Normal-Tension Glaucoma
Normal-Tension Glaucoma (NTG)
Expert Diagnosis & Care by Austin’s Glaucoma Specialist, Zarmeena Vendal, MD
Normal-Tension Glaucoma (NTG) is a unique and often misunderstood form of glaucoma where optic nerve damage occurs despite normal intraocular pressure (IOP) readings. It requires careful diagnosis and highly individualized management, which is why patients across Austin, Kyle, Killeen, and New Braunfels trust Dr. Zarmeena Vendal, MD, a Harvard-trained glaucoma specialist, at Westlake Eye Specialists.
Unlike other forms of glaucoma, NTG can easily go undetected without advanced testing and a provider who understands its subtleties. Our team has the tools—and the expertise—to protect your vision.
What Is Normal-Tension Glaucoma?
Glaucoma is generally associated with elevated eye pressure, but in Normal-Tension Glaucoma, optic nerve damage occurs even though IOP remains within normal limits (typically under 21 mmHg).
This condition suggests that the optic nerve is unusually sensitive to pressure, or that other factors such as blood flow, vascular dysregulation, or structural abnormalities contribute to the nerve’s degeneration.
Because NTG does not present with high pressure, it can be easily missed during routine exams unless you are seeing a specialist who actively screens for it—like Dr. Vendal.
Who’s at Risk for NTG?
Although NTG can affect anyone, certain risk factors make it more likely. These include:
- Family history of glaucoma
- History of migraines or vascular disease
- Low blood pressure (especially at night)
- Sleep apnea
- Raynaud’s syndrome
- Japanese or Korean ancestry
- Thin corneas
- Female gender
If you live in Austin, Kyle, Killeen, or New Braunfels and have any of these risk factors, we recommend scheduling a glaucoma screening at Westlake Eye Specialists.
Symptoms of Normal-Tension Glaucoma
Like most types of glaucoma, NTG is often asymptomatic in its early stages. That’s why it’s sometimes referred to as the “silent thief of sight.”
As NTG progresses, symptoms may include:
- Gradual loss of peripheral (side) vision
- Difficulty seeing at night
- Central vision loss in more advanced cases
- No eye pain or redness
By the time most patients notice symptoms, permanent vision loss has already occurred—which makes early detection and monitoring essential.
How We Diagnose NTG
At Westlake Eye Specialists, we take a proactive approach to detecting and managing NTG, using state-of-the-art diagnostic technology at all our locations.
Our diagnostic tools include:
- Optical Coherence Tomography (OCT): Scans the optic nerve for early signs of damage
- Visual Field Testing: Identifies patterns of vision loss
- Gonioscopy: Assesses the angle to rule out other glaucoma types
- Tonometry: Measures intraocular pressure, even if it appears “normal”
- Pachymetry: Measures corneal thickness to interpret pressure readings accurately
- Ocular blood flow assessment: May be used to evaluate vascular risk factors
With this comprehensive toolkit, Dr. Vendal can identify NTG even when pressure readings appear deceptively normal.
Treatment Options for NTG
Although eye pressure in NTG patients is within a standard range, research shows that further lowering IOP can slow disease progression. We tailor treatments based on your optic nerve health, age, lifestyle, and other health conditions.
Common treatments include:
- Prescription Eye Drops
Medications that lower IOP further—typically by 20-30%—to protect optic nerve fibers. - Laser Therapy
• SLT or DSLT »: Gentle in-office treatments that help reduce eye pressure with minimal downtime. - Medication Implants
• Durysta® by AbbVie »: A biodegradable implant that offers sustained pressure reduction over several months. - Minimally Invasive Glaucoma Surgery (MIGS)
If NTG continues to progress, even at low pressures, we may recommend MIGS procedures during cataract surgery or as standalone interventions. These include:
- Glaukos iStent Inject »
- Hydrus Microstent »
- OMNI Surgical System »
All procedures are performed by Dr. Zarmeena Vendal in a safe, comfortable outpatient setting.
Why Patients Choose Dr. Zarmeena Vendal for NTG
- Harvard-trained glaucoma specialist with deep experience in NTG
- Four convenient locations: Austin, Kyle, Killeen, New Braunfels
- Advanced diagnostics to detect vision loss before symptoms begin
- Personalized care with clear communication and long-term monitoring
- Expertise in vascular and neurological contributors to NTG
- Flexible scheduling, including second opinions and early-detection exams
Book Your NTG Evaluation Today
If you have risk factors for Normal-Tension Glaucoma or a family history of vision loss, don’t wait. Early intervention is your best defense.
Call now or book your visit online with Dr. Zarmeena Vendal, trusted Austin glaucoma specialist serving patients from Kyle, Killeen, and New Braunfels.
