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Is MIGS Safe?

These days, there are a variety of treatment options for glaucoma patients. While glaucoma is a serious condition that can cause permanent damage to your vision or even blindness, you can manage it.

This is often done with a combination of medication or surgery to slow the progression of the disease and save your remaining vision.  Some surgical options are more intensive than others. Other, newer options for patients are MIGS, known as minimally invasive glaucoma surgeries or micro incisional glaucoma surgery.

MIGS are an effective option for certain patients. They can also be safer than other surgical options. Keep reading to learn more about MIGS!

What are MIGS?

Micro incisional glaucoma surgeries are surgical procedures used to treat glaucoma that is considered to be less invasive. This is because there are less equipment and fewer incisions used. There are several procedures that are considered to be MIGS, including:

iStent Trabecular Micro-Bypass Stent:

The iStent is for patients with glaucoma that also need cataract surgery. iStent is different because it reduces eye pressure and helps manage open-angle glaucoma. iStent removes the blockage in the eye’s natural drainage system, which leads to increased eye pressure.

The iStent creates an opening that’s permanent to improve how fluid can flow and drain through the eye. By restoring how the eye’s fluid flows, this lowers and controls intraocular pressure. iStent is implanted during cataract surgery. 

Hydrus Microstent:

Another option for patients with glaucoma that need to have cataract surgery is the Hydrus Microstent. The Hydrus Microstent is inserted into the eye using a gonioprism. It’s guided through the trabecular meshwork and into Schlemm’s canal.

After being put into position, the Hydrus Microstent is then delivered using a stainless steel cannula. The Hydrus Microstent enhances the flow of fluid in the eye and reduces eye pressure.

Gonioscopy-Assisted Transluminal Trabeculectomy:

Gonioscopy-Assisted Transluminal Trabeculectomy (GATT) is another MIGS procedure meant to treat patients with open-angle glaucoma. It is a modification of a more traditional glaucoma surgery called a trabeculectomy.

The GATT procedure is performed using micro-incisions in the cornea. The procedure takes place using an incision that’s about 1 millimeter and made in the periphery of the cornea.

After entering the eye, the procedure cuts through the trabecular meshwork, followed by cannulation of Schlemm’s canal 360 degrees and unroofing Schlemm’s canal. GATT gives the surgeon full access to the natural drainage system, which helps with efforts to lower intraocular pressure.  

Kahook Goniotomy:

Kahook Goniotomy or Kahook Dual Blade involves removing the trabecular meshwork from a portion of the drainage system. The goal of this is to lower eye pressure for patients with glaucoma.

This can be done as a standalone procedure or performed at the same time with cataract surgery.

Is MIGS Right for You?

MIGS is best for patients in the early to moderate stages of glaucoma. Some MIGS procedures, like trabecular surgery, have very little effect on more severe cases of glaucoma.

They are best used in the early stages as a way to slow the progression of the disease. Experts agree that advanced glaucoma is best treated by traditional surgeries.

Traditional surgeries often involve a longer recovery time and more intensive procedures.  When your vision is threatened by severe glaucoma symptoms, more aggressive treatment may be the only way to save it.

MIGS can still be effective for many glaucoma patients. These procedures are also more convenient for patients who don’t want to spend a lot of time recovering from postoperative care.

Used with certain medications, MIGS can be the perfect way to manage your glaucoma and keep it from progressing. Of course, any surgery still carries some degree of risk, and there is no guarantee that MIGS will always be 100% effective. But for many glaucoma patients, MIGS is a safer alternative.

Wondering if MIGS could be right for you? Schedule an appointment at Sierra Nevada Eye Center in Reno, NV to find out if MIGS could be the best way to treat your glaucoma symptoms!

woman looking at window

In the past, getting cataract surgery meant having the natural lens removed without any replacement for it. Cataract surgery patients would have to wear thick glasses to see normally.

But when you get cataract surgery now, the natural lens is instead replaced with an artificial lens called an intraocular lens. Not only can IOLs help you see clearly, but they can also improve your vision and reduce the need for glasses. 

Premium IOLs can be more expensive, but for some people, the cost is worth the visual improvement. It depends on you and your individual needs. Keep reading to learn if premium lens implants are worth it!

Standard IOLs

Standard IOLs are the most basic kind of IOL available and are usually covered by insurance. These are monofocal IOLs.

These IOLs are uniform lenses set to one refractive power, much like standard glasses. Most of the time, patients who opt for monofocals are given one in one eye set to see at a distance and the other for close focus.

This creates monovision, and it allows most patients to see at a middle distance without the need for contacts or glasses. But they may still need reading glasses to see well up close.

Premium IOLs

There are several kinds of premium IOLs, with more being developed and added to the market every few years. Each kind of IOL works a little differently.

They all have the same goal of providing patients with crisp vision and eliminating the need for glasses after cataract surgery.

Multifocal IOLs are lenses that have rings of alternating refractive powers coming out of the center of the lens. The design trains the eye to look out of the right part of the lens depending on what is being focused on.

This allows for fine focus when viewing objects up close.

Accommodative IOLs are lenses that actually change shape depending on what you are viewing. When focusing on something up close, the lens thickens to see objects clearly.

When the eye is relaxed, the lens is thin and allows comfortable distance vision.

The PanOptix trifocal IOL is like a multifocal IOL, but instead of rings that alternate between two refractive powers, it alternates between three refractive powers. One for close vision, one for distance, and one for middle distance.

This allows the patient to see more clearly at a middle distance as well as up close. The PanOptix trifocal IOL works very well for patients that want to be able to complete tasks that are at an intermediate distance, like an arm’s length away.

Toric IOLs are designed specifically to correct astigmatism. For patients with astigmatism, toric IOLs may reduce the need for glasses or contacts used to correct their vision normally.

What Are Your Needs?

For some people, monofocal IOLs are adequate and they don’t need anything else. For others, the visual freedom that premium IOLs offer is well worth the price.

To determine who you are, think about what you want to get out of cataract surgery. Are you okay with reading glasses?

If you don’t mind wearing reading glasses after cataract surgery, then a standard monofocal IOL may be a good fit. Do you want to be able to see better up close?

Most premium IOLs can provide that ability very well. Want to correct your astigmatism? A toric IOL is the way to go.

If you spend a lot of time on the computer, doctors previously recommended that you stick to monofocals, as they provide good middle-distance vision. With the PanOptix trifocal lens now available, this is a good premium alternative for frequent electronics users as it allows for strong middle-distance vision.

The final decision is up to you, but don’t be afraid to consult with your doctor to figure out the best lens for you.

Still not sure what kind of IOL to choose? Schedule a cataract screening at Sierra Nevada Eye Center in Reno, NV to discuss your options with our expert ophthalmologists!

Woman gardening in yard

Cataracts are extremely common. Usually, they are something that’s associated with age.

They form in the eye’s natural lens when the cells that compose the lens become slightly opaque. This causes the lens to become cloudy.

Cataracts tend to develop slowly over a period of years, making it difficult to tell if you even have them. The only way to know you have them is to have an eye exam from a professional. But there are symptoms you can and should be aware of.

Risk Factors

Many people will get cataracts at some point in their life, some earlier than others. There’s no way to prevent cataracts. There are a variety of factors that put you at higher risk for developing them. These include:

  • Being over 40
  • Tobacco use
  • Obesity
  • UV damage from overexposure to sunlight
  • Excessive alcohol consumption
  • Diabetes
  • Hypertension
  • Traumatic eye injury
  • Extended use of corticosteroid medication

Some of these factors are avoidable to lower your risk, but some are not. If any of these factors apply to you, you should have regular eye exams so any cataracts you may develop can be spotted early.


Cataract symptoms include:

  • Blurry vision
  • Intense glare
  • Seeing halos around light sources
  • Trouble seeing in low light
  • Difficulty seeing contrast
  • Light sensitivity
  • Seeing double vision in one eye (monocular double vision)

These symptoms are usually subtle at first as cataracts develop slowly. Often, symptoms may be mistaken for presbyopia, which is age-related farsightedness.

Many people with cataracts also have presbyopia as they are both associated with age. When you have cataracts, you may have trouble reading or doing other fine motor tasks.

This is because it’s harder to see without direct light, but this may be mistaken as not being able to see as well up close. The distinction can be hard to make especially if you also have more trouble seeing up close due to presbyopia as well.

There are some more clear signs that you have cataracts as they develop. For instance, driving at night can be very hard for people with advanced cataracts.

Driving at night can become very dangerous. This is due to decreased ability to see in low light, glare from headlights, and sensitivity to lights from headlights and other road lights.

This is a clear sign of cataracts. You don’t want to wait until you find you’re putting yourself in danger driving at night to get a cataract diagnosis.


Ideally, you should have your cataracts diagnosed while they’re still in early development. That way, they can be monitored and you can tell when they start to cause visual problems. This is why it’s important to have regular eye exams once you turn 40.

