A glaucoma diagnosis usually arrives with a list of questions. Will I lose my sight? Do I have to use drops forever? Is surgery the next step? At Eye Consultants in Wilmington, glaucoma care is led by Dr. Heather Dealy, a board-certified ophthalmologist and fellowship-trained glaucoma specialist, and the same questions come up in the exam room every week. This page collects the ones patients ask most, grouped by where they tend to arise: at the start of treatment, when laser or surgery is discussed, and over the years of follow-up that glaucoma care involves.
When You Are First Diagnosed
What is glaucoma treatment actually trying to do?
Every form of treatment aims to lower the pressure inside the eye, because that pressure can damage the optic nerve over time. Treatment protects the sight you still have. It does not restore vision that has already been lost, which is why early diagnosis and steady follow-up matter so much.
How is glaucoma confirmed?
Your doctor will measure your eye pressure, examine your optic nerve and check your vision. Depending on what they find, you may have additional testing. The practice’s glaucoma diagnosis page explains the evaluation in more detail.
Why didn’t I notice any symptoms?
Many people with glaucoma notice nothing in the early stages. Vision loss often begins at the edges of your field of view and progresses slowly, so it can go unnoticed until it is advanced. That is why routine exams that check eye pressure and the optic nerve are so important.
Am I at higher risk?
A family history of glaucoma, diabetes and high blood pressure all raise the risk. If any of these apply to you, regular glaucoma evaluations are worth keeping on the calendar even before any diagnosis.
Starting With Drops or Pills
Why are eye drops usually the first treatment?
Eye drops are the most common medical treatment for glaucoma and are usually the first approach tried. They lower eye pressure either by reducing the fluid the eye produces or by helping it drain. Some glaucoma medications are taken as pills instead. Your doctor will choose based on your symptoms and the type of glaucoma you have.
Will I need drops for the rest of my life?
Many patients do use drops long term. For some, a laser procedure or surgery later reduces or removes the need for them. Your doctor will review this as your treatment progresses.
What happens if I skip doses?
Drops only work while you use them, so missed doses can let pressure rise again. If a schedule is hard to keep, mention it at your next visit; a different medication, a laser procedure or surgery may suit you better.
What if the drops irritate my eyes or I keep forgetting them?
Tell your doctor. Allergy or intolerance to drops, and wanting less reliance on them, are both reasons to look at other options. There is often more than one way to reach the pressure your eyes need.
When Laser Becomes an Option
What is selective laser trabeculoplasty (SLT)?
SLT is an in-office procedure in which a small laser stimulates the eye’s natural drainage tissue, the trabecular meshwork. Drainage improves over the following months. It is mainly used for open-angle glaucoma, including for patients whose pressure is not responding well enough to medication.
What is a laser iridotomy?
A laser iridotomy uses a beam of light to make a very small opening in the iris. It is used to treat or prevent acute angle-closure glaucoma. Patients can resume normal activities afterwards but need someone to drive them home.
Questions About Surgery and MIGS
When is glaucoma surgery recommended?
Surgery is generally considered when vision loss continues despite treatment, when drops cause allergy or intolerance, or when a patient wants to depend less on drops. The goal is to lower eye pressure and protect remaining sight; surgery may not improve vision itself.
What does MIGS involve?
Minimally invasive glaucoma surgery covers a group of small-incision procedures. At Eye Consultants these include iDose TR, Hydrus, iStent, Streamline, Xen, goniotomy with the Kahook Blade and Durysta, which can be placed in the office. Several, including iStent and Hydrus, are often performed during cataract surgery. The MIGS overview and the traditional glaucoma surgery page describe each option.
I have glaucoma and cataracts. Can both be treated together?
Often, yes. Several MIGS procedures can be performed during cataract surgery, so one trip to the operating room addresses both. Glaucoma can also affect which replacement lens is the best choice, so your surgeon will factor it into your cataract plan.
What is recovery like after MIGS?
Expect blurry vision for a while after the procedure, and arrange for someone to drive you home. Driving is not recommended right afterwards. Your first follow-up visit is usually about a week after surgery.
Living With Long-Term Glaucoma Care
How often will I need to come in?
Pressure checks are typically recommended every three to six months, depending on how advanced your glaucoma is. Visits include checking eye pressure, the optic nerve and your vision so changes are caught early. The practice’s glaucoma management page covers ongoing care.
Do I still need check-ups after surgery?
Yes. Glaucoma is a long-term condition, and follow-up visits continue after any procedure, typically every three to six months, so your doctor can confirm the pressure is staying where it should.
Is there anything I can do at home?
Regular exercise, a healthy diet and not smoking may help, and smoking is linked to poorer surgical results. Alcohol can raise eye pressure. Keeping diabetes and blood pressure under control also matters. None of these replace treatment, but they support it.
Will insurance cover my treatment?
Coverage depends on your plan and the treatment involved. Review the practice’s insurance information and ask the team to help confirm your benefits before a procedure.
Who Leads Glaucoma Care at the Practice
Dr. Dealy founded Eye Consultants in Wilmington in 2009 after completing a glaucoma fellowship at the Scheie Eye Institute at the University of Pennsylvania, with particular attention to the surgical management of advanced disease. She determines the right treatment for each patient and walks them through procedures and recovery. You can read her background on her profile page, or see the full glaucoma care overview.
Bring Your Questions to Limestone Road
If you have been told you have glaucoma, or your pressure readings are creeping up, the next step is a visit where your questions get answered with your own test results in front of you. Request an exam online, or phone the office to schedule with the glaucoma team.