Areas of Expertise


What is Glaucoma?

Glaucoma shouldn’t
get in your way.

Glaucoma is a progressive eye disease that can eventually lead to vision loss. It can be managed with regular eye exams, early detection and treatment. When you have glaucoma, the optic nerve that carries electrical signals from your eye to your brain slowly becomes compromised, affecting your vision and potentially causing gradual blindness. It’s often hereditary or experienced by patients over 60 or of African descent, but can also develop from a past eye injury, high eye pressure or a thin cornea.

What Causes GLAUCOMA?

Elevated eye pressure can often
damage the eye’s optic nerve.

  • Glaucoma is the result of damage to the optic nerve and increased pressure in the eye. The increased eye pressure is due to buildup of aqueous humor fluid (fluid inside fo your eye).

  • When the trabecular meshwork (eye’s natural drain) becomes clogged or stiffer, the eye’s fluid has trouble draining and the pressure builds. Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage.

What are the symptoms?

Many people don’t realize they have glaucoma until the disease has progressed. There are often no early visible symptoms. Your ability to read the letters on an eye chart represents the very last portion of your vision to be affected. People can have 20/20 vision and still have advanced glaucoma. Others could potentially experience any of the following symptoms.

  • Disruption in sight
  • Poor vision in dim lighting
  • Bright Halos
  • Eye Redness
  • Eye Tenderness or Hardness
  • Glare
  • Peripheral Vision Loss
  • Nausea and Vomiting

What are the different types of glaucoma?

There are a few major categories of glaucoma, each based on the configuration of the drainage angle of the eye. A patient’s eye pressure can increase when the eye’s drainage angle is blocked, resulting in closed-angle glaucoma. Or the patient can experience problems within the drainage system of the eye, resulting in open-angle glaucoma. When a patient has developed glaucoma, the eye’s shape, normal function and vision is affected.

  • Primary open-angle glaucoma

    With open angle glaucoma, fluid doesn’t flow out of your eye properly, causing pressure to develop that eventually causes a disruption in sight. There are usually no symptoms for the patient to notice, which is why this a leading but preventable cause of blindness.

  • Closed angle glaucoma

    This type of glaucoma occurs if the iris completely blocks the eye's natural drain. This often leaves patients experiencing sudden eye pain, blurred vision, bright halos, eye redness, tenderness and hardness. Closed angle glaucoma is a true eye emergency.

  • Narrow angle glaucoma

    If the iris is pushed forward, it can narrow the drainage angle of the eye without completely blocking it. This can increase the pressure and damage your optic nerve. Symptoms can be intermittent blurry vision, eye pain and headaches. If not treated, a narrow angle can progress to being fully closed.

  • Secondary glaucoma

    Secondary glaucoma occurs due to other eye problems such as an eye injury, inflammation, certain drugs like steroids and advanced cases of cataract or diabetes. It can be treated with medications, laser or surgery. Secondary Glaucoma types include Exfoliative Glaucoma, Neovascular Glaucoma, Pigmentary Glaucoma, Traumatic Glaucoma, Uveitic Glaucoma and Congenital Glaucoma.



Patients who schedule routine eye exams are often at lower risk for developing glaucoma. Those with high risk factors (African descent, diabetics, family history or a parent or brother or sister with glaucoma) are considered high risk and should be tested every year after age 35. Other ways to prevent or slow the progression of glaucoma include leading a healthy lifestyle, including good nutrition and regular exercise, and wearing protective eyewear to avoid trauma to the eye.


We use many tests to diagnose glaucoma and determine the right approach to treatment.

There are many ways to diagnose glaucoma. A Tonometry Test uses numbing eye drops and a tonometer to measure the inner pressure of the eye. Ophthalmoscopy examines the shape and color of the optic nerve for glaucoma damage through dilation. Perimetry is a visual field test using a moving light to asses your peripheral vision. A Gonioscopy exam is a test where a contact lens is used to determine if the angle where the iris meets the cornea is closed or blocked. A Pachymetry test uses a pachymeter probe to measure the thickness of the cornea. A pupil exam can identify optic nerve asymmetry. Lastly, advanced imaging techniques of the optic nerve can be used to identify pathology.

Treatment Options

When we treat glaucoma, we reduce the pressure inside your eye. It’s often treated with eye drops, an in-office laser, minimally invasive surgery or traditional glaucoma surgery. We work with each patient to evaluate symptoms, understand your challenges and propose the best plan for recovery.

  • Eye Drops

    There are several classes of eye drops used to lower the eye‘s pressure to stop the progression of glaucoma. Once started, this is usually a lifetime of treatment.

  • Laser Trabeculoplasty

    This in-office, non-invasive procedure allows the eye to drain fluid more efficiently, lowering eye pressure and slowing further progression of glaucoma in the affected eye. Many patients will choose this laser procedure instead of beginning chronic eye drop treatment.

  • Laser Iridotomy

    An iridotomy is performed on patients who have narrow angles, closed-angle glaucoma, or pigmentary glaucoma. During this procedure, the surgeon makes a small hole in the iris to reestablish normal drainage.

  • Xen Gel Stent

    A mildly invasive surgery, where we implant a stent in the eye that drains fluid, reduces eye pressure and helps prevent future vision loss.

  • Trabeculectomy

    Our skilled glaucoma surgeons will create an entirely new drainage system for the eye, bypassing the problematic normal drain mechanism and reducing eye pressure.

  • Tube Shunt

    Our skilled glaucoma surgeons place a glaucoma device to drain fluid from the eye, bypassing the problematic normal drain mechanism and reducing eye pressure.

  • Endoscopic Cyclophotocoagulation (ECP)

    This laser procedure allows patients to be treated for their glaucoma during cataract surgery. We use a small camera along with a laser to lower eye pressure.

  • Minimally Invasive Glaucoma Surgery (MIGS)

    iStent, goniotomy, hydrus and OMNI are newer surgery innovations that lower eye pressure with a smaller incision than traditional glaucoma surgeries. These surgeries typically do not lower eye pressure as well as a trabeculectomy or tube shunt, but they have less risk and a quicker recovery.

Learn more about our practices that provide these treatment options:

  • Kremer Eye

  • Ludwick
    Eye Center

  • Omni Eye

  • Phillips Eye

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