After receiving a diagnosis of cataracts, your doctor may or may not recommend treatment right away. The only way to treat cataracts is with cataract surgery.

This involves removing the eye’s natural lens and replacing it with an artificial lens. Because cataracts develop slowly, it may take years before they present any real symptoms.

As a result of this, you don’t usually need cataract surgery if they’re diagnosed in the early stages. Doctors recommend you have cataract surgery when your cataracts begin to affect your quality of life. At that point, cataract surgery can do wonders for your eyesight by restoring any lost vision due to cataracts.

Concerned that you may have cataracts? Schedule a cataract screening at Sierra Nevada Eye Center in Carson City, NV to find out!

Family playing on beach

At the height of the summer, it’s more important than ever to be aware of the dangers of UV light. What are you doing to protect yourself?

UV light from the sun can be an issue all year long, but in the summer the days are longer and the sun is hotter! Keep in mind basic safety measures to take when you’re going to be outside.

Keep reading for a few important tips to follow this UV Safety Month to help protect your eyes!

Why UV Safety Matters

Ultraviolet, or UV light, is a form of radiation most commonly found in sunlight. But it can come from artificial sources, too, like tanning beds.

Even limited exposure to concentrated UV light can cause health issues. You’re probably aware UV light causes sunburns, wrinkles, and even skin cancer.

But it can affect your eyes, too. Too much UV damage can lead to cataracts and even a growth in your eyes called a pterygium.

It can also increase your risk of developing eye cancer. It’s as important to protect your eyes as it is to protect the rest of your body from UV light.

Keep You and Your Family Safe

The best thing you can do to protect your eyes is to wear sunglasses when you go outside. Even if it isn’t sunny, you should wear them when you’re outside for an extended period of time.

UV rays penetrate through clouds and are intensified by white surfaces like snow. Sunglasses are something you should have on hand at any time of year.

But not just any pair of sunglasses will do. Not all sunglasses will protect your eyes against UV light. For this reason, you need to be careful when you buy any sunglasses.

Be sure to buy a pair of sunglasses that have a sticker or tag that says they block out 99% of UV light. You may also want to wear a wide-brimmed hat.

This will protect your eyes even if you’re already wearing sunglasses. A wide-brimmed hat and sunglasses may be the best solution on days that you’ll be outside and it’s sunny.

Don’t forget to make sure your children have ample protection as well! Dress them appropriately with their own sunglasses and hats. Their eyes are especially prone to damage while they’re still growing!

Don’t feel like you have to avoid getting out when the weather is nice. As long as you’re smart, you can enjoy your time outside.

Be extra careful when you’re outside during the middle of the day. This is when the sun is at its highest and is strongest.

Stick to the shade when you can. If you have protective sunglasses and dress the right way, you can safely enjoy hot summer days.

Protect Your Skin, Too!

Don’t forget about sunscreen. Always make sure you apply it to any exposed areas of skin and reapply every few hours.

If you can, cover up with lightweight clothing that will keep you cool while also protecting your skin. Both your skin and eyes can be severely damaged by UV exposure.

It’s important to protect both. Make sure your kids know how important it is to protect themselves, too!

Concerned about your eyes this summer? Schedule an appointment at Sierra Nevada Eye Center in Carson City, NV today!

woman suffering from dry eye

Plenty of people suffer from dry eye syndrome. Dry eyes can be triggered by several different factors. Some people are more prone to developing it than others.

Compared to more serious eye-related conditions, it may not seem as severe or threatening to your vision. But even beyond easing the discomfort of having dry eyes, it’s important to treat them to preserve your long-term eye health. Keep reading to learn why dry eye treatment is important!

Your Eyes Need Tears

There’s a reason your eyes produce tears beyond the important function of washing away contaminants. Without tears, the surface of your eyes won’t receive the oxygen necessary.

By providing your cornea with key nutrients and keeping the surface clear and lubricated, tears ensure you’re able to see.

Dry eye is usually caused by not having enough tears or producing low-quality tears. Tears are made of oil, mucus, and water.

When your tears have too much mucus and oil and not enough water, your eyes can’t don’t stay moisturized and healthy. Having dry eyes isn’t only uncomfortable, either, because it can damage your vision.

Dry Eye Complications

Without tears to keep your eyes healthy, they’re more susceptible to infection. Left untreated, dry eyes can even cause corneal ulcers or corneal abrasions.

An ulcer, which is an open sore, can develop as a result of an infection caused by inadequate tear production. Ulcers, when left untreated, can cause permanent scarring and even lead to vision loss.

