Our Approach to Glaucoma Care
Montefiore Einstein Ophthalmology is a global leader, providing comprehensive, state-of-the-art care for adults and children with the full spectrum of glaucoma and related optic nerve conditions, from glaucoma suspect and ocular hypertension to primary open angle, angle-closure, congenital, and secondary glaucomas. Our multidisciplinary team of world-renowned doctors includes board-certified, fellowship-trained ophthalmologists with subspecialized expertise in managing all types and stages of glaucoma. Home to one of the largest academic glaucoma practices in the tristate region, we collaborate closely with optometrists, cornea, cataract, retina, neuro-ophthalmology, pediatric and oculoplastics specialists, primary care physicians, and other experts to deliver seamless, coordinated care and ensure the best possible outcomes for each patient. As pioneers in minimally invasive glaucoma surgery (MIGS), our ophthalmologists co-invented the Trabectome®,the first FDA-cleared device for MIGS, and continue to advance the field through innovation and collaboration.
Using the latest diagnostic technologies and most advanced treatments, we deliver individualized, precision-based care tailored to each patient’s unique needs and disease progression. We prioritize shared decision-making to ensure each patient is informed and empowered throughout their care journey. We also serve as a referral center for the most complex, refractory glaucoma cases.
Our approach integrates leading-edge imaging, advanced visual field analysis, and precision intraocular pressure monitoring to guide both medical management and surgical decision-making. Montefiore Einstein Ophthalmology offers the full spectrum of glaucoma interventions, from medication optimization and in-office laser therapies to advanced surgical options including MIGS, glaucoma drainage implants, and complex filtration procedures. For individuals with congenital or syndromic glaucoma, we offer genetic counseling in collaboration with the Children’s Hospital at Montefiore Einstein Pediatric Genetic Medicine, one of the nation’s first and best-known programs, which has been leading the way in genetic and genomic disease care for more than fifty years and continues to serve as a model for the field. To further support individuals with significant visual impairment, we also provide access to comprehensive vision rehabilitation and work in close partnership with our Burke Rehabilitation Center, ranked among the top 1% of all hospitals in the nation for rehabilitation, according to U.S. News and World Report.
We are dedicated to preserving vision, preventing disease progression, and enhancing quