At MarinEyes, our ophthalmologists have many years of experience diagnosing and treating glaucoma. We select from the most current proven equipment and methods. While the vast majority of our glaucoma patients do well with medical therapy alone, some patients will require surgery to preserve vision. We have performed hundreds of glaucoma laser surgeries and incisional glaucoma surgeries at our facilities. For those needing surgery, Marin Ophthalmic Surgery Center (across the hall from our medical suites) houses specialized lasers and a microsurgery suite where the doctors operate. The staff of the surgery center specializes in eye surgery.

What is Glaucoma?

Glaucoma is a progressive wasting away of the optic nerve, usually associated with higher than normal eye pressure but not always. Once diagnosed, the condition generally responds favorably to treatment. Treatment usually means daily use of eye drops, but may also sometimes involve laser or other surgery.

How we discover Glaucoma

Routine Eye Examinations! Most cases of glaucoma are unsuspected! They are usually detected in the course of an eye examination for done for some other reason, such as "routine" exams, cataract evaluations, or even follow-up of a patient with macular degeneration (an unrelated condition). It is a fortunate discovery, because the worst cases of glaucoma are those that go undetected and untreated. This is one of the reasons we recommend a schedule of periodic eye exams even for individuals with presumably "healthy eyes."

Individuals having or suspected of having glaucoma undergo more in-depth evaluation:

Glaucoma Consultation

In preparation for your doctor's evaluating your condition, you will have a number of pre-tests, the examination by your ophthalmologist, and some follow-up testing as well. Your complete glaucoma consultation will include a comprehensive eye examination and special testing to determine the best treatment plan for your particular needs. We sometimes have to spread the testing over 2 visits to get everything done and avoid excessive waiting times.

Special Testing for Glaucoma

There is no single test for glaucoma. Patients with or suspected of having glaucoma will find the following diagnostic and treatment tools in use at MarinEyes:

Tonometry  measures eye pressure. At Marin Eyes, we use applanation tonometry, because it is the most accurate method available. Applanation tonometry is quick and painless.

Pachymetry  measures the corneal thickness ultrasound (sonar).  Thin corneas may predispose a patient to glaucoma, whereas thick corneas may occasionally be considered somewhat protective.

Gonioscopy A special viewing lens (gonioprism) is used after numbing the eye with a drop of anesthetic. This test is to distinguish open angle from narrow angle glaucoma, the two main categories of glaucoma.

Visual field tests Early damage from glaucoma can often be detected by this test. At Marin Eyes, we uses the latest computerized technology to assess peripheral vision. Currently we are using the Humphrey SITA 24-2 test. The visual field examination is repeated annually to monitor for progression of glaucoma damage. The physician's assessment is enhanced by use of glaucoma progression analysis ("GPA") computer software.

Nerve fiber analysis A scanning low-energy laser measures the optic nerve and the thickness of the nerve fiber layer (the nerve that carries the vision message from the eye to the brain). This is the nerve that is damaged in glaucoma.  This testing is performed by our state of the art "OCT", a scanning instrument with computerized image processing and analysis. The test is usually repeated annually.

MarinEyes Glaucoma Specialty Equipment

Pressure measurement: Goldman applanation, MedTronic TonoPen

Pachymetry: DGH ultrasonic Pachymeter

Optic Nerve Analysis: Zeiss "OCT" scanner and analysis software

Visual Fields: Zeiss-Humphrey Perimeter with GPA progression analysis software

Lasers: Coherent Argon and YAG Lasers

Incisional Surgery: Marin Ophthalmic Surgery Center microsurgical suite is adjacent to our offices, eliminating the need to go to the hospital for glaucoma treatment. The staff specializes in eye surgery.

Marin Eyes Mission

Examinations    Optical    Cataract    Glaucoma    Surgery Center