Early Signs of Glaucoma

In the beginning, glaucoma often does not present with any obvious signs that are noticeable by the patient. Most individuals with early-stage or mild glaucoma have no subjective complaints, even though measurable damage may already be occurring inside the eye. When glaucoma starts, the drainage system encounters a slight blockage that leads to a mild increase in intraocular pressure, and the optic nerve begins to show early signs of stress; however, these changes are usually silent to the patient’s experience.

Here are some important points to understand about the early stages:

• Minimal or No Symptoms: Early on, patients typically report no eye pain, no discomfort, and generally do not notice any loss of vision. Regular eye examinations are crucial because the changes are subclinical.
• Subtle Visual Field Changes: Clinical tests may reveal slight losses in peripheral vision before any central vision changes occur. Most patients are unaware of these small blind spots until asked to perform specific tests.
• Increased Intraocular Pressure (IOP): Even though the patient feels normal, there may be a mild elevation in IOP which is one of the first indicators of glaucoma. This slight pressure increase can be a warning sign, prompting early intervention.

Because the early stage is asymptomatic, the emphasis is on routine check-ups. Our eye doctor advises that comprehensive testing, including measuring IOP and examining the optic nerve, can help catch these early changes before they develop into noticeable vision loss.

As glaucoma advances from its earliest stage, symptoms begin to manifest in more recognizable ways. Patients entering the moderate stage often start noticing subtle visual changes that may affect everyday tasks, although many might still assume these changes are just part of the normal aging process.

At this stage, the optic nerve experiences more noticeable damage, and the following symptoms may be observed:

• Visual Disturbances: Occasionally, patients may see halos or rainbow-colored rings around bright lights. These phenomena are particularly noticeable under low light conditions or when driving at night, creating an extra strain in visually challenging environments.
• Peripheral Vision Loss: One of the hallmark signs is a gradual constriction of the peripheral visual field. You might begin to notice that objects coming from the sides are not as clear, or that you miss items on the edges of your vision. This loss is typically painless and develops over time.
• Blurred Vision: In some instances, patients experience blurred or fuzzy vision, especially when transitioning focus between near and far objects. This blurring can indicate a worsening condition that affects the ability to see fine details.
• Mild Discomfort or Eye Strain: Although usually not accompanied by severe pain, moderate glaucoma might be associated with a sensation of fatigue or mild discomfort in the eyes after long periods of reading or screen time.

During this stage, patients are more likely to notice that some tasks become a bit more challenging. For instance, activities that require good peripheral vision, such as walking in crowded areas or driving at night, may start to become problematic. Attentive eye doctor can detect these changes through advanced imaging and visual field tests, which helps in adjusting treatment plans to slow further progression.