Glaucoma Treatment in Omaha, Nebraska
Glaucoma diagnosis, monitoring, and surgical management by Dr. Ivey L. Thornton, MD — Board-Certified Ophthalmologist.
Caught early, glaucoma is a condition you live alongside — not one that defines what you see. Vigilance and patience matter more than any single intervention.
The silent thief of sight.
Glaucoma is a group of eye diseases that damage the optic nerve — typically because of elevated pressure inside the eye (intraocular pressure, or IOP). It is the second leading cause of blindness worldwide, and the most insidious because it develops silently. By the time most patients notice vision changes, significant damage has already occurred.
The good news: glaucoma caught early is almost always manageable. The entire framework of modern glaucoma care — drops, laser treatments, minimally invasive surgery — is designed to lower eye pressure and protect the optic nerve from further damage. When treatment begins early and continues consistently, most patients preserve the sight they have.
Dr. Thornton approaches glaucoma as a long-term partnership rather than a single event. The exam, the pressure check, the visual field, the optical coherence tomography (OCT) scan of the optic nerve — each piece builds a picture that informs treatment over years, not weeks.
Types of glaucoma.
Glaucoma is not one disease. The major types require different monitoring and different treatments:
Open-Angle Glaucoma
The drainage angle of the eye appears open but fluid drainage is inefficient. Gradual pressure rise, no pain, peripheral vision loss first.
Angle-Closure Glaucoma
The drainage angle is narrow or blocked. Can present as a sudden painful red eye with halos and nausea — a true ophthalmic emergency.
Normal-Tension Glaucoma
Optic nerve damage occurs despite pressures in the statistically normal range. Treatment still targets lower IOP plus vascular evaluation.
Pigmentary / Pseudoexfoliation
Material (pigment, protein flakes) clogs the drainage system. Common in Caucasian populations; strong genetic component.
Neovascular Glaucoma
New blood vessels grow on the iris and block drainage — often secondary to diabetic retinopathy or vein occlusion. Aggressive intervention required.
Glaucoma Suspect
Elevated eye pressure without nerve damage yet — not glaucoma, but warrants monitoring every 6-12 months.
Risk factors & who should be screened.
- Age 40+ (risk increases with each decade)
- Family history of glaucoma
- African American, Hispanic, or Asian heritage (certain types more common)
- Diabetes, high blood pressure, heart disease
- High myopia (nearsightedness) or high hyperopia (farsightedness)
- Thin corneas
- Long-term steroid use (oral, inhaled, eye drops)
- History of eye injury or eye surgery
Anyone over 40 should have a comprehensive eye exam including IOP measurement every 1-2 years. Anyone with risk factors above should be screened annually. If you’ve never had a dilated eye exam or had one in the past ten years, you may be overdue.
How glaucoma is diagnosed.
Glaucoma diagnosis uses several tests in combination — no single test is definitive:
- Tonometry — measures eye pressure. The traditional “puff” test, or more accurately with a Goldmann applanation tonometer.
- Optic nerve evaluation — examining the optic nerve directly through a dilated pupil for cupping and other changes.
- Visual field testing (perimetry) — maps blind spots in peripheral vision that patients themselves cannot feel.
- Optical Coherence Tomography (OCT) — high-resolution imaging of the optic nerve fiber layer, sensitive to loss before it shows up on visual field.
- Pachymetry — measures corneal thickness (affects pressure readings).
- Gonioscopy — examines the drainage angle to distinguish open-angle from angle-closure glaucoma.
Dr. Thornton uses all of these at Truhlsen Eye Institute. Follow-up visits typically repeat OCT and visual field testing every 6-12 months to detect change early.
Glaucoma treatment options.
Medical management — eye drops
First-line treatment for most open-angle glaucoma. Several drug classes exist (prostaglandins, beta-blockers, alpha agonists, carbonic anhydrase inhibitors, rho-kinase inhibitors). Drops are usually once- or twice-daily and can lower pressure by 20-35%. Adherence is critical — missed doses undo the benefit.
Laser treatment — SLT & ALT
Selective Laser Trabeculoplasty (SLT) is a painless in-office procedure that opens drainage channels to lower pressure — often an alternative or complement to drops. Effects last 3-5 years on average and the procedure can be repeated.
Minimally Invasive Glaucoma Surgery (MIGS)
A category of newer procedures (iStent, Hydrus, Xen, Kahook Dual Blade, PreserFlo) that can be combined with cataract surgery or done independently. Faster recovery than traditional trabeculectomy. Best fit for mild to moderate glaucoma.
Traditional surgery — trabeculectomy, tube shunts
Reserved for advanced glaucoma not controlled by other means. Creates a new drainage pathway. More recovery time but can dramatically lower pressure.
Frequently asked questions.
Is glaucoma curable?
Glaucoma cannot be cured, but it can almost always be managed. Treatment halts or slows further damage. Vision already lost to glaucoma cannot be restored, which is why early diagnosis matters so much.
Will I go blind from glaucoma?
With consistent treatment, most patients with glaucoma preserve useful vision for the rest of their lives. Blindness is rare when the disease is caught early and treated consistently. The patients who lose significant vision are typically those who went years without screening or without treatment.
What is the difference between glaucoma and cataract?
They are different conditions. Cataract is clouding of the lens inside the eye — affects clarity of vision and is treated with surgery replacing the lens. Glaucoma is damage to the optic nerve — affects peripheral vision first and is treated with drops, laser, or surgery to lower eye pressure. Many patients have both; MIGS can be performed alongside cataract surgery.
How often do I need to be seen?
For established glaucoma, follow-up every 3-6 months is typical. For glaucoma suspects or those with stable controlled glaucoma, every 6-12 months. Dr. Thornton will set a schedule appropriate to your specific situation.
Do glaucoma drops have side effects?
Yes, some patients experience redness, stinging, eyelash changes, or darkening of the iris (with prostaglandins). Most patients tolerate drops well; if side effects are significant, alternative drops or laser treatment can be considered.
Is glaucoma surgery covered by insurance?
Yes — glaucoma is a medical condition and treatment (drops, laser, surgery) is covered by Medicare and commercial insurance plans. Copays and specific coverage vary.
About Dr. Thornton & glaucoma care.
Dr. Ivey L. Thornton is Board-Certified by the American Board of Ophthalmology and has managed glaucoma patients in Nebraska and the surrounding states for since 2011. Her practice emphasizes long-term relationships — the nature of glaucoma care — and the clinical data to support that patients who stay consistent with treatment protect their sight.
She performs MIGS procedures at Truhlsen Eye Institute (often combined with cataract surgery when the timing is right) and collaborates with the glaucoma subspecialty team at UNMC for complex cases requiring traditional trabeculectomy or tube shunts.
Glaucoma Care Locations.
- Truhlsen Eye Institute — Omaha, Nebraska. Primary glaucoma evaluation, monitoring, and surgery site.
- Consultations also available at Harlan Ophthalmology (Harlan, IA) and Burgess (Onawa, IA).
See the Contact & Locations page for specifics.