Glaucoma and cataracts – protecting your sight
Two of the biggest causes of sight loss in South Africa. Why glaucoma has no early symptoms, why cataract surgery works so well, and who should have their eyes checked.
Two different problems, often confused
- Cataract is clouding of the lens inside the eye. Vision becomes misty, colours dull, and glare from headlights or sun gets worse. It is treatable with surgery and sight usually returns.
- Glaucoma is damage to the optic nerve, usually linked to pressure inside the eye. It takes peripheral vision first, so slowly that most people notice nothing until a lot is gone. Sight already lost cannot be restored — but further loss can be prevented.
Who should have their eyes checked
- Anyone with diabetes, at the interval their clinician advises. Diabetes also damages the retina, and that damage is silent early too.
- Anyone with a parent, brother or sister who has glaucoma. It runs strongly in families.
- Adults from middle age onward, as part of routine health checks.
- Anyone using steroid eye drops or long-term steroid treatment, which can raise eye pressure.
- Anyone noticing bumping into things on one side, difficulty in dim light, or worsening glare while driving at night.
Glaucoma treatment is drops, for life
Most glaucoma is controlled with eye drops that lower the pressure inside the eye. They do not make vision better and they do not make the eye feel different, which is exactly why people stop them — nothing seems to change either way. Their entire job is preventing loss you will otherwise not notice until it is permanent.
Eye drops used to lower eye pressure in South Africa:
Latanoprost — Xalatan, Monoprost
Open-angle glaucoma; ocular hypertension
Timolol Eye Drops — Timoptol, Nyolol
Open-angle glaucoma; ocular hypertension
Dorzolamide + Timolol — Cosopt
Open-angle glaucoma; ocular hypertension (when monotherapy insufficient)
Brimonidine — Alphagan, Brimonidine
Open-angle glaucoma; ocular hypertension (add-on or when other agents not tolerated)
- Wash your hands, tilt your head back and pull the lower lid down to make a pocket.
- Squeeze one drop into the pocket without letting the bottle tip touch the eye or lashes.
- Close the eye gently and press the inner corner, next to the nose, for about a minute. This keeps the drop in the eye and reduces effects on the rest of the body.
- If you use more than one kind of drop, leave about five minutes between them or the second washes the first out.
- Do not skip a day because the eye feels fine. It always feels fine.
Cataract surgery, and the emergency you must know
Cataract surgery replaces the clouded lens with a clear artificial one. It is one of the most effective operations in medicine, done under local anaesthetic, and is performed in the public sector — waiting lists vary by province, so ask your clinic how to be referred.
Common questions
- Does glaucoma have symptoms?
- The common form usually has none until significant sight has already been lost, because it takes peripheral vision first and the brain fills the gap. An eye examination is the only reliable way to find it early.
- Can lost vision from glaucoma come back?
- No. Vision already lost is permanent, which is why treatment focuses on preventing further loss. Daily drops do that even though they change nothing you can feel.
- Is cataract surgery available in the public sector?
- Yes, though waiting times vary by province. Ask your clinic how referral works in your area.
Sources
- Adult Hospital Level Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
- Clinical and public health guidanceWorld Health Organization
Last reviewed 11 August 2026.