Fichte, Endl & Elmer Eyecare evaluates and manages glaucoma for patients in Buffalo and Western New York through its Amherst and Niagara Falls offices. Glaucoma can damage the optic nerve gradually and may cause no noticeable early symptoms. Treatment is intended to lower eye pressure or otherwise reduce the risk of additional damage. It cannot restore vision already lost to glaucoma. The plan may include observation, prescription eye drops, laser treatment, minimally invasive glaucoma surgery, or traditional glaucoma surgery, depending on glaucoma type, severity, anatomy, rate of change, medication tolerance, other eye disease, and the pressure goal established for the individual patient.
Michael J. Endl, M.D., describes micro-invasive glaucoma procedure experience in his physician biography. Patients may also receive coordinated testing and follow-up through the practice’s ophthalmologists and optometrists.
How Glaucoma Is Evaluated
A glaucoma evaluation may include eye-pressure measurement, examination of the optic nerve and drainage angle, corneal thickness measurement, optic-nerve imaging, visual-field testing, and review of family history, medications, prior surgery, and other risk factors. A single pressure reading does not determine whether glaucoma is stable. The doctor compares findings over time and sets an individualized monitoring interval and target pressure.
Open-Angle and Angle-Closure Glaucoma
Open-angle glaucoma is commonly gradual and may be unnoticed until damage is advanced. Angle-closure disease involves the eye’s drainage angle and can sometimes produce sudden severe symptoms. Glaucoma also includes secondary, normal-tension, congenital, and other forms. Identifying the type matters because the recommended treatment and urgency can differ.
Treatment Categories
- Prescription eye drops: may reduce fluid production, improve drainage, or both. Consistent use, correct technique, cost, side effects, and interactions are important.
- Laser treatment: may improve drainage in selected open-angle glaucoma or create an opening in the iris for certain narrow-angle conditions. Results vary, and medication or additional treatment may still be needed.
- Minimally invasive glaucoma surgery: includes several procedures intended to improve outflow with smaller incisions or less tissue disruption than traditional surgery. Some may be performed with cataract surgery.
- Traditional glaucoma surgery: trabeculectomy or a drainage implant may be considered when a lower pressure is needed or other treatment has not controlled the disease.
Compare glaucoma drops, laser, MIGS, and surgery in the patient treatment guide.
Glaucoma and Cataract Surgery
When glaucoma and cataracts occur together, the surgeon may discuss cataract surgery alone or cataract surgery combined with a glaucoma procedure. The decision depends on angle anatomy, disease severity, target pressure, current medications, prior procedures, and the expected benefit of each approach. A specific device or procedure is not appropriate for every patient.
Monitoring After Treatment
Glaucoma requires ongoing care even when pressure improves. Follow-up may include pressure checks, visual-field testing, optic-nerve imaging, and medication review. Treatment may be adjusted when damage progresses, pressure exceeds the individualized target, side effects are unacceptable, or the treatment plan is difficult to follow.
Symptoms That Need Immediate Evaluation
Sudden severe eye pain, a red eye, blurred vision, halos, headache, nausea, or vomiting can be signs of acute angle closure or another emergency. Seek immediate medical care rather than waiting for a routine appointment.
Schedule a Glaucoma Evaluation
Patients with a glaucoma diagnosis, elevated pressure, suspicious optic-nerve findings, a family history, or unexplained vision changes can request an evaluation at the Amherst or Niagara Falls office. Call 1-800-309-2020 or request an appointment.