Abrasions can occur when your eyes are vulnerable due to dryness by rubbing them or having debris in them. Without tears to wash out the debris, it can damage the layer of protective tissue over your cornea called the epithelium.

This leaves parts of your cornea vulnerable to even more severe damage from more debris or even sunlight. Corneal abrasions and ulcers can often be treated.

They are also preventable by having healthy tear production. If you have dry eye syndrome, you can save yourself from discomfort by getting proper treatment before the issue becomes severe.

Eye Surgery

You should treat your dry eye as soon as you realize you might have it. Only an eye care professional can diagnose dry eye syndrome.

Be sure to see your eye doctor if you start to experience dry eye symptoms. Proper treatment can save you from infection but it can also make it safer to have eye surgery.

Whether you need cataract surgery or you want to get LASIK, having dry eye syndrome under control is a must. Surgery affects tear production.

If you already have poor tear production, it can leave your eyes drier and more prone to infection after surgery. Luckily, whether you have a history of dry eye, your surgeon will assess how well your eyes produce tears before any eye surgery.

If pre-surgical screening finds you have dry eyes or are at an increased risk for developing them after surgery, your doctor will recommend treatment before you can have the procedure. Treatment may be as simple as adding nutritional supplements to your diet and using artificial tears.

In extreme cases, you may have punctal plugs implanted in your tear ducts. Punctal plugs prevent drainage, forcing your tears to stay on the surface of your eye longer.

Most cases of dry eye can be treated with these minimally invasive measures, keeping your eyes healthier and safer. There’s no reason to continue suffering from the symptoms of dry eye syndrome.

Ready to consider treating your dry eyes? Schedule an appointment at Sierra Nevada Eye Center in Reno, NV today!

June is both Fireworks Eye Safety and Cataract Awareness Month. Both cataracts and fireworks can cause blindness, although one is far easier to avoid.

Practicing basic firework safety can prevent eye injury. Unfortunately, cataracts are common in individuals over the age of 40 and can’t be prevented.

The good news is that though they aren’t preventable, they are treatable. Being aware of cataract signs can help you know when treatment is necessary.

Cataract Symptoms

Cataract symptoms usually appear slowly over the course of months or even years. Cataracts themselves form on the eye’s natural lens causing it to become more cloudy.

The more cloudy your lens gets, the harder it is to see. Visual symptoms of cataracts include:

  • Blurry vision
  • Light sensitivity
  • Excessive glare
  • Seeing halos
  • Decreased color contrast
  • Difficulty seeing in low light

At first, some of these symptoms can be mistaken for normal signs of aging, or presbyopia. Presbyopia makes it difficult to see up close.

With cataracts, it’s harder to see in low light, which makes it difficult to read without a source of light. Reading glasses may also help if you have both presbyopia and cataracts, which isn’t uncommon.

If you find it’s hard to see in the dark and yet you’re more sensitive to light, that’s a good sign that you may have cataracts. If you think you may have cataracts, you should see an eye doctor.

Cataract Treatment

Once you’ve been diagnosed with cataracts, your doctor may not want to treat them right away. If you have regular eye exams, this increases your chances that your cataracts will be diagnosed before developing enough to impede your vision.

Once cataracts start making it hard to see and affect your quality of life, most eye doctors will recommend having cataract surgery. Cataract surgery is a very common and minimally invasive procedure.

It involves removing the eye’s natural lens through a very small incision. After removing the lens, it’s then replaced with an artificial lens, called an intraocular lens, or IOL. IOLs can even correct visual errors like presbyopia.

You should have cataract surgery before it completely impacts your vision. Vision loss because of cataracts can be restored with cataract surgery. The same is not true with traumatic eye injuries from fireworks.

Firework Safety

The summer is a popular time for fireworks, especially around July 4th. Though they look pretty, fireworks shouldn’t be something you handle yourself.

You should only let professionals handle fireworks. Consumer fireworks often cause horrible injuries, up to 9,000 a year.

Even if they’re legal where you live, consumer fireworks are extremely dangerous. If you want to keep you and your family safe, enjoy fireworks displays at fairs and the Fourth of July.

Skip the at-home fireworks, including sparklers! Sparklers may seem like harmless fun, but when handled by children, they can go off and cause unnecessary injuries.

Stick to glow sticks and other non-incendiary accessories to keep the kids entertained!

Have questions about how to keep your eyes healthy this summer? Schedule an appointment at Sierra Nevada Eye Center in Reno, NV today!