Glaucoma Treatment in Orange County: Diagnosis, Laser Therapy, and MIGS Surgery

Reviewed by Dr. Audrey Tai, board-certified, fellowship-trained ophthalmologist — Athena Eye Care, Mission Viejo, Orange County, CA

Quick answer: Glaucoma is a chronic, progressive eye disease that damages the optic nerve and causes gradual, permanent loss of peripheral (side) vision if left untreated. Many forms of glaucoma have no symptoms in early stages, which is why routine dilated eye exams are essential. Treatment ranges from prescription eye drops to Selective Laser Trabeculoplasty (SLT) and Minimally Invasive Glaucoma Surgery (MIGS) — including the iStent, OMNI surgical system, and Kahook Dual Blade — often performed at the time of cataract surgery.

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What Is Glaucoma?

Glaucoma is a chronic eye disease that causes damage to the optic nerve — the bundle of nerve fibers that carries visual information from your eye to your brain. Without treatment, glaucoma leads to gradual and permanent loss of peripheral vision, and ultimately, complete blindness.

Glaucoma is often called the "silent thief of sight" because:

• It can be completely painless
• Many types have no significant symptoms until the disease is advanced
• The vision loss it causes cannot be reversed once it has occurred

The pressure inside the eye — known as intraocular pressure (IOP) — is commonly elevated in people with glaucoma. However, IOP can also be normal in certain types of glaucoma (called normal-tension glaucoma), which is one of the reasons regular comprehensive eye exams are so important. Pressure measurements alone are not enough to detect every case.

Why Routine Dilated Eye Exams Are Critical

Because glaucoma typically causes no early symptoms, routine dilated eye exams are the only reliable way to detect it before significant vision loss occurs. During a glaucoma evaluation, Dr. Tai will:

• Measure intraocular pressure (IOP)
• Examine the optic nerve for signs of damage
• Test peripheral vision with a visual field test if indicated
• Image the optic nerve and retinal nerve fiber layer using OCT (optical coherence tomography) when warranted
• Measure corneal thickness (pachymetry), which influences IOP readings and treatment decisions

Adults with risk factors — family history of glaucoma, African or Hispanic heritage, age over 60, diabetes, high myopia, or prior eye injury — should have more frequent comprehensive exams.

Treatment Options for Glaucoma

There is no cure for glaucoma, but there are highly effective treatments that can slow or stop progression and protect the vision you still have. Dr. Tai will tailor your treatment plan based on the stage and type of your disease, your overall health, and your lifestyle.

1. Prescription Eye Drops For many patients, glaucoma is controlled with daily prescription eye drops that lower intraocular pressure. Several drug classes are available, and Dr. Tai will choose the medication best suited to your eye and your tolerance.

2. Selective Laser Trabeculoplasty (SLT) SLT is a quick, painless in-office laser procedure that improves the eye's natural drainage system, lowering intraocular pressure. It is often used as a first-line alternative or complement to eye drops. SLT can be repeated over time and has an excellent safety profile.

3. Microinvasive Glaucoma Surgery (MIGS) MIGS procedures are a category of minimally invasive surgical treatments that lower IOP with a much lower risk profile than traditional glaucoma surgery. They are most commonly performed at the time of cataract surgery, allowing patients to address both conditions in a single procedure with one recovery period.

Dr. Tai offers a comprehensive range of MIGS options, including:

• iStent Trabecular Micro-Bypass Device — A tiny stent (the smallest medical device ever approved by the FDA) that creates a permanent bypass through the eye's drainage system
• OMNI Surgical System — A precision device that performs both canaloplasty and trabeculotomy through a single small incision, addressing two outflow obstructions at once
• Kahook Dual Blade — A specialized blade designed to remove a strip of trabecular meshwork tissue, opening the drainage pathway

4. Other Surgical Options For more advanced glaucoma, traditional procedures such as trabeculectomy or glaucoma drainage devices (tube shunts) may be appropriate. Dr. Tai will discuss whether these or other options fit your specific case.

Frequently Asked Questions About Glaucoma

Can glaucoma be cured?

No, but it can be effectively controlled. With timely diagnosis and consistent treatment, most patients can preserve functional vision throughout their lives.

Will I lose my vision from glaucoma?

Not necessarily. The key is early detection and consistent treatment. Vision loss from glaucoma is most often the result of late diagnosis or untreated disease.

How is high eye pressure measured?

Several methods are used, including Goldmann applanation tonometry (the gold standard) and modern non-contact methods. Pressure alone doesn't diagnose glaucoma — it's one piece of a comprehensive evaluation.

Is glaucoma hereditary?

Family history is one of the strongest risk factors. If a parent or sibling has glaucoma, your risk is significantly higher and you should have regular dilated eye exams starting in your 40s, or earlier if recommended.

Are eye drops a lifelong commitment?

For many patients, yes — though SLT and MIGS procedures can sometimes reduce or eliminate the need for daily drops.

What is "normal-tension glaucoma"?

A form of glaucoma where the optic nerve is damaged despite intraocular pressure being in the normal range. It accounts for a significant minority of glaucoma cases and requires careful monitoring and individualized treatment.

Are MIGS procedures safe?

MIGS has a strong safety profile compared to traditional glaucoma surgery, which is why these procedures have become standard of care for mild-to-moderate glaucoma — especially when paired with cataract surgery.

Don't Wait — Get Screened for Glaucoma

Because glaucoma typically causes no symptoms in its early stages, a routine dilated eye exam is the only way to catch it in time. If you are concerned about glaucoma, have a family history of the disease, or have noticed any vision changes, schedule a comprehensive eye exam with Dr. Tai today.

📞 Call: (949) 889-2020
🌐 Visit: www.athenaeyecare.com

Your journey to your best vision starts here — with Dr. Audrey Tai at Athena Eye Care, serving Mission Viejo, San Juan Capistrano, Laguna Niguel, Dana Point, San Clemente, and the wider Orange County, California community.

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