Experts call for heightened awareness as only one in 20 are aware they have glaucoma

The early detection of glaucoma is essential to improve the chances of preventing vision loss and blindness. File image.

The early detection of glaucoma is essential to improve the chances of preventing vision loss and blindness. File image.

Published Mar 11, 2024


Glaucoma, a group of eye conditions that damage the optic nerve and is essential for good vision, is one of the leading causes of irreversible blindness in Africa.

It affects more than six million people, but the South African Glaucoma Society (Sags) has revealed that only one in 20 are aware that they have this condition.

They added that another concerning finding is that 50% will be blind in one eye by the time they seek an ophthalmologist for the first time.

In sub-Saharan Africa, it is estimated that 4.16% of the population aged 40 years and older are affected by glaucoma.

Despite being treatable, Sags emphasised the major challenges that sufferers face, including lack of awareness, late diagnosis, poor follow-up visits and low compliance with treatment plans.

Sags president and ophthalmologist Dr Marissa Willemse highlighted that glaucoma, often termed the “silent thief of sight“, exhibits no noticeable symptoms in its early stages, underscoring the critical importance of awareness.

“Vision loss has devastating social, personal and economic impact, often leading to unemployment, loss of income, lowered standards of living, depression and anxiety.”

And with World Glaucoma Week commemorated from March 10 to 16, she believes that the early detection of glaucoma is essential to improve the chances of preventing vision loss and blindness.

“Untreated glaucoma increases intraocular pressure, which is the pressure that builds up inside of the eyes and damages the optic nerve, which is responsible for transmitting visual information from the eye to the brain.”

“Over time, the optic nerve damage leads to vision loss and in advanced stages, blindness which cannot be restored.”

The early detection of glaucoma is essential to improve the chances of preventing vision loss and blindness. File image.

Who is most at risk?

Willemse says that there are certain risk factors for developing glaucoma and that regular eye examinations with an ophthalmologist are crucial in detecting glaucoma early.

The risk factors include:

Age: The risk of developing glaucoma increases with age, particularly in individuals over 60 years old although in Africa the age is as recent as 40.

Family history: A family history of glaucoma, especially in a first-degree relative, which is a parent or sibling.

High intraocular pressure: Individuals with elevated intraocular pressure (IOP) are at a greater risk of developing glaucoma.

Thin central corneal thickness: Studies have shown that individuals with thinner corneas may be at a higher risk.

Medical conditions: Certain medical conditions, such as diabetes, hypertension and cardiovascular disease can increase the risk.

Previous eye injuries or surgeries: Trauma to the eye or previous eye surgeries.

Near-sightedness: increases the risk of developing glaucoma.


With progression over time, certain warning signs will appear which should not be ignored, Willemse warned.

These are some of the signs to look out for:

Gradual loss of peripheral vision: Glaucoma often affects peripheral vision first, leading to tunnel vision or more often blind spots in the side or corners of the visual field.

Blurred vision: Blurry or hazy vision can indicate damage to the optic nerve.

Halos around lights: Some glaucoma patients may experience halos or glare around lights, especially at night.

Eye pain or redness: In a few cases eye pain, redness, or discomfort can be detected.

Nausea or vomiting: Severe cases of acute angle-closure glaucoma can cause symptoms such as nausea, vomiting and severe eye pain.

Screening for glaucoma

It is recommended that anyone under the age of 40 undergo screening every two to four years, those between 40 and 60 years of age every two to three years and seniors over 60, on a yearly basis.

Willemse said that screening for glaucoma typically involves a comprehensive eye exam that includes several tests to assess the health of the eye and detect any signs of glaucoma.

Treatment options

Willemse explained that once the screening has been completed, the ophthalmologist will establish an individual treatment plan for each glaucoma patient.

“It is essential that the patient adheres to the plan and attends regular follow-up appointments to monitor their eye health and ensure that the condition is well-managed.”

She added that the main aim of treatment is to lower the intraocular pressure and to prevent further damage to the optic nerve.

“This can be done with medication which is used to help protect the optic nerve from oxidative stress and damage.”

Eye drops are also often prescribed to lower intra-ocular pressure in glaucoma and can be used chronically to prevent the build-up of pressure.

In addition, laser therapy may be used to improve the drainage of fluid from the eye and lower intra-ocular pressure.

And in some cases where medications and laser therapy are not effective, surgical procedures may be recommended.