Low-Tension Glaucoma: Causes, Risks, and What You Can Do

When you think of glaucoma, you probably think of high eye pressure. But low-tension glaucoma, a form of optic nerve damage that occurs even when intraocular pressure is within the normal range. Also known as normal tension glaucoma, it affects people who never had elevated pressure but still lose vision over time. This isn’t rare—it makes up about 30% of all glaucoma cases in some populations. The real danger? You won’t feel it coming. No pain, no blurry vision at first. By the time you notice blind spots, damage is often advanced.

So what’s really going on? It’s not just about pressure. optic nerve damage, the core problem in all glaucoma types. Also known as glaucomatous neuropathy, it’s what steals your side vision quietly. In low-tension glaucoma, the nerve seems extra sensitive—even normal pressure is too much. Researchers think blood flow issues, genetic factors, or autoimmune reactions might be to blame. People with migraines, Raynaud’s syndrome, or low blood pressure are more likely to develop it. It’s also more common in East Asian populations.

And here’s the twist: treating it isn’t just about lowering eye pressure. While eye drops that reduce pressure still help, studies show they don’t always stop progression. That’s why doctors now look at intraocular pressure, the fluid pressure inside the eye, measured in millimeters of mercury as just one piece of the puzzle. Blood pressure control, avoiding nighttime drops in blood pressure, and even supplements like ginkgo biloba (under medical supervision) are being explored. Regular eye exams with optic nerve imaging are non-negotiable—if you’re at risk, you need annual scans, not just pressure checks.

What you’ll find in the posts below isn’t a list of drug names or generic advice. It’s real-world insight from people who’ve lived with this, and the doctors who treat it. You’ll see how medications like beta-blockers and prostaglandins are used differently here, how lifestyle changes can slow damage, and why some people respond to treatment while others don’t. There’s no one-size-fits-all fix. But understanding what’s happening inside your eye—beyond the pressure reading—can make all the difference in keeping your vision intact.