The first step in glaucoma care is not choosing a device. It is confirming whether the optic nerve is protected at the pressure the eye is living with now, then matching treatment to the disease stage and target pressure.
If another doctor has already recommended iStent, Hydrus, Durysta, iDose, goniotomy, or canaloplasty, the MIGS guide can help you understand that option. If the diagnosis, pressure goal, or need for treatment is still unclear, begin with a glaucoma evaluation rather than a device page.
Glaucoma can damage peripheral vision before you notice symptoms. That is why the exam has to connect pressure readings with optic nerve structure, visual field function, corneal thickness, drainage angle, cataract timing, medication tolerance, and your target pressure. If you need the condition-level explanation first, review the glaucoma overview before comparing a procedure with medication or laser options.
Ocular hypertension and elevated eye pressure should not be rushed into surgery. Ocular hypertension means eye pressure is elevated without confirmed optic nerve damage or visual-field loss. Some patients are monitored with repeat pressure checks, OCT, visual fields, corneal thickness, and drainage-angle exams; higher-risk patients may need drops or SLT. MIGS enters the conversation when open-angle glaucoma, cataract timing, drop burden, or a specific pressure goal makes a procedure medically appropriate.
Visionary Eye is based in Plano and sees local and traveling patients who need a documented pressure goal, a second opinion, or a clearer next step before adding more drops. The plan should separate monitoring, selective laser trabeculoplasty, sustained-release medication, MIGS, combined cataract and glaucoma surgery, and referral for traditional surgery when advanced disease needs a lower pressure target. Traveling patients can send prior records before deciding whether an in-person visit makes sense.
Glaucoma is often silent early, so an evaluation is especially important for patients with high eye pressure, suspicious optic nerves, family history, diabetes, prior eye injury, steroid use, severe nearsightedness, or changing side vision. Sudden eye pain, redness, halos, headache, nausea, or abrupt blurry vision can signal an urgent pressure problem and should not wait for a routine consultation.
These options separate diagnosis, pressure management, drops alternatives, and surgery decisions so the next step matches the actual pressure problem.
A glaucoma evaluation reviews pressure history, optic nerve imaging, visual fields, corneal thickness, and drainage-angle anatomy before treatment is chosen.
See the exam guideHigh eye pressureOcular hypertension may need monitoring, drops, SLT, sustained-release medication, or MIGS depending on optic nerve risk, pressure trend, corneal thickness, and the target pressure.
Review glaucoma careDrops alternativeCompare drop side effects, adherence, cost, Durysta, iDose, SLT, and drainage-based MIGS before choosing a device.
Compare optionsGlaucoma surgeryMIGS can fit many mild-to-moderate open-angle glaucoma patients, but the evaluation should also clarify when referral for traditional glaucoma surgery is safer.
Read surgery guideTraveling patientsFor patients traveling from elsewhere in Texas, prior pressure records, OCT, visual fields, medications, and cataract notes should be reviewed before deciding whether a Plano visit is the right next step.
Plan Texas visitSecond opinionA second opinion should review pressure trend, OCT, visual fields, drainage angle, cataract timing, drop side effects, and whether SLT, Durysta, iDose, MIGS, or referral makes sense before treatment changes.
Review records neededChoosing careWhen comparing glaucoma care, look at the quality of the evaluation: pressure trend, OCT, visual fields, angle anatomy, medication burden, cataract timing, and referral judgment.
Choose careA glaucoma plan is only as good as the measurements behind it. The visit should define the current pressure problem, show how the optic nerve is holding up, and identify the least burdensome step that can protect vision before adding drops or scheduling surgery.
For earlier disease or borderline ocular hypertension, the safest plan may be continued monitoring, pressure-lowering drops, or selective laser trabeculoplasty. SLT is a no-incision, repeatable laser option that belongs in the conversation before assuming another bottle or an implant is the next step.
Durysta and iDose TR place glaucoma medication inside the eye for selected open-angle glaucoma or ocular hypertension patients who fit the pressure, angle, and corneal safety criteria.
iStent, Hydrus, goniotomy, and canaloplasty may be considered when drainage anatomy fits and cataract surgery can safely share the same treatment window.
When pressure needs to be much lower, disease is advanced, or prior procedures have not protected the optic nerve, trabeculectomy, tube shunts, or fellowship-glaucoma care may be more appropriate.
Start here for diagnosis, pressure-goal evaluation, ocular hypertension, treatment planning, or a second opinion before choosing a device.
Review exam guideUse this if you are still learning what glaucoma is, why lower eye pressure matters, how ocular hypertension differs from glaucoma, and when drops, SLT, Durysta, iDose, or MIGS may enter the plan.
Review glaucomaUse the MIGS procedure page when you are ready to compare iStent, Hydrus, goniotomy, canaloplasty, Durysta, and iDose.
Compare MIGSReview the biodegradable bimatoprost implant for selected open-angle glaucoma or ocular hypertension patients.
View DurystaReview sustained-release travoprost medication delivery and the corneal safety testing used in candidacy decisions.
View iDoseUse this guide to send pressure records, OCT scans, visual fields, medications, and cataract notes before deciding whether a longer trip for glaucoma or MIGS care makes sense.
Plan travelGlaucoma estimates depend on medical necessity, insurance benefits, deductibles, copays, procedure type, and cataract timing.
Review costs
Dr. Shehz is a double board-certified vision correction surgeon who completed ophthalmology residency at Dean McGee Eye Institute and pursued advanced refractive training. He performs every surgery at Visionary Eye personally and leads the diagnostic plan used to decide whether a procedure is appropriate.
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Read articleGlasses on the nightstand. Contacts fighting you at the gym. The menu blurring at dinner. You don't have to live with it. Come find out what's possible for your eyes.