Glaucoma

Elevated eye pressure: Pressure inside the eye strains the optic nerve over time. This is the strongest known risk for glaucoma. Treatment often focuses on lowering this pressure.

Thin central cornea: A thinner cornea is linked to higher risk because it may reflect a more delicate eye structure. It can also make pressure readings seem lower than they truly are.

Optic nerve sensitivity: Some optic nerves are more vulnerable to pressure or blood‑flow changes. This biological sensitivity raises the chance of damage. Two people with the same exposure can react very differently—biology shapes the response.

Older age: Risk rises as the eye’s drainage tissues stiffen and the optic nerve becomes less resilient. People over about 60 years face higher odds.

Ancestry patterns: People of African or Caribbean ancestry have higher open‑angle risk, and Latino/Hispanic groups face increased risk as well. People of East or Southeast Asian or Inuit ancestry are more prone to angle‑closure.

Narrow drainage angle: A naturally crowded front of the eye can block fluid outflow. This angle shape can trigger sudden or chronic forms of glaucoma.

Nearsighted eye shape: High myopia stretches eye tissues and can stress the optic nerve. This anatomy is linked with open‑angle glaucoma.

Farsighted eye shape: A shorter eye with a shallow front chamber increases angle crowding. This makes angle closure more likely, especially in dim light or with pupil dilation.

Blood‑flow problems: Conditions such as migraine, Raynaud‑type features, or very low nighttime blood pressure can reduce optic nerve perfusion. Reduced circulation increases susceptibility to pressure‑related damage.

Sleep apnea: Repeated drops in oxygen during sleep may injure the optic nerve. People with obstructive sleep apnea have higher glaucoma risk.

Eye inflammation: Inflammation inside the eye can scar the drainage pathway and raise pressure. A history of uveitis increases the chance of optic nerve damage.

Eye injury: Blunt or penetrating trauma can damage the eye’s drainage angle. Glaucoma may appear soon after or many years later.

Steroid medicines: Long‑term use of steroid eye drops, inhalers, pills, injections, or skin creams can raise eye pressure. Some people are especially sensitive to steroids, making glaucoma more likely.

Internal eye debris: Flaky material or pigment can clog drainage channels inside the eye. This buildup raises pressure and the risk of glaucoma.

Aerobic exercise: Regular moderate aerobic activity can modestly lower eye pressure and improve blood flow to the optic nerve. Sedentary routines miss these protective effects.

Heavy straining: Max-effort lifting and breath-holding (Valsalva) can spike eye pressure briefly. Exhaling during exertion and avoiding maximal lifts may reduce these spikes.

Inverted poses: Head-down yoga or prolonged inverted postures can rapidly increase eye pressure. Choosing modified poses that keep the head above the heart may be safer.

Caffeine habits: Large or rapid caffeine doses can transiently raise eye pressure, especially soon after intake. Limiting high-dose or late-day caffeine may help stabilize readings.

Rapid fluid loading: Quickly drinking large volumes of fluid can increase eye pressure for a short time. Spreading fluids evenly through the day may blunt these surges.

Smoking: Cigarette smoking can impair optic nerve blood flow and increase oxidative stress. Quitting supports healthier vascular supply to the eye.

Diet quality: Diets low in leafy greens and flavonoid-rich produce may miss nutrients linked with better ocular blood flow. Including nitrate-rich greens like spinach or kale has been associated with lower glaucoma risk in observational studies.

Sleep position: Sleeping flat or face-down can raise nighttime eye pressure. Elevating the head of the bed 20–30 degrees or avoiding pressure on the affected eye may reduce strain.

Alcohol use: Heavy or binge drinking can destabilize blood pressure and worsen optic nerve health over time. If you drink, moderation helps avoid pressure and perfusion swings.

Medication adherence: Skipping prescribed eye drops or inconsistent timing allows pressure to fluctuate and damage to progress. Building a daily routine and using reminders can keep pressure controlled.

Regular eye exams: Get comprehensive eye exams with pressure checks and optic nerve evaluation at intervals your eye doctor recommends. Early detection lets treatment start before noticeable vision loss.

Know family history: Tell your eye doctor if close relatives have glaucoma. Family risk may mean earlier and more frequent screening.

Treat high pressure: If you have high eye pressure or early glaucoma, timely treatment can lower the risk of damage. Drops or laser procedures help protect the optic nerve.

Use drops correctly: Take glaucoma or pressure-lowering drops exactly as prescribed, every day. Good technique and not missing refills make the treatment work better.

Manage health conditions: Keep diabetes, blood pressure, and sleep apnea well controlled. Stable overall health supports blood flow to the optic nerve.

Safe exercise: Do regular moderate aerobic activity, which can help lower eye pressure. Avoid heavy straining or long head-down poses if you have glaucoma, and ask your doctor before new routines.

Eye protection: Wear certified eye protection for sports, yardwork, or jobs with flying debris. Preventing eye injuries reduces the risk of traumatic glaucoma.

Review steroid use: Steroid eye drops, inhalers, pills, or creams can raise eye pressure in some people. Use the lowest effective dose and monitor with your eye doctor.

Caffeine and smoking: Avoid tobacco, which harms blood vessels. Limit very high caffeine intake, which can temporarily raise eye pressure in some people.

Hydration habits: Sip fluids steadily rather than drinking large volumes all at once. Rapid chugging can briefly raise eye pressure, so spread intake through the day.

Peripheral vision loss: Side vision often fades first, making it easier to miss people or objects coming from the edges. This can make crowded spaces or crossing streets feel less predictable.

