Protecting Sight
Before It’s Lost.

What Is Glaucoma?

Glaucoma is an eye disease that damages the optic nerve, the cable that carries visual information from the eye to the brain, often associated with elevated pressure inside the eye. Primary open-angle glaucoma (POAG) is the most common form. Its exact cause isn’t fully understood, and there is currently no cure, though progression can be slowed or stopped with treatment.

Because glaucoma damages peripheral vision first, most patients don’t notice a problem until an eye doctor detects it during an exam. A comprehensive glaucoma evaluation at Sierra Nevada Eye Center includes measurement of eye pressure, corneal thickness, gonioscopy to examine the eye’s drainage structures, and optical coherence tomography (OCT) to assess the optic nerve itself.

Treatment starts with the least invasive option that will control eye pressure. For many patients, that’s a daily eye drop or a quick in-office laser procedure such as selective laser trabeculoplasty (SLT) or direct selective laser trabeculoplasty (DSLT). When these aren’t enough, minimally invasive glaucoma surgery (MIGS) offers a lower-risk alternative to traditional glaucoma surgery. Dr. Wolff was the first surgeon in Northern Nevada to implant the iStent, and our surgeons have some of the most extensive MIGS experience in the state, including iStent Inject, Hydrus microstent, OMNI, GATT, and Kahook Dual-Blade. Many of these devices can be placed at the same time as cataract surgery.

Other laser procedures treat specific types of glaucoma. Laser iridotomy creates a small opening in the iris to give fluid an alternate pathway, and is used for narrow-angle and angle-closure glaucoma. It is a quick procedure performed in the office or an outpatient surgery center. Endocyclophotocoagulation (ECP) treats the ciliary body, the tissue that produces fluid in the eye, to lower fluid production, and is often combined with cataract surgery. Transscleral cyclophotocoagulation (CPC) applies laser energy through the white wall of the eye to reduce fluid production and lower eye pressure. ECP and CPC are performed in an outpatient surgery center.

For glaucoma that doesn’t respond to drops, laser, or MIGS, our surgeons also have experience with traditional glaucoma surgeries, performed when a more significant reduction in eye pressure is needed. These include trabeculectomy, which creates an opening that lets fluid drain out of the eye, and tube shunts, including the ExPress mini-shunt and the Ahmed and Baerveldt shunts. Canaloplasty, an FDA-approved procedure, widens the eye’s natural drainage canal to improve outflow while avoiding some of the risks of other glaucoma surgeries.