When Vision Changes Before You Notice

Glaucoma is one of the most common causes of irreversible blindness in Australia, yet it remains widely underdiagnosed. Approximately 300,000 Australians are estimated to have the condition, with around half unaware they have it. The reason is straightforward: in its most common form, glaucoma causes no noticeable symptoms in the early stages. Vision loss begins at the periphery, builds slowly, and is often attributed to normal aging before the damage becomes significant.

This is why consulting a Glaucoma Specialist in Melbourne whom patients trust is not just appropriate after symptoms appear. It is most valuable before they do.

Why Glaucoma Progresses Without Warning

The most prevalent form of the condition, primary open-angle glaucoma, earns its description as the silent thief of sight for a reason. Fluid pressure builds inside the eye, placing sustained load on the optic nerve. Because the optic nerve transmits visual information from the eye to the brain, ongoing pressure leads to progressive damage. But this process unfolds gradually, and the peripheral vision that is typically affected first is not the vision people actively monitor.

By the time central vision is affected, or a patient seeks care because something feels noticeably wrong, the disease has often advanced considerably. Vision lost to glaucoma cannot be restored. What can be done is to slow or halt further progression through appropriate treatment. This makes the timing of detection genuinely consequential.

Who Is at Highest Risk

Certain factors increase the likelihood of developing glaucoma. Understanding these risk factors helps identify when to seek formal assessment from a Glaucoma Specialist in Melbourne rather than waiting for symptoms.

The key risk factors include:

• Age over 40, with risk increasing significantly after 60
• A first-degree family history of glaucoma, particularly in parents or siblings
• Raised intraocular pressure, even in the absence of other signs
• Short-sightedness (myopia)
• Diabetes or certain cardiovascular conditions
• Long-term use of corticosteroid medications, including some eye drops

For people with a family history, Glaucoma Australia recommends commencing regular screening from the age of 40. For those without identifiable risk factors, screening from 50 is generally advised. These are population-level guidelines. An individual’s actual risk profile should be assessed by a qualified specialist who can review clinical history and conduct a thorough examination.

What Glaucoma Assessment Involves

An assessment for glaucoma is not a single test. A comprehensive evaluation typically draws together several types of information to build a complete clinical picture. This includes measurement of intraocular pressure, assessment of the optic nerve’s appearance, and visual field testing, which maps peripheral and central vision to identify areas where function may have declined.

At the practice of a Glaucoma Specialist in Melbourne like Dr Simon Skalicky, visual field testing is supported by Eyeonic, a cloud-based AI platform developed by Dr Skalicky himself. This technology allows visual field assessment to be conducted more efficiently and with greater patient comfort than traditional equipment. The platform is now used in more than 25 countries, with its accuracy validated through published research and scientific review.

The combination of these assessments, reviewed by an experienced clinician, allows for a more precise picture of the optic nerve’s condition than eye pressure measurement alone provides.

Treatment Options When Glaucoma Is Found

When glaucoma is identified, treatment focuses on reducing intraocular pressure to levels that protect the optic nerve from further damage. The appropriate approach depends on the type of glaucoma, the degree of optic nerve involvement, and individual patient factors. Options available at the practice include:

• Selective Laser Trabeculoplasty (SLT), a gentle procedure that improves fluid drainage from the eye
• Pressure-lowering eye drops used on a daily basis
• Minimally Invasive Glaucoma Surgery (MIGS), including iStent procedures that improve fluid outflow
• Trabeculectomy or glaucoma drainage tube surgery for more advanced cases requiring sustained pressure control

Not every patient will require surgery. For many, early detection means that medical management or laser treatment is sufficient to maintain safe intraocular pressure over the long term. The critical factor is that these options are most effective when the optic nerve has not yet sustained extensive damage.

Why Specialist Review Matters

A general eye examination with an optometrist remains valuable and is an important entry point into glaucoma care. Optometrists are well-positioned to screen for raised eye pressure and to identify patients who warrant further specialist review. However, definitive diagnosis, treatment decisions, and ongoing monitoring for glaucoma require the skills and resources of a specialist ophthalmologist.

As a Glaucoma Specialist in Melbourne whom patients are referred to from across Australia, Dr Simon Skalicky holds a FRANZCO qualification, completed subspecialty fellowship training at Cambridge, and is an Associate Professor at the University of Melbourne and University of Sydney and an Honorary Researcher at the Centre for Eye Research Australia. His practice spans medical management, laser treatment, and complex surgical intervention for glaucoma and cataracts, giving patients access to the full range of treatment pathways under consistent specialist care.

Patients are seen at Eye Surgery Associates in East Melbourne and at Cabrini Hospital, Malvern.

Taking the Next Step

If you are over 40 with a family history of glaucoma, or over 50 and have not had a comprehensive eye assessment, speaking with your GP or optometrist about a referral is a practical first step. A valid referral is required for a specialist ophthalmology consultation. Early assessment by a Glaucoma Specialist in Melbourne gives the clearest picture of your eye health and the most options for protecting it.

To learn more about glaucoma assessment, treatment options, and what to expect from a specialist consultation, visit drsimonskalicky.com.au.