Glaucoma has been called ‘the silent thief of sight’—an apt moniker, says Dr. J. Daniel Friederich of Vision Care Consultants. The routine puff of air on the eyeball—a common eye pressure screening test—can indicate when pressure is elevated, but not all cases of glaucoma are related to increased eye pressure, and the disease has no symptoms until permanent damage has been done.

“Getting your eyes’ pressure checked isn’t enough. You have to have a full examination performed in which your eyes are dilated so we can look at the optic nerve thoroughly,” Friederich explains. “Damage from glaucoma is irreversible.”

The eye’s internal structures are constantly washed and nourished by a clear fluid that flows into and out of the eyeball. Glaucoma occurs when that fluid drains too slowly, often building up pressure that can damage the optic nerve. Loss of peripheral vision usually is the first symptom and cannot be restored. For this reason, early detection is crucial in diagnosing and managing this chronic eye condition.

“Everybody should get routine eye exams, but definitely for those age 40 and older, I recommend a yearly exam,” says Dr. Joseph Gira of Ophthalmology Consultants. The American Academy of Ophthalmology recommends an examination by the age of 40 and then every two to four years until the age of 64. Individuals 65 or older should have an exam every one to two years or as needed, depending on individual risk factors.

“Age is the biggest risk factor and family history is just behind that. High blood pressure, diabetes and past ocular trauma also can cause glaucoma.” African-Americans are five times more likely than Caucasians to develop glaucoma, which is the leading cause of blindness in the United States.

Although there is no cure for glaucoma, there are effective treatments that can prevent vision loss. The first-line treatment recommended by many ophthalmologists is prescription eye drops. “This treatment lowers intraocular (inside the eye) pressure by decreasing the amount of fluid the eye forms or increasing the function of the natural drain of the internal fluid,” explains Dr. Carla Siegfried, an ophthalmologist and glaucoma specialist with Washington University Physicians.

“Although most patients start out with medications, if the pressure is not lowered adequately, the medications are not tolerated or the patient cannot stick to a daily regimen due to memory, cost, or inability to take the drops (e.g. arthritis), then the risk of surgery may be warranted,” she adds. Two procedures are used to treat glaucoma: a laser treatment that helps the eye’s natural drain function better and a traditional surgery that creates a new outlet for the intraocular fluid.

Eyesight is precious. Glaucoma doesn’t have to be the silent thief that it so often is. Regular checkups and close monitoring can prevent vision loss.