Patchy blind spots: Small missing areas in the visual field can appear and slowly enlarge. People may notice skipped words while reading or gaps when scanning shelves.

Tunnel vision: As glaucoma advances, remaining sight can narrow into a central tunnel. This makes navigating unfamiliar places and detecting hazards off to the side much harder.

Low-light difficulty: Dim environments and dusk can become challenging because the eye has trouble picking up detail. Night outings or finding steps in a movie theater may feel unsafe.

Glare and halos: Bright light, oncoming headlights, or sunlight off wet roads can be uncomfortable and overwhelming. Some notice halos around lights, especially at night.

Reduced contrast: Edges can look washed out, making it harder to tell where a curb ends or to see gray text on a gray background. Faces and small print can blend into the surroundings.

Reading slows: Words may blur together or vanish in small patches, leading to frequent re-reading. Longer sessions can cause eye strain and fatigue over time.

Driving limitations: Glaucoma can make it harder to spot pedestrians, cyclists, or cars coming from the side. Night driving and merging at busy junctions often become particularly difficult.

Risk of falls: Missing parts of the visual field can lead to missteps, stumbles, or bumping into objects. Stairs, curbs, and uneven ground can be especially tricky to judge.

Regular eye exams: Scheduled checks help spot pressure changes and early nerve damage before vision loss worsens. Your eye team may use visual field tests and imaging to track small changes over time.

Laser trabeculoplasty: A clinic-based laser helps fluid drain better in open-angle glaucoma. It can lower eye pressure and may delay or reduce the need for additional drops.

Laser iridotomy: A tiny laser opening in the iris can prevent or treat angle-closure attacks. This helps fluid reach the eye’s drain and protects the optic nerve.

Minimally invasive surgery: Small stents or micro-procedures can improve drainage with a quicker recovery than traditional surgery. These are often done during cataract surgery when both issues are present.

Filtering surgery: Operations like creating a new drainage channel or placing a small tube can lower pressure when other steps aren’t enough. Close follow-up is important to keep the new drain working well.

Aerobic exercise: Regular brisk walking, cycling, or swimming can modestly reduce eye pressure and support overall eye health. Avoid heavy straining or breath-holding during lifts, which can raise pressure.

Head-up sleeping: Elevating your head by about 10–20 cm (4–8 in) at night may reduce pressure spikes while you sleep. A wedge pillow or extra pillows can make this easier.

Caffeine and fluids: Large amounts of caffeine can briefly raise eye pressure, so moderation helps. Sip water steadily rather than chugging large volumes at once.

Body positions: Prolonged head-down posture or inverted yoga poses can raise eye pressure. Take breaks and favor neutral head positions during exercise or work.

Smoking and vascular health: Quitting smoking and managing blood pressure and sleep apnea support healthy blood flow to the optic nerve. These steps can help protect vision over time.

Low-vision rehabilitation: Training and tools like magnifiers, high-contrast lighting, and orientation support can make daily tasks easier if vision is reduced. Supportive therapies can improve safety and independence.

Lighting and glare control: Brighter task lighting and glare-reducing lenses can boost contrast and comfort. Sunglasses with UV protection may help outdoors by cutting glare.

Fall and home safety: Clear walkways, high-contrast stair edges, and grab bars reduce injury risk if side vision is limited. Family members often play a role in supporting new routines.

Monitoring at home: Keeping a symptom journal and noting any vision changes can help guide care between visits. Keep track of how lifestyle changes affect your symptoms.

Prostaglandin analogs: Latanoprost, bimatoprost, travoprost, and tafluprost increase fluid outflow and are often used once at night. They are highly effective with few systemic effects. Redness, eyelash growth, or gradual darkening of the iris can occur.

Beta blockers: Timolol and betaxolol reduce fluid production in the eye and are used once or twice daily. They may slow heart rate or worsen asthma or COPD, so doctors screen carefully. Burning or stinging can occur when the drop goes in.

Alpha-2 agonists: Brimonidine (and apraclonidine for short-term use) both reduce production and help fluid leave the eye. They are usually used two to three times a day. Dry mouth, fatigue, or allergy-like redness can develop in some people.

Topical CAIs: Dorzolamide and brinzolamide (carbonic anhydrase inhibitors) lower fluid production and are often added to other drops. They are used two to three times daily. Temporary stinging or a bitter taste are common.

Oral CAIs: Acetazolamide and methazolamide are tablets used short term for pressure spikes or when drops aren’t enough. Tingling in fingers, frequent urination, and nausea can occur, and kidney stones are a known risk. Doctors monitor electrolytes and adjust dose if needed.

Rho kinase inhibitor: Netarsudil improves drainage through the eye’s natural pathway and is often taken once at night. Redness or faint corneal changes may appear but are usually mild. A fixed combo with latanoprost is available for added effect.

Miotic agent: Pilocarpine helps open the eye’s drainage route, especially useful in angle-closure settings or after certain laser procedures. It often requires multiple daily doses. Brow ache, blurred vision at night, and small pupils are common trade-offs.

Fixed-combination drops: Pre-mixed pairs like dorzolamide/timolol, brimonidine/timolol, or netarsudil/latanoprost can simplify routines. They may improve adherence and reduce exposure to preservatives. Side effects mirror the individual components.

Hyperosmotic agents: Mannitol by vein or oral glycerol/isorsbide rapidly pull fluid from the eye during acute angle-closure attacks. These are emergency treatments used while arranging laser or surgery. They can strain the heart or kidneys, so careful monitoring is needed.