Your vision is one of your most valuable assets, and at Focus Eye Care & Surgery, we’re here to help you protect it. Dr. Neelofar Ghaznawi and Dr. Daniel Barmas-Alamdari, both board-certified ophthalmologists and glaucoma specialists, provide advanced glaucoma care to patients in Queens, Brooklyn and Long Island. With personalized treatment options and a compassionate approach, our team is dedicated to preserving your vision and supporting your eye health.

Glaucoma Treatment

The primary goal of glaucoma treatment is to lower intraocular pressure (IOP) to minimize damage to the optic nerve and slow the progression of vision loss. Although glaucoma cannot be cured, there are several effective options available to help manage the condition and protect your eyesight.

Glaucoma Medications

Prescription eye drops are often the first approach for managing glaucoma. These medications work by either decreasing the amount of fluid the eye produces or improving the outflow of fluid, helping to lower IOP. In some situations, oral medications may be recommended to complement or replace eye drops. Regular and consistent use of these treatments is vital to effectively manage the condition and preserve vision.

Laser Glaucoma Surgery

• Selective Laser Trabeculoplasty (SLT): This minimally invasive procedure is commonly recommended for open-angle glaucoma. Using laser energy, SLT targets the trabecular meshwork, enhancing fluid drainage and reducing eye pressure. The treatment is quick, virtually painless, and can often reduce or eliminate the need for long-term medications.
• Laser Peripheral Iridotomy (LPI): For patients with narrow-angle or closed-angle glaucoma, LPI creates a tiny opening in the outer edge of the iris. This allows fluid to flow freely, reducing pressure and preventing acute glaucoma attacks. LPI is a highly effective preventative and therapeutic option for angle-closure glaucoma.

Each treatment plan is tailored to the patient’s unique needs, with the goal of preserving vision and maintaining quality of life. Regular follow-up care is essential to monitor disease progression and adjust treatments as necessary.

Drug-Eluting Implants

For certain individuals, topical drops and oral medications may not be well tolerated, but surgery may not be desired. In some cases, these drug-eluting implants, which slowly release eye pressure lowering medications into the eye, may be an option to discuss with your glaucoma specialist.

• Durysta: This device is a small implant that is inserted into the front portion of the eye and slowly secretes eye pressure medication directly into the eye. It can last for a few years, though it cannot be repeated more than once in its present form. It can be inserted in the clinic setting, not requiring an operating room or full surgical evaluation.
• iDose: This device is inserted into the angle of the eye in the operating room. It has a drug lower medication that slowly seeps out of the canister that has been shown in some studies to have effectiveness for several years! Smaller than a grain of rice, it goes directly into the drain of the eye and is able to save certain patients the hassle of a daily eyedrop.

Minimally Invasive Glaucoma/Bleb Surgery

Minimally invasive glaucoma surgeries (otherwise known as MIGS/MIBS) are a series of different procedures that are the new frontier in the treatment of glaucoma. By utilizing smaller incisions with less invasive methods, these surgeries help to lower eye pressure by directly targeting the trabecular meshwork (the drain) of the eye. More and more devices are being researched and developed, but here are a few options that our glaucoma surgeons can utilize, whether on their own, or paired with a standard cataract surgery.

• Goniotomy: Using a small device, the trabecular meshwork drain of the eye is “cleaned” of debris. Imagine a drain gutter that is full of leaves. By performing a goniotomy, the glaucoma surgeon is able to remove the leaves blocking the drain, allowing your natural filter to function more effectively.
• Canaloplasty: By inserting a small catheter directly into the drain of the eye, canaloplasty devices help to dilate the natural filter, getting rid of any strictures or blockages that are preventing the fluid from exiting the eye properly.
• iStent: These small stents that are microscopic in size are inserted directly into the drain of the eye to function as a bypass to your natural filter. They help direct fluid through small tunnels in the stent to avoid any areas of your eye that are not functioning to their highest capacity.
• Xen Gel Stent: This small tube is implanted into the trabecular meshwork of the eye and creates a small “bleb” or balloon reservoir where fluid can escape from the eye.

Traditional Glaucoma Surgery

Glaucoma, as mentioned above, is unfortunately without a cure. Though eyedrops, lasers, and some minor surgeries are sometimes sufficient to delay vision loss, many individuals may lose responsiveness to their treatment and require more substantial surgery. This is where the traditional glaucoma surgeries come into play. These surgeries serve to bypass your eye’s natural drainage system and create a new filter for your eye.

• Trabeculectomy: this surgery uses your eye’s natural tissue to create a new opening and reservoir for fluid to drain out of your eye. Just as the Xen Gel Stent, it creates a “bleb” and this serves to give the fluid of your eye an extra space to reduce eye pressure.
• Glaucoma drainage implants: similar to trabeculectomy, glaucoma drainage implants, such as the Baerveldt or Ahmed implants, function to bypass your natural drain. However, they involve placing a tube in the eye, with a plate serving as the reservoir for fluid to drain over.