The disease that takes your sight without telling you.
Glaucoma painlessly damages the optic nerve slowly and from the outside in. By the time you notice it, the vision you have lost is gone for good — which is why testing matters more here than almost anywhere else in eye care.
Your brain fills in the gaps.
Glaucoma takes peripheral vision first, and it takes it symmetrically enough that the brain quietly paints over the missing pieces. Most people have lost a meaningful amount before anything feels wrong. There is no pain, no redness, no blur to warn you.
That is why we do not rely on how your vision feels. We measure it — eye pressure, the thickness of your cornea, the drainage angle, the structure of the optic nerve on scan, and your field of vision mapped point by point. Repeated over time, those measurements show change long before you could notice it yourself.
You are at higher risk if glaucoma runs in your family, if you have been told you have high eye pressure or a suspicious optic nerve, or simply as you get older.
Lowering the pressure, by the least invasive means that works.
Glaucoma cannot be reversed, but it can almost always be controlled. The goal is to lower the pressure enough to stop the damage progressing — and to do it with the smallest intervention that achieves it.
SLT laser
Selective laser trabeculoplasty is often used as first line threatment to lower pressure with reduced or no need for glaucoma drops. It improves the eye's natural drainage. It takes minutes in the office, there is no incision, and no downtime. Performed by Dr. Mallon, Dr. Branigan, Dr. Ohlstein and Dr. Vander Woude.
Prescription Drops
Eye drops effectively lower pressure when used consistently. If your routine is hard to maintain or the drops cause discomfort, please let us know. A treatment only works if you are able to use it, and we have excellent alternatives available.
MIGS
Minimally invasive glaucoma surgery — procedures that improve the eye’s drainage through microscopic devices or channels. Most often performed at the same time as cataract surgery: one procedure, one recovery, two problems addressed. The procedures we perform
Traditional surgery
For advanced disease or pressures that will not come down, Dr. Vander Woude performs the established filtering and drainage-device operations in our own surgery center.
We perform the full range of minimally invasive glaucoma surgery.
There is no single best MIGS procedure. There is the one that suits your anatomy, your target pressure, and whether you are having cataract surgery at the same time. Because we perform all of them, that choice is made on your eye rather than on what happens to be available.
Extensive Selection of MIGS
- Goniotomy: iTrack, Omni, Kahook Dual Blade, Streamline
- Viscocanaloplasty: iTrack, Via, Omni
- Sustained-Release Implants: iDose, Durysta
- Micro-Stents & Shunts: iStent, Hydrus, XEN, Alloflow
- Glaucoma Tube Shunts
Trabecular micro-bypass stents
Microscopic stents placed into the eye’s natural drainage channel — iStent inject® Inifinte and the Hydrus® Microstent. Usually combined with cataract surgery.
Goniotomy & trabecular excision
Removing a strip of the blocked drainage tissue rather than stenting through it — Kahook Dual Blade®, Streamline® and Via®. No implant left behind.
Canaloplasty & trabeculotomy
Opening and reinforcing the drainage canal along its length — the OMNI® Surgical System, iTrack™ canaloplasty and GATT. Useful when a longer stretch of the outflow pathway is the problem.
Subconjunctival drainage
The XEN® Gel Stent creates a new drainage pathway under the conjunctiva — a bigger pressure reduction for eyes that need one, without a full filtering operation.
Sustained-release therapy
Having issues with your drops? Redness, irritation, cost, miss doses? Consider iDose, an implant placed in a 4 minute surgery, that lasts for years or Durysta®, an implant placed in the office that releases medication over months.
Performed by Dr. Vander Woude, who performs the full range of MIGS as well as our traditional glaucoma surgery. Dr. Ohlstein performs selected MIGS procedures.
What patients ask
Will I go blind?
Most people with glaucoma who are diagnosed and treated keep useful vision for life. The people who lose sight are overwhelmingly those who were found late or who stopped coming in. Showing up is most of the treatment.
Can the damage be undone?
No. Vision lost to glaucoma does not come back, which is why we treat to protect what you still have and why we test before you notice anything.
Do I have to take drops forever?
Often, but not always. SLT laser and MIGS reduce or eliminate drops for many patients. It is worth asking about, particularly if the routine is difficult or the drops irritate your eyes.
I have glaucoma and a cataract. Can both be handled at once?
Frequently, yes. Combining cataract surgery with a minimally invasive glaucoma procedure is one of the most useful things modern eye surgery does — one operation, one recovery.
My parent has glaucoma. Should I be checked?
Yes, and earlier than you would otherwise. Family history is one of the strongest risk factors we know of.
Testing is the whole game.
If glaucoma runs in your family, or you have been told your pressure is high, come in and let us measure it properly.