Protect the vision you still have. Full-spectrum glaucoma care — drops, laser, MIGS, valves, and combined cataract surgery — with a fellowship-trained glaucoma surgeon.
Glaucoma is a group of eye diseases that damage the optic nerve. The most common form, open-angle glaucoma, usually has no early symptoms. Side vision fades first, and the loss is permanent once it happens. Pressure inside the eye is often higher than the nerve can tolerate — but not always. Some eyes are damaged at “normal” pressure.
That is why the plan has to fit the eye. Dr. Schmitz and Dr. Shields are board-certified ophthalmologists with subspecialty glaucoma training that treat the full spectrum: medical care, selective laser trabeculoplasty, minimally invasive glaucoma surgery, Ahmed valve implantation, and cataract surgery combined with glaucoma surgery. They see patients at SHARPEVISION Seattle–Bellevue and Renton.
A glaucoma decision is only as good as the measurements behind it. We look at pressure, corneal thickness, the drainage angle, the optic nerve, OCT scans of the nerve fiber layer, and visual fields — then compare them over time, not at a single visit.
Drops are right for some eyes. A laser is right for others. Mild disease and a cataract may call for MIGS the same day. Advanced or difficult glaucoma may need a valve. The recommendation follows your nerve, your pressure, and your life — not a protocol.
Surgery is done in our Seattle-Bellevue ambulatory surgical suite, dedicated to anterior-segment procedures, not a general hospital OR. Dr. Schmitz trained in glaucoma at UCLA’s Stein Eye Institute. Dr. Shields trained at the University of Washington in micro-invasive glaucoma surgery. Both have taught cataract and glaucoma surgery for more than a decade.
Many patients are well controlled with prescription eye drops, sometimes one medication, sometimes a combination. Drops lower pressure by decreasing fluid production or improving outflow. We also coordinate care with your optometrist when that is the right long-term home for monitoring.
Selective laser trabeculoplasty is an in-office laser that treats the eye’s natural drain, the trabecular meshwork, so fluid leaves the eye more easily. It is often used as a first treatment or to reduce the drop burden. There is no incision. Many patients return to normal activity the same day. SLT can be repeated in selected eyes if the effect fades.
Minimally invasive glaucoma surgery uses tiny incisions and specialized devices or angle procedures to improve outflow, with a faster recovery than traditional filtering surgery. MIGS is typically chosen for mild to moderate open-angle glaucoma, and it is often paired with cataract surgery so both problems are treated in one trip to the operating room.
The Ahmed glaucoma valve is a small drainage implant. A tube carries fluid out of the eye to a plate placed under the conjunctiva, and a valve mechanism is designed to limit pressure from dropping too far. Dr. Schmitz uses it for more advanced glaucoma, eyes that have not responded to drops, laser, or earlier surgery, and selected complex cases.
Cataract and glaucoma often arrive together. Removing the cloudy lens and treating the glaucoma in the same operation can lower pressure, sharpen vision, and spare a second surgery. The glaucoma portion may be MIGS or, when the nerve needs more, a valve or other filtering procedure. Lens choice is matched to the eye — including when glaucoma limits the premium-lens options that would otherwise be available.
A good procedure is not the end of glaucoma care. Pressure, nerve scans, and visual fields are repeated on a schedule set by how stable the eye is. If the nerve starts to change, the plan changes with it. Early treatment is what keeps peripheral vision.
We currently see patients for glaucoma in our Seattle-Bellevue and Renton locations only.
Dr. Shields specializes in Cataract surgery, advanced RLE, Refractive surgery, and micro-invasive Glaucoma surgery. He treats patients at SHARPEVISION SEATTLE-BELLEVUE and RENTON, WA.
Meet Dr. Jerry Shields
Dr. Schmitz is an Ophthalmologist specializing in Cataract removal, Refractive Lens Exchange (RLE), Glaucoma surgery, and Refractive surgery. He treats patients at SHARPEVISION SEATTLE-BELLEVUE and RENTON, WA.
Meet Dr. Joseph Schmitz
Glaucoma cannot be cured. It can be controlled. The goal is to lower eye pressure enough to halt progression and keep the vision you have. SHARPEVISION SEATTLE-BELLEVUE offers every step on that ladder.
A glaucoma visit is a medical eye exam, not a LASIK screening. Expect pressure checks, a look at the drainage angle, optic-nerve imaging, and, when needed, a visual field test. Dilation is common and will blur near vision for several hours. Bring your insurance card and a list of your eye drops.
You will leave knowing whether the nerve looks stable, what the target pressure is, and which treatment fits. That may be a new drop, SLT in the clinic, or a surgery date in the Bellevue suite. Medical insurance often covers medically necessary glaucoma care. We will review benefits before a procedure.
SLT is usually a short office visit. MIGS and cataract surgery are outpatient, with drops and activity limits for a short recovery. An Ahmed valve needs closer early follow-up. Either way, glaucoma care continues — the win is a stable field, year after year.
No. Treatment does not bring back vision that is already lost. It lowers eye pressure to stop or slow further damage. Caught early, most people keep useful vision for life.
No. Patients come on their own and by referral from optometrists across the Puget Sound. If you have records — fields, OCT scans, a drop list — bring them or ask your doctor to send them.
No. Laser vision correction does not raise or lower the risk of developing glaucoma. It can make later pressure readings look lower than they are, so anyone who has had LASIK should tell the doctor who checks their pressure. We already screen the optic nerve at every vision-correction consultation.
Often, yes. Combined cataract and glaucoma surgery treats the cloudy lens and the pressure problem in one operation. Dr. Schmitz will say when a staged plan is safer than a combined one.
Central vision is usually the last thing glaucoma takes. By the time reading or driving feels different, a large share of the optic nerve may already be gone. Treatment is how we keep the vision that still feels normal.
SLT is a laser, done in the clinic, with no incision. MIGS is surgery through a micro-incision, usually for mild to moderate open-angle glaucoma, often at the time of cataract surgery. An Ahmed valve is a drainage implant for more advanced or uncontrolled glaucoma. They are steps on one ladder, not competing brands of the same procedure.
Anyone can be affected by poor vision. We get to help people from all walks of life and hear some amazing stories along the way.
