What changes occur in the eyes with glaucoma?

Nov 18, 2025 Source: Cainiu Health

Dr. Wang Lei

Introduction

Changes in the eye when glaucoma occurs generally include elevated intraocular pressure, optic nerve atrophy, visual field defects, abnormal pupils, and ocular discomfort or pain. Elevated intraocular pressure: Glaucoma patients commonly exhibit intraocular pressure beyond the normal range. Prolonged high pressure continuously compresses ocular tissues, particularly damaging the optic nerve, and this pressure change may gradually worsen over time.

1. Elevated Intraocular Pressure: Patients with glaucoma commonly exhibit intraocular pressure beyond the normal range. Prolonged high pressure continuously compresses ocular tissues, especially damaging the optic nerve. This pressure change may gradually worsen. In early stages, there might be no obvious symptoms, but later it can impair visual function.

2. Optic Nerve Atrophy: Due to sustained high intraocular pressure, optic nerve fibers progressively become damaged and die, leading to optic nerve atrophy. This manifests as a paler optic disc and an increased cup-to-disc ratio. This change is irreversible and directly impairs visual signal transmission, resulting in vision loss.

3. Visual Field Defects: As optic nerve atrophy progresses, the patient's visual field gradually narrows. In early stages, this often presents as peripheral vision loss—such as "shadows" or blind spots on the sides, above, or below the line of sight. In advanced stages, only central vision may remain, severely affecting daily activities.

4. Abnormal Pupils: Some glaucoma patients may experience pupil changes, such as sluggish or absent pupillary light reflexes, or abnormal pupil size (often dilated). These result from high intraocular pressure affecting the function of the iris sphincter muscle and the optic nerve, leading to impaired pupillary regulation.

5. Ocular Discomfort or Pain: During acute glaucoma attacks, patients may experience significant eye pain, possibly accompanied by headache and nausea. This results from a sudden, sharp rise in intraocular pressure, which stimulates ocular tissues and causes pain. In chronic glaucoma, early-stage discomfort is usually mild and easily overlooked.

Upon noticing any of the above changes, individuals should seek prompt medical evaluation of intraocular pressure, optic nerve health, and related indicators. Once diagnosed with glaucoma, patients should follow medical advice for regular medication or treatment to control intraocular pressure. Regular monitoring of visual fields and optic nerve status is essential to prevent further disease progression.

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