Glaucoma Treatment in San Antonio

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What is Glaucoma?

Glaucoma is a complex disease that causes gradual diminution of the peripheral vision over the course of many years. Glaucoma occurs when excess fluid builds up in the front part of the eye, which can damage the optic nerve. Left untreated, glaucoma can cause blindness. According to the American Academy of Ophthalmology, glaucoma is the leading cause of blindness for people over the age of 60. The key to managing glaucoma is early diagnosis and treatment. The eye pressure, optic nerve appearance, and thickness of the optic nerve fiber play an important role in the progression of glaucoma.

Types of Glaucoma

Primary Open Angle Glaucoma

The most common type of glaucoma in the U.S., its cause is presumed to be a microscopic obstruction of the drainage system of the fluids circulating in the anterior compartment of the eye. The intraocular pressure (IOP) is usually high, with abnormal optic nerve appearance and peripheral visual field defects consistent with glaucoma.

Narrow Angle Glaucoma

This type of glaucoma is more common in patients of Asian origin or with high degrees of hyperopia, or farsightedness, where the anterior compartment of the eye is crowded with structures that cause mechanical obstruction of the drainage site.

Glaucoma Suspects

This is a term given to patients who have a suspicious optic nerve appearance but have normal tests and parameters. Glaucoma Suspects are statistically at a higher risk for developing Primary Open Angle Glaucoma. Cirrus OCT testing can help determine high-risk Glaucoma Suspects. Prophylactic treatment may be instituted in these cases.

Ocular Hypertension

This term is given to patients with elevated eye pressure who have normal tests and parameters. Corneal pachymetry and Cirrus OCT testing can help determine high-risk Ocular Hypertension patients. Prophylactic treatment may also be instituted in these cases.

Glaucoma Treatments in San Antonio

While there is no cure for glaucoma, treatment options vary from eye drops, laser treatment, or surgery. With most of these glaucoma treatment plans, the goal is to help drain fluid from the eye to decrease the internal eye pressure, or intraocular pressure (IOP). Read more about our treatment options below:

Selective Laser Trabeculoplasty (SLT)

SLT is an innovative 5-minute, relatively painless in-office procedure that utilizes state-of-the-art laser beam technology to improve drainage outflow, which can help control glaucoma. SLT is safely repeatable and effective in 60–95% of patients. Effectiveness will vary depending on the type and severity of the patient’s glaucoma.

Medicated Eye Drops

Many patients are able to manage their glaucoma with medical therapy and topical eye drops. There are many types of medicated drops available in the market. Some reduce the production of aqueous/fluid in the eye, while others try to improve the drainage. Some glaucoma drop regimens can control glaucoma with daily doses, while others may require 2–3 doses a day.

Glaucoma Filtration or Shunt Surgery

If glaucoma cannot be controlled by medications or lasers, surgery is the last resort. Glaucoma surgery can take the form of shunts, trabeculectomy, or MIGS (Minimally Invasive Glaucoma Surgery). While there are different types of surgical procedures to treat glaucoma, the most commonly performed, trabeculectomy, creates a channel that drains the fluid from inside the eye to the outside under the conjunctiva (the skin of the eye). During this procedure, Mitomycin-C is used to prevent postoperative scarring and the closing of this channel. For more advanced cases of glaucoma, procedures use “Seton devices”, or synthetic tubes to drain the fluid from the inside the eye to the outside.

iStent Implant

The iStent Implant is one of the MIGS implemented by Dr. Iskander. MIGS can reduce internal eye pressure, or intraocular pressure (IOP), while also reducing the risks involved with more invasive glaucoma surgeries. The iStent inject can help patients with mild to moderate glaucoma. During an iStent procedure, Dr. Iskander will insert two small stents into the trabecular meshwork of the eye, which is responsible for fluid drainage. This creates permanent channels for improved flow of aqueous humor, which is clinically proven to lower the IOP and reduce a patient’s dependence on IOP-lowering eye drops and medication.

Smiling Dr. Iskander

Why Choose San Antonio Eye Specialists?

Dr. Nader Iskander is a board-certified ophthalmologist with over 20 years of experience helping patients diagnose and treat their glaucoma. Here at San Antonio Eye Specialists, Dr. Iskander and his esteemed staff stay up to date with the latest diagnostic technology and treatment options to provide our patients with the highest quality of care possible. That’s why we’re proud to offer a wide selection of glaucoma treatment options, such as the iStent inject that can help patients manage their glaucoma and reduce their need for medication.

