Glaucoma is essentially an optic nerve atrophy which is often (but not always) accomanied by an increase in the pressure of the fluid (aqueous) within the eye. Typically, the "cup" which can often be present in normal opric nerves, becomes bigger and bigger. This in turn, damages bundles of the optic nerve fibres causing the "arcuate scotoma" which is typical of glaucoma. Your eye care practitioner can examine your optic nerve for these changes and can detect the beginnings of "arcuate scotomas" well before they affect the eyesight, using a computerised perimeter. The eye's pressure can be measured during a normal visual assessment using a "tonometer".