Before people get married, there is usually a familiar checklist for medical tests and consultations, including genotype, HIV, sometimes hepatitis and blood group.
Couples sit through these conversations and consultations, sometimes uncomfortable ones, but they don’t flinch because everyone agrees that knowing your status matters; a striking occurrence is that glaucoma is never on that list.
It should be.
Let me explain what glaucoma is in plain terms.
At the back of your eye sits the optic nerve, a bundle of over a million tiny fibers that carries everything you see to your brain.
With glaucoma, pressure inside the eye slowly damages that nerve.
The damage is permanent because when those fibers die, they do not come back, and vision lost to glaucoma cannot be restored.
Here is what makes glaucoma dangerous.
Most people feel nothing while it happens.
There is no pain, no blur, no warning sign that sends you running to a clinic. Your peripheral or side vision fades first, so gradually that your brain quietly fills in the gaps without you noticing, until a significant portion of your sight is already gone. That is why optometrists and ophthalmologists call it the silent thief of sight. Silent killer fits just as well, because by the time most people notice something is wrong, real damage has already happened.
The numbers back this up starkly.
Globally, glaucoma affects an estimated 68.6 million people, a figure projected to climb to 111.8 million by 2040.
In Nigeria specifically, a large national survey found glaucoma in 5.02 percent of adults aged 40 and above, roughly 1.2 million Nigerian adults living with the condition as of 2012 .
One in every five Nigerians found to have glaucoma in that same survey was already blind by the time they were examined.
But here is the number that should genuinely alarm you.
Of everyone in that Nigerian survey who actually had glaucoma, only 5.6 percent knew it .
Not 5.6 percent were unaware of the details.
5.6 percent knew they had the disease at all. Everyone else was walking around with a condition quietly stealing their sight, completely in the dark.
Now to the part that matters for marriage conversations specifically. Glaucoma has a real, well-documented genetic and hereditary component, arguably as strong as many of the conditions couples already screen for. Research shows that roughly half of all primary open-angle glaucoma cases, the most common form of the disease, have a family history.
Having a first-degree relative, a parent or sibling, with glaucoma raises your own risk by up to nine times compared to someone with no family history.
If that relative is specifically a sibling, the risk climbs even higher, up to ten times.
One widely cited study found something even more striking: first-degree relatives of glaucoma patients carried a 22 percent lifetime risk of developing the disease themselves, compared to just 2.4 percent for people with no family history at all.
One more detail worth knowing, specifically as a Nigerian reading this.
Open-angle glaucoma, the type most strongly tied to genetics, is also more common and often more aggressive in people of African descent.
In Nigeria’s own national survey, 86 percent of all glaucoma cases were this exact type.
Put those two facts side by side.
A disease with a strong genetic pattern, more aggressive in people who look like most of us, silently affecting over a million Nigerian adults, and rarely tested for before two families join together.
Compare that to genotype testing, which exists specifically to avoid passing sickle cell disease to children.
The logic is identical.
If we screen for one hereditary condition before marriage, why not the one quietly threatening someone’s eyesight, and potentially their children’s, in the same way?
I want to be careful here, because this is not an argument for discrimination.
A glaucoma diagnosis should never end a relationship or be treated as a flaw in a person. That is not the point at all. The point is simpler.
Knowing your status lets you actually do something about it, adjust your lifestyle, monitor your eye pressure regularly, and catch any damage early enough to stop it, rather than discovering it after your vision has already narrowed.
This is where I have to speak honestly, from what I actually see.
As an optometry student, I often see patients come in to the clinic, get diagnosed, and then disappear.
No return visit for a follow-up.
Sometimes because of the cost of eye drops like timolol, which need to be used consistently, sometimes for years.
For some patients, they hold a quiet belief that prayer alone will resolve it; accepting the diagnosis feels like giving up on a miracle. I believe in miracles too, but I also believe faith and medical follow-up are not opposites.
You can pray fervently and still show up for your next check-up with the optometrist.
You can trust God completely and still take your eye drops as prescribed. Choosing to disappear from care is not faith; it is just risk, quietly compounding while nothing visibly changes, until one day something does, and by then the damage is already permanent.
And the financial argument genuinely runs the other way.
Managing glaucoma early is far less costly than the alternative.
Untreated glaucoma eventually leads to significant vision loss, and living with blindness carries its own enormous, ongoing financial and emotional weight, for the person affected and for the family around them.
Indeed, penny-wise, pound-foolish.
So back to where we started.
The next time genotype and HIV testing come up before a wedding, glaucoma deserves a seat at that same table.
Not to frighten anyone, not to create stigma, because it is the one thing that protects sight, protects families, and protects children who come after.
A comprehensive eye test costs very little.
Losing your vision silently costs everything.