Learn More About Us

How We Diagnose Glaucoma

At San Antonio Eye Specialists, we use state-of-the-art technology to ensure we are able to diagnose glaucoma as early as possible for our patients. Here are some of the technologies we use:

Visual Field Testing for Glaucoma

The Humphrey Zeiss 700 Series visual field testing is one of the fastest and most accurate methods for mapping the peripheral and central visual fields to detect early changes that are consistent with glaucoma.

iCare Measurements

At San Antonio Eye Specialists, we don’t use inaccurate or uncomfortable “air puff” methods to measure your eye pressure. Instead, intraocular pressure measurements are performed by experienced personnel.

Measure Corneal Thickness

Ultrasound pachymetry is a painless and accurate method of determining the corneal thickness. This helps determine the accuracy of IOP measurements in correlation to each individual cornea. With our advanced diagnostic equipment, pachymetry is performed in a no-touch optical method.

Optic Nerve Fiber Analysis

Optic nerve fiber analysis by Cirrus OCT (Optic Coherence Tomography) provides a higher level of diagnostic insight. Using near-infrared frequency light, it reveals cross-sectional views of the optic nerves and its fibers with high resolution. Computerized comparisons are graphed and compared to age-matched normative data.

See What Our Patients Are Saying

"I have glaucoma so I see an opthamologist every 6 months. I decided to see Dr. Iskander after my daughter had a wonderful experience there. I have to say it was the best visit I’ve had in years. The staff is wonderful and Dr. Iskander listened to me and gave me solutions to issues I’ve been having. I have moved my records to him. They are on top of technology and Dr Iskander knows what he’s talking about. I would give them a 10 if I could."

- Mary K.

"The best doctors in San Antonio.
My glaucoma is great!"

- Jacquelin Q.

Paying for Glaucoma Treatment

Because glaucoma is an eye disease that can ultimately lead to blindness, glaucoma treatment is covered by most insurance providers. At San Antonio Eye Specialists, we accept all major insurance carriers, with a few exceptions. To verify if we accept your specific insurance plan, contact our office.

Frequently Asked Questions About Glaucoma

How is glaucoma diagnosed?

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Our state-of-the-art diagnostic technology allows us to diagnose and treat glaucoma as early as possible. As part of our diagnosis, we use visual field testing, intraocular pressure measurements, corneal thickness measurements, and optic nerve fiber analysis to monitor any changes in our patient's vision.

Is there a cure for glaucoma?

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While there is no cure for glaucoma and damage can’t be reversed, early diagnosis and treatment can help slow or prevent blindness.

How much does glaucoma treatment cost?

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If left untreated, glaucoma can lead to blindness. As such, glaucoma treatment is generally covered by most insurance providers. To verify insurance coverage for your glaucoma treatment, contact our office.

Can I get LASIK eye surgery if I have glaucoma?

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It is possible for those experiencing glaucoma to receive LASIK eye surgery, especially if the glaucoma is considered under control, without significant vision loss. How glaucoma affects your eye may change the exact type of corrective vision surgery you receive, whether it’s LASIK or PRK surgery. For PRK surgery or LASIK eye surgery in San Antonio, as well as glaucoma treatment, San Antonio Eye Specialists is here for you.

What are the symptoms of glaucoma?

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There are several symptoms of glaucoma, including no symptoms at all. But, if you’re feeling some of the following symptoms, you may be suffering from glaucoma:

• Vision loss
• Blurry vision
• Distorted vision
• Severe headache
• Severe pain in the eyes
• Unexplainable nausea or vomiting
• Colored rings, known as "halos" around light sources
• Eye redness

There are different types of glaucoma that result in different symptoms. If you’re experiencing one or more of the following symptoms, consider visiting your general practitioner or optometrist to get a referral for an ophthalmologist in San Antonio like San Antonio Eye Specialists.

How common is glaucoma?

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About 3 million people in the United States are currently living with glaucoma. Each year in the United States, there are approximately 200,000 new glaucoma cases, making it a common condition. Some types of glaucoma are more common than others, but the most common type of glaucoma is known as open-angle glaucoma. 9 out of 10 people in the United States living with glaucoma have open-angle glaucoma.

Who is at the most risk for glaucoma?

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Some groups of individuals have a higher-than-normal risk of experiencing glaucoma. People who fit the following criteria are more at risk for glaucoma: 

• Over the age of 40 
• Family history of glaucoma
• Hispanic, Asian, or African heritage
• Generally high eye pressure
• Nearsightedness or farsightedness 
• History of eye injury 
• Long-term use of steroid-like medications
• Thinner than normal cornea 
• Thinning of the optic nerve 
• Experiencing migraines, high blood pressure, poor circulation, or diabetes

If some or all of the above criteria describe you, then you are at a higher risk of developing glaucoma than others.

Have more questions about? Visit our FAQs page, or contact our office.

Manage Your Glaucoma With Innovative Treatments

Glaucoma is best managed with early diagnosis and treatment. If you think you may have glaucoma or are seeking a treatment plan, contact San Antonio Eye Specialists to schedule consultation.