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The Latest Advances in Glaucoma that May Help Save your Sight

Q+A session with Dr. Grace Richter


Richter Clinic


  1. What is Glaucoma and can it make me blind?

Glaucoma affects millions of people worldwide and is the leading cause of irreversible blindness. Approximately 3 million Americans have glaucoma with over half that go undiagnosed.1 Glaucoma is a complex eye condition that damages the optic nerve, which is the nerve that connects the eye to the brain and is responsible for transmitting images to the brain.   It is often accompanied with elevated eye pressure. We treat glaucoma by reducing eye pressure to prevent additional nerve damage. There are two main types of glaucoma: primary open-angle glaucoma (POAG) and angle-closure glaucoma, both of which can lead to permanent vision loss if left untreated.


  1. Are you at risk of getting Glaucoma?

Knowing the risk factors of glaucoma is essential as early diagnosis is key to saving your sight.

General Risk factors include:

  • Family history of glaucoma
  • Ocular trauma, inflammation of the eye or previous eye surgeries
  • Over the age of 40
  • Suspicious findings on the eye exam


Risk factors for open-angle glaucoma include:

  • Family history of glaucoma
  • Increasing age
  • Nearsightedness
  • African American or Latino ancestry


Risk factors for angle-closure glaucoma:

  • Chinese ancestry
  • Farsightedness


  1. What are the treatment options?

The only proven way to prevent additional damage to the optic nerve is to lower the eye pressure.  While pressure can be managed by eye drops, patients may also benefit from laser treatments and even surgery. Depending on the type and severity of glaucoma, some patients benefit most from minimally invasive glaucoma surgery (MIGS), which has a quicker recovery than traditional glaucoma surgery and can be combined with cataract surgery. Some examples of MIGS procedures2 currently performed at USC include:


  • XEN gel stent. A unique device that conforms to the ocular tissue and is successful at fluid drainage and reducing eye pressure while also being extremely comfortable for the patient.
  • iStent. A 1mm trabecular bypass microstent is inserted into the trabecular meshwork, the natural drainage system of the eye. This improves outflow of fluid from the eye using the natural drainage pathway. This is the smallest implantable device in the human body!
  • Trabectome. A portion of the trabecular meshwork is ablated (removed) to increase outflow of fluid from the eye.
  • Endoscopic cyclophotocoagulation. An endoscopic laser probe is inserted into the eye and used to apply laser to the ciliary body, the part of the eye that produces fluid. The effect is reduced production of fluid in the eye, which lowers eye pressure.
  • Micropulse transcleral cyclophotocoagulation. A micropulse laser probe is applied to the outside of the eye near the ciliary body. The effect is also reduced fluid in the eye.


The USC Roski Eye Institute clinical researchers are actively involved in improving glaucoma diagnosis and treatment. Our researchers are also developing novel glaucoma drainage devices, intraocular pressure sensors, as well as drug delivery systems that will improve glaucoma control and quality of life for our glaucoma patients.


  1. Which treatment is right for you?

Each glaucoma patient is treated individually with a unique treatment plan considering all clinical factors. After your glaucoma consultation at USC, we will discuss the best treatment options specific to you and your eyes.


  1. What lies ahead: new glaucoma treatments on the horizon?

One exciting new device which was recently FDA-approved is the XEN gel stent, which was developed in part by USC researchers. This is a promising MIGS device that provides greater pressure reduction than other minimally invasive treatment options, and we are proud to offer it to our patients at USC.


  1. Is there anything you can do to prevent getting Glaucoma?

In general, blindness from glaucoma is preventable through early detection.  If you believe you may be at risk, are over 50 years of age, or have family members with glaucoma, please get your eyes examined with an emphasis on assessing the optic nerve and peripheral vision. In general it is good practice to get regular eye exams.  To make an appointment, please call (323)442-6335.



Dr. Grace Richter is an ophthalmologist and Assistant Professor of Clinical Ophthalmology at the Keck School of Medicine of USC. She is residency and fellowship trained and a fellow of the Heed Ophthalmic Foundation.


1Vajaranant TS, Wu S, Torres M, Varma, R. Am. J Ophthalmol, 152,2; 303–314.e3.
2 Richter GM, Coleman, AL. Clinical Ophthalmology 2016:10 189-206.

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