Ophthalmology

You are here

Glaucoma Services

Weill Cornell Medicine Glaucoma Services

Glaucoma is a disease of the optic nerve which, if untreated, can result in permanent damage to the field of vision.

Weill Cornell Medicine ophthalmologists are trained in the most state-of-the-art evaluation and treatment methods for patients with glaucoma. Through advanced imaging technology, our experienced professionals diagnose glaucoma as early as possible and arrest the disease in its earliest stage. In most cases, glaucoma is treated by lowering intraocular pressure (pressure inside the eye). Although glaucoma surgery is avoided whenever possible, our ophthalmic physicians also practice the most sophisticated surgical techniques for the treatment of glaucoma.

Glaucoma Detection

As glaucoma may not affect vision until late in the disease process, it has been called the "sneak thief" of vision. Those at risk for glaucoma include anyone with a family history of glaucoma, patients with ocular hypertension, those with myopia (nearsightedness), the elderly and African-Americans. The only way to be sure that you are unaffected by glaucoma is to undergo a comprehensive eye examination. Weill Cornell Medicine ophthalmologists use standard photography, high-resolution optic nerve imaging technology and specialized visual field testing to monitor the optic nerve for changes and detect glaucoma.

Ocular Hypertension

Occasionally, elevated intraocular pressure can develop without any signs of damage to the optic nerve. This condition, ocular hypertension, may lead to glaucoma in some individuals. Weill Cornell Medicine patients with ocular hypertension undergo a comprehensive risk assessment based on demographic information and data from ophthalmic examination (including optic nerve appearance, intraocular pressure, central corneal thickness and visual field data). This risk assessment allows us to treat patients who are likely to develop glaucoma (damage to the optic nerve), and to avoid unnecessarily treating patients who are unlikely to develop glaucoma.

Types of Glaucoma

The myriad of glaucoma types are broadly grouped into two categories, based on whether or not the eye's natural fluid drainage system has been physically blocked by the iris. Open-angle glaucoma presents no physical blockage. Closed-angle glaucoma forces the iris in contact with the eye's natural drain, and prevents fluid from leaving the eye.

Open-Angle Glaucoma

Primary Open-Angle Glaucoma (POAG) is the most common form of glaucoma and is present in approximately 1 percent of all Americans. Unfortunately, up to one-half of all people with this disease do not yet know that they have it and are therefore untreated. Weill Cornell Medicine ophthalmologists diagnose open-angle glaucoma through advanced evaluation of the optic nerve and visual field, and provide treatment primarily by lowering intraocular pressure to slow or stop the progression of the disease. Intraocular pressure reduction is typically achieved through medication (usually eye drops), lasers (argon laser trabeculoplasty or selective laser trabeculoplasty) or surgery (trabeculectomy, tube placement or other methods).

Closed-Angle Glaucoma

Closed-angle glaucoma is often preventable. Chronic angle-closure glaucoma scars the iris to the eye's drain after a long period of contact, often years. Acute angle-closure glaucoma closes the eye's drain with the iris very suddenly, causing intraocular pressure to rise quickly, often resulting in an "attack" of pain, eye redness and blurry vision. Before the angle becomes closed, it is often very narrow. If diagnosed when the angle is narrow but not fully closed, laser iridotomy can prevent both acute angle-closure glaucoma attacks as well as the insidious chronic angle-closure glaucoma. Laser iridotomy is a procedure in which a small hole is created in the iris to allow fluid to escape from the eye without pushing the iris against the eye's drain. Not all patients with narrow angles require laser iridotomy; careful evaluation and monitoring are required before performing the procedure. Weill Cornell Medicine ophthalmologists expertly manage narrow angles and angle-closure glaucoma, and often employ highly specialized diagnostic imaging equipment including non-contact slit lamp Optical Coherence Tomography (OCT) units as well as the Artemis Very High Frequency (VHF) ultrasound eye scanner.

Treatment

Minimally Invasive Glaucoma Surgery (MIGS)

For patients with glaucoma, elevated intraocular pressure can, over time, result in vision loss. Fortunately, for many patients, the daily use of eyedrops will slow or stop the disease. Traditional glaucoma surgeries including trabeculectomy and tube shunt procedures are typically reserved for patients who are at risk of severe vision loss from glaucoma.

However, the daily administration of eye drops can lead to side effects in some patients, and many glaucoma patients would prefer to avoid this treatment method altogether.

Now, an advanced surgery technique known as Minimally Invasive Glaucoma Surgery (MIGS) is available for Weill Cornell Medicine patients. MIGS procedures, including cutting-edge iStent operations, are typically performed during cataract surgery, only slightly increasing the duration of the procedure. Importantly, MIGS procedures do not significantly change the overall (favorable) safety profile of cataract surgery, but often result in additional benefits for patients with glaucoma, including lower intraocular pressure and the need for fewer (or no) glaucoma medications.

Related Physicians

Anna Demetriades
Anna Demetriades, M.D., Ph.D.
  • Assistant Attending Ophthalmologist
  • Assistant Professor
Anna Demetriades's Clinical Profile Anna Demetriades's Research Profile
Leila Demetrious
Leila Rafla- Demetrious, M.D.
  • Assistant Clinical Ophthalmology Professor
  • Assistant Attending Ophthalmologist
Leila Demetrious's Clinical Profile Leila Demetrious's Research Profile
Stephanie Muylaert
Stephanie Muylaert, M.D.
  • Assistant Professor
  • Assistant Attending Ophthalmologist
Stephanie Muylaert's Clinical Profile Stephanie Muylaert's Research Profile
Paul Petrakos
Paul Petrakos, D.O., M.S.
  • Assistant Professor
  • Assistant Attending Ophthalmologist
Paul Petrakos's Clinical Profile Paul Petrakos's Research Profile
Sara Tassel
Sarah Van Tassel, M.D.
  • Assistant Professor
  • Assistant Attending Ophthalmologist
Sarah Tassel's Clinical Profile Sarah Tassel's Research Profile

Patient Care

Please refer to Glaucoma Patient Care for further clinical service information.

Glaucoma Patient Care

(646) 962-2020