our guide to what glaucoma vision looks like, including what your optometrist sees that you cannot.
Because glaucoma typically has no early warning signs, routine screening during comprehensive eye exams is critical. At Doctor Lili Optometry, our glaucoma evaluation includes:
We measure your intraocular pressure using non-contact or applanation tonometry. Elevated pressure is a key risk factor, but normal pressure does not rule out glaucoma.
Using a slit-lamp microscope and dilated examination, we assess the size, shape, and color of your optic nerve head, looking for signs of damage or thinning.
This test maps your peripheral vision, detecting blind spots that may indicate early optic nerve damage. We use the RetinaLogik VR visual field system for a faster, more comfortable testing experience.
This advanced imaging technology creates detailed cross-sectional images of the optic nerve and retinal nerve fiber layer, allowing us to detect structural damage before vision loss is noticeable.
When indicated, this test examines the drainage angle of the eye to determine whether it is open or narrow, helping us classify the type of glaucoma.
Glaucoma cannot be cured, and vision lost to the disease cannot be restored. However, treatment can slow or stop further damage. The goal of all glaucoma treatment is to lower intraocular pressure to a level that protects the optic nerve.
Medicated eye drops are the most common first-line treatment for open-angle glaucoma. They work by either reducing the production of aqueous humor or increasing its outflow. Common categories include prostaglandin analogs, beta-blockers, alpha-adrenergic agonists, and carbonic anhydrase inhibitors. Consistent daily use is essential — even one missed dose can allow pressure to rise.
Selective laser trabeculoplasty (SLT) is a safe, in-office procedure that improves fluid drainage through the eye's natural outflow system. It can be used as a first-line treatment or in addition to eye drops. SLT is repeatable and does not involve incisions.
For angle-closure glaucoma, laser peripheral iridotomy (LPI) creates a small opening in the iris to allow fluid to flow more freely to the drainage angle, relieving or preventing pressure buildup.
When medications and laser treatment are not sufficient, surgical options include:
A surgical procedure that creates a new drainage pathway for fluid to leave the eye, reducing intraocular pressure.
A group of newer procedures that use microscale devices to improve fluid drainage with less tissue disruption and faster recovery than traditional surgery.
Tiny tubes or shunts are placed in the eye to divert fluid to a reservoir, providing long-term pressure reduction in more advanced cases.
At Doctor Lili Optometry, we co-manage glaucoma patients with trusted ophthalmologists in Vancouver. We handle your ongoing monitoring, visual field testing, and pressure checks, and coordinate closely with the surgical team when intervention is needed.
A glaucoma diagnosis can feel overwhelming, but with proper treatment and regular monitoring, most patients maintain functional vision for the rest of their lives. The key is adherence to your treatment plan and keeping all follow-up appointments.
We recommend that patients with glaucoma maintain a consistent schedule for eye drops, attend all scheduled monitoring appointments, report any changes in vision immediately, and stay informed about their condition. Managing overall health — including blood pressure, blood sugar, and cardiovascular fitness — also supports optic nerve health.
