{"id":91596460033,"date":"2025-11-18T06:48:07","date_gmt":"2025-11-18T05:48:07","guid":{"rendered":"https:\/\/www.augenarzt-banyai.de\/blog\/general\/normal-tension-glaucoma-when-eye-pressure-is-normal-but-the-optic-nerve-is-damaged\/"},"modified":"2026-06-18T12:15:50","modified_gmt":"2026-06-18T10:15:50","slug":"normal-tension-glaucoma-when-eye-pressure-is-normal-but-the-optic-nerve-is-damaged","status":"publish","type":"post","link":"https:\/\/www.augenarzt-banyai.de\/en\/blog\/glaucoma\/normal-tension-glaucoma-when-eye-pressure-is-normal-but-the-optic-nerve-is-damaged\/","title":{"rendered":"Normal-tension glaucoma: When eye pressure is normal but the optic nerve is damaged"},"content":{"rendered":"\n

Some patients have heard of normal-pressure glaucoma\u2014also called low-pressure glaucoma\u2014and ask, “How can glaucoma develop when the intraocular pressure is normal?”<\/p>\n\n

In fact, this form of glaucoma presents a particular challenge: the intraocular pressure is within the normal range when measured, yet damage to the optic nerve still occurs.<\/p>\n\n

In this article, I explain, as an ophthalmologist, what you should pay particular attention to with normal-tension glaucoma, how it develops, how it is detected, and which preventive measures are useful for it.<\/p>\n\n

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Glaucoma \u2013 learn more<\/a><\/div>\n<\/div>\n\n

What is normal-tension glaucoma?<\/h2>\n\n

Normal-tension glaucoma is a particular form of glaucoma in which characteristic optic nerve damage occurs despite the intraocular pressure being within the normal range.<\/p>\n\n

Definition and special features<\/h3>\n\n

In normal-tension glaucoma, the optic nerve damage typical of glaucoma is present, with thinning of the nerve fibers and visual field defects, even though the intraocular pressure is below 21 mmHg. This form of the disease accounts for about 30\u201340% of all glaucoma cases in Europe.<\/p>\n\n

Because intraocular pressure is not elevated, it is often detected late. What’s particularly insidious is that many patients remain entirely symptom-free for a long time, even though the nerve fibres are already damaged. Therefore, normal-tension glaucoma is considered one of the “silent” forms of vision loss.<\/p>\n\n

It’s important to understand that pressure measurements alone do not indicate the risk. Only when combined with imaging techniques and visual field testing can a reliable diagnosis be made.<\/p>\n\n

What causes normal-tension glaucoma?<\/h2>\n\n

The causes are multifactorial and primarily involve blood flow and the optic nerve’s individual sensitivity to pressure.<\/p>\n\n

Causes and risk factors<\/h3>\n\n

Vascular\/circulatory disturbance<\/strong>
<\/strong> Disturbed blood flow to the optic nerve head is considered the main cause. Particularly notable is the so-called Flammer syndrome, with symptoms such as cold hands, migraines, or low blood pressure.\u00a0<\/p>\n\n

The blood supply to the optic nerve is complex and vulnerable \u2014 especially in people with low nighttime blood pressure, where reduced blood flow can occur and may cause long-term damage to the nerve tissue.<\/p>\n\n

Other vascular conditions, such as diabetes or chronic hypotension<\/a>, also increase the risk.<\/p>\n

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Pressure-sensitive optic nerve<\/strong>
<\/strong>Some optic nerves are more susceptible to damage, even at normal pressure levels. This can be genetic or age-related. Studies show that lean women with low blood pressure, in particular, are at increased risk.\u00a0<\/p>\n\n

A family history also plays a role: if you have close relatives with glaucoma, you should undergo regular check-ups even if your eye pressure is normal.<\/p>\n\n

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Read more about pressure readings<\/a><\/div>\n<\/div>\n\n

Diagnosis \u2013 How is normal-tension glaucoma diagnosed?<\/h2>\n\n

A reliable diagnosis depends on more than just measuring intraocular pressure. At B\u00e1nyai Augenheilkunde, we use targeted examinations to detect normal-pressure glaucoma early.<\/p>\n

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