For thousands of South Africans, vision loss does not arrive suddenly, it slips in gradually, unnoticed, often only discovered when permanent damage has already occurred.
Health specialists are drawing renewed attention to glaucoma, which is a leading cause of preventable blindness that continues to affect people long before symptoms become obvious.
During World Glaucoma Week, which runs from 8th to 14th March, eye health professionals are encouraging people to make regular eye check–ups a priority.
They are cautioning that there is still a dangerously low level of awareness about the condition, even though it can be treated if caught early.
Only one in 20 people living with glaucoma know they have it. Often, by the time they visit a doctor, about half have already lost vision in one eye.
Glaucoma refers to a group of eye conditions that damage the optic nerve, the crucial pathway carrying visual information from the eye to the brain.
The disease develops slowly, often without pain or early warning signs, earning its reputation among specialists as the ‘silent thief of sight’.
Dr Marissa Willemse, a specialist ophthalmologist and President of the South African Glaucoma Society (SAGS), says that the condition has an impact that goes beyond just vision.
‘Glaucoma is more than just a disease of the eyes,’ she explains. ‘Vision loss from glaucoma often starts in the periphery, creating gaps in vision that go unnoticed until they interfere with everyday activities.’
She adds that even mild vision loss can reshape daily life, affecting driving, reading, digital device use and mobility, challenges that may also trigger anxiety, depression and social withdrawal.
Health professionals emphasise that glaucoma’s consequences extend beyond medical concerns, as vision impairment can disrupt employment, independence and household stability, placing financial and emotional strain on families.
‘Vision loss has devastating social, personal and economic impact, often leading to unemployment, loss of income and lowered standards of living,’ Willemse notes, stressing that early detection significantly improves outcomes.
In Sub-Saharan Africa, about 4.16% of people aged 40 and older are living with glaucoma. Research shows that Black populations have a higher rate of the condition, ranging from 5 to 7%, compared to Caucasians, who have a rate between 3 and 5%, highlighting the importance of targeted awareness campaigns across the region.
Medical experts highlight several factors that increase the likelihood of developing glaucoma. Age remains a major contributing factor, particularly after 60, although in Africa, cases frequently appear from around age 40.
Other risk factors include:
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Family history of glaucoma
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African, Asian or Hispanic ancestry
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Elevated intraocular pressure
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Thin corneas
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Diabetes, hypertension or cardiovascular disease
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Previous eye injuries or surgeries
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Near-sightedness
Because symptoms may remain absent for years, specialists stress that risk awareness alone is not enough without regular testing.
While early glaucoma rarely produces symptoms, progression may eventually lead to noticeable changes. These include:
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Gradual loss of peripheral vision or ‘tunnel vision’
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Blurred or hazy sight
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Halos around lights, especially at night
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Eye discomfort or redness
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Severe eye pain accompanied by nausea or vomiting in emergency cases
Willemse warns that these symptoms may also appear in other eye problems, so it’s important to see a professional for an exam.
‘It’s important to note that some of these symptoms can also be caused by other eye conditions, necessitating a thorough eye examination to find the root cause,’ she explains.
Eye specialists recommend routine screenings even for people without symptoms:
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Under 40 years: every 2–4 years
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Ages 40–60: every 2–3 years
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Over 60: annually
Comprehensive eye exams may include pressure testing (tonometry), optic nerve assessment, visual field testing, drainage angle examination and advanced imaging such as Optical Coherence Tomography to detect early damage.
While vision already lost cannot be restored, treatment can slow or prevent further deterioration. Management typically aims to reduce intraocular pressure through prescription eye drops, laser procedures or surgery when necessary.
‘Once the screening has been completed the ophthalmologist will establish an individual treatment plan for each patient. We cannot stress enough how early detection and treatment of glaucoma is essential for preserving vision,’ Willemse highlights.
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