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Normal Tension Glaucoma: Causes, Symptoms, and Treatment

What is Normal Tension Glaucoma?

Normal Tension Glaucoma (NTG) is a type of glaucoma in which optic nerve damage occurs despite normal intraocular pressure. NTG’s exact cause is unknown, but it has been linked to conditions such as atherosclerosis, Raynaud’s phenomenon, and nocturnal hypotension. Early diagnosis and treatment can prevent or stabilize damage to the optic nerve. Here are some of the risk factors of normal tension Glaucoma:

  • Age: Older patients are at high risk of developing NTG
  • Patients with increased central corneal thickness
  • Gender: NTG is more common in women than men
  • Patients with heart disease
  • Genetic
  • High body mass index
  • Smoking habits

normal eye and normal tension glaucoma eye


What causes Normal-Tension Glaucoma?

symptoms of normal tension glaucoma

The exact cause of Normal Tension Glaucoma (NTG) is not fully understood. However, research suggests that certain medical conditions may play a role in developing NTG. These include atherosclerosis, Raynaud’s phenomenon, and nocturnal hypotension.

Atherosclerosis is a condition in which fat deposits may build up in the walls of the arteries, which can disrupt blood circulation. 

Raynaud’s phenomenon is a condition that results in decreased blood flow in certain areas of the body, particularly the hands and feet. 

Nocturnal hypotension, a decrease in blood pressure at night, has also been linked to an increased risk of NTG and ultimately causes vision loss.

Additionally, other factors like genetics and certain medications can also be instrumental in the growth of NTG. However, further research is required to fully understand the underlying cause of this condition.


development of glaucoma


Normal Tension Glaucoma Symptoms

Normal Tension Glaucoma (NTG) is often called the “silent thief of sight” because it does not usually bring about noticeable symptoms in the initial stages of the disease. As a result, many people with NTG may not be aware that they have the condition until it has progressed and caused significant damage to their vision. Some of the symptoms of NTG may include:

Also known as the “silent thief of sight”, NTG doesn’t show significant symptoms in the early stages. :

  • Increased frequency of headaches
  • Migraine
  • Cold hands and feet
  • Low blood pressure
  • Increased frequency of headaches: People with NTG may experience more headaches than usual, particularly in the morning or at night.
  • Migraine: Some individuals with NTG may develop migraines, which are severe headaches that are accompanied by other symptoms such as sensitivity to light and nausea.
  • Cold hands and feet: NTG has been linked to poor circulation, which can cause cold hands and feet.
  • Low blood pressure: Some people with NTG may have low blood pressure, also known as hypotension.
  • Blind spots in vision: As the disease progresses, people with NTG may develop blind spots in their vision, making it difficult to see objects in the periphery of their visual field.
  • Blind spots in vision

Girl having glaucoma eye

It is important to note that these symptoms are not specific to NTG and may be caused by other conditions. Therefore, a thorough eye examination is needed to diagnose NTG. Additionally, it is important to consult an ophthalmologist if you notice any alterations in your vision, even if they seem minor.


Normal Tension Glaucoma treatments options 

To treat NTG, there are several options available, including medications, laser treatments, and surgery.

Medicines are often the obvious line of Normal Tension Glaucoma treatments. Anti-glaucoma medications such as latanoprost, bimatoprost, and timolol are effective in reducing IOP and treating NTG. These medications are typically administered in the form of eye drops.

Laser treatments, such as Selective laser trabeculoplasty (SLT), can also reduce intraocular pressure (IOP) and treat NTG. Selective laser trabeculoplasty is a technique that targets the trabecular meshwork, the area where fluid drains out of the eye, to increase the outflow of fluid and reduce IOP.

Surgery may be recommended if medications and laser treatments are ineffective in treating NTG. Microscopic incisional trabeculectomy and tube shunt implantation are two common surgeries used to treat NTG. Microscopic incision trabeculectomy involves making a small incision in the eye to create a new pathway for fluid to drain, which reduces IOP. Tube shunt implantation involves the insertion of a drainage implant that creates a new way for aqueous humor to drain from the eye and lower IOP.

Minimally Invasive Glaucoma Surgery (MIGS) is another option usually combined with cataract surgery. MIGS procedures aim to increase the outflow of aqueous humor and lower IOP minimally invasively, causing minimum discomfort and leading to more rapid recovery periods.

Overall, treating Normal Tension Glaucoma involves reducing the eye pressure as low as possible through medications, laser treatments, and surgery. The treatment plan will rely on the individual case and may involve a combination of these options.


Consult Clear Vision Clinic for expert eye treatment 

Clear Vision Clinic is one of the best eye clinics in Mumbai for normal tension glaucoma treatments. We have a great team of doctors with extensive experience and highly successful clinical records. So if you are looking for any type of eye surgeries, Clear Vision is the right choice. Visit the Clear Vision website to consult our eye expert online and get prompt treatments for your eye conditions here.



  • What is normal tension glaucoma? 

Normal Tension Glaucoma (NTG) is a type in which the intraocular pressure (IOP) is within the normal range; however, the optic nerve is still damaged. If left untreated, it can result in vision loss and blindness.

  • What are the symptoms of normal tension glaucoma? 

Normal Tension Glaucoma symptoms may include gradual vision loss, particularly in peripheral vision, and a subtle change in the shape of the optic nerve. Some people with NTG may not experience symptoms until significant vision loss occurs.

  • What causes normal tension glaucoma? 

The exact cause of Normal Tension Glaucoma is obscure. Nonetheless, it is related to poor blood flow to the optic nerve. Risk factors for NTG include a family history of glaucoma, a history of cardiovascular disease, and being of Japanese descent.

  • How is Normal Tension Glaucoma diagnosed? 

Normal Tension Glaucoma symptoms require a comprehensive eye exam. This may include measuring the IOP, evaluating the optic nerve, and performing visual field tests. Your doctor may also order additional tests, such as a visual field test or an optical coherence tomography (OCT) scan.

  • What is the treatment for normal tension glaucoma? 

Normal Tension Glaucoma treatments typically includes medications to lower the IOP, such as eye drops, oral medications, or laser therapy. In some cases, surgery may be recommended to improve the blood flow to the optic nerve. Regular follow-up visits with an ophthalmologist are important to monitor the condition and adjust the treatment as needed.

  • Can Normal Tension Glaucoma be prevented? 

There is currently no known way to prevent normal tension glaucoma, but regular comprehensive eye exams can help detect the condition early, allowing for early treatment and potentially slowing or preventing vision loss.

  • Can Normal Tension Glaucoma be cured? 

Normal Tension Glaucoma is a chronic condition that cannot be treated and can only be managed with treatment options. The goal of normal tension glaucoma treatments is to slow down or prevent vision loss, but once it has occurred, it cannot be regained.