Glaucoma Treatment & Technology.

Glaucoma Treatment

Unfortunately, glaucoma can’t be cured and damage caused by the disease can’t be reversed. Treatment can prevent vision loss in patients with early glaucoma. If vision loss has already occurred, treatment can slow or prevent further vision loss.

The primary goal of glaucoma treatment is to lower pressure in the eye (intraocular pressure). Each patient’s course of treatment is different, and one of our general ophthalmologists and/or glaucoma specialists will discuss your particular needs with you.

Eye Drops & Oral Medications

Glaucoma is similar to high blood pressure. The drops control the pressure. Stop the drops and the pressure reoccurs. It is important to continue the glaucoma eye drops exactly as prescribed or the optic nerve damage could get even worse. If eye drops alone don’t bring the eye pressure down to the desired level, your eye doctor and/or one of our glaucoma specialists may also prescribe an oral medication.


For the first time in decades, there is a new class of glaucoma medication available—Rhopressa™ (netarsudil ophthalmic solution), was approved in December 2017.

Here are the facts on Rhopressa:

  • Rhopressa is a rho-associated protein kinase inhibitor (ROCK inhibitor).
  • Rhopressa lowers IOP by improving outflow through the eye’s natural drainage system, the trabecular meshwork.
  • Rhopressa’s safety profile was established in clinical trials enrolling a total of 800 patients.
  • Rhopressa’s advantages include once daily administration, which simplifies use for patients.


Laser procedures are a common treatment for patients with glaucoma. Laser procedures are performed at all of our office locations, as well as at the Albany Regional Eye Surgery Center in Latham, New York. Laser treatment is usually quick and painless and is a very safe form of treatment for glaucoma.

  • The Selective Laser Trabeculoplasty (SLT) laser operates at very low power levels and can selectively treat cells in the eye’s drainage system to help increase the drainage of fluid from the eye in order to lower the eye pressure.
  • A Laser Peripheral Iridotomy (PI) is performed to keep the eye’s drainage system open and to allow fluid easy access to the drain. If fluid is not allowed to properly drain from the eye, the eye pressure could rise and lead to optic nerve damage.


Some patients with glaucoma require outpatient surgery. These procedures are performed at the Albany Regional Eye Surgery Center in Latham, New York.

MIGS (Minimally Invasive Glaucoma Surgery) Options

Dr. Allen Zieker and Dr. Shafiq Jivanjee perform MIGS procedures during cataract surgery. There are several MIGs options that have shown to successfully treat glaucoma. It’s important to discuss with your doctor if MIGS is right for you.

iStent® Trabecular Micro-Bypass


About the iStent

The iStent is the world’s smallest medical device implanted in the eye during cataract surgery to help reduce eye pressure caused by mild to moderate open-angle glaucoma.

How the iStent works

iStent works like the stents used to prevent heart attacks. When blood vessels get clogged, a stent creates access to the vessel flow. With glaucoma, over time the eye’s natural drainage system becomes blocked; iStent creates a permanent opening through the blockage to improve the eye’s natural outflow, lowering the pressure within the eye.

Who is the best candidate for an iStent?

If you suffer from mild to moderate open-angle glaucoma and need cataract surgery, the iStent may be a great way for you to control your glaucoma. iStent is the first medical device approved by the FDA for treating glaucoma and cataracts simultaneously.

Benefits of iStent 

Most patients with mild to moderate glaucoma take one, two, or even three types of medications daily to control intraocular pressure. Unfortunately, these drops can be inconvenient and expensive. The iStent helps many patients reduce or eliminate the need for glaucoma medications.

How do I know if the iStent is right for me?

The experienced eye surgeons at Ophthalmic Consultants of the Capital Region are here to help. We will give you a comprehensive eye exam and discuss treatment options with you.

XEN Gel Stent

Many people who have glaucoma can control the pressure by using special drops. However, if drops are no longer working, in my patients I’ve implanted the XEN® (pronounced Zen) Gel Stent. Manufactured by Allergan, Xen is designed to lower high eye pressure in patients with moderate and severe glaucoma.

The XEN Gel Stent insertion is an outpatient procedure. Unlike the older trabeculectomy procedure, there is no cutting or suturing of tissues. The recovery period is less intense and shorter. The complications occur less often and they are less severe when they occur.

During the procedure, one end of the stent is placed inside the eye and the other end of the stent is placed just under the conjunctiva, which is the clear membrane that covers the white of your eye. The XEN Gel Stent lowers the fluid pressure inside the eye helping to prevent vision loss from damage to the optic nerve.

It is important to note that glaucoma cannot be cured. With early detection, proper treatment, vision can be preserved. The Xen Gel Stent procedure is an important advancement in the surgical treatment of glaucoma.

If your glaucoma drops are no longer managing the pressure in your eyes, it’s important to act fast and discuss your options with a glaucoma specialist. Be sure to schedule an appointment immediately.

Hydrus Microstent

About the size of an eyelash, this new minimally invasive glaucoma surgery (MIGS) device is one of the most studied to date. With more than 6,000 patients treated, the Hydrus Microstent helps reduce eye pressure by restoring the patient’s natural outflow pathway (known as Schlemm’s canal) through which fluid (called aqueous humor) exits the eye. The FDA approved the Hydrus Microstent for use in combination with cataract surgery.


Other Glaucoma Procedures

Trabeculectomy is a more invasive procedure that increases fluid drainage from the eye. It is performed in patients with more advanced glaucoma who require an aggressive lowering of their eye pressure to stabilize glaucoma. During this procedure, a new drainage system is created for the eye.

Canaloplasty is a procedure in which a microcatheter is used to enlarge the eye’s natural drainage system (known as Schlemm’s Canal) to allow for better fluid drainage from the eye and thus reduce the pressure inside the eye. It is important to note that in 2009, our own Dr. Nalini A. Madiwale was one of the first doctors to perform a canaloplasty procedure in the Albany area. To read more about Dr. Madiwale’s achievement, click here.

Tube shunts are drainage devices implanted inside and around the eye. They are also implanted in patients with more advanced glaucoma who require a more aggressive lowering of their eye pressure. Tube shunts are often used when patients do not respond to or are not good candidates for other glaucoma surgeries. Our Glaucoma Specialist, Dr. Madiwale performs the tube shunt surgical procedures.

Important Information About Trabeculectomy and Tube Shunts for Glaucoma Treatment.

Why choose Ophthalmic Consultants of the Capital Region for your glaucoma treatment?

They’re specially trained and educated on the latest treatment options for glaucoma. Often, these treatments such as Trabectome and iStent are only offered by a select handful of eye surgeons across the country.

At Ophthalmic Consultants of the Capital Region, we focus on offering the latest technology and treatment options for our glaucoma patients and continue being involved in the research and development of cutting-edge eye care technology.


Ophthalmic Consultants of the Capital Region has five convenient locations to serve your glaucoma treatment needs. No need to travel to the big city. You can find advanced eye care right here in your hometown.

We have offices in:

Next Steps

If you have a family history of glaucoma, have risk factors for glaucoma (such as near-sightedness, diabetes, or of African American or Latino descent), or have been informed you may have glaucoma, it is important to schedule an appointment. The sooner we can diagnose and treat glaucoma, the better the outcome.

Get in touch with us today at our nearest location to you.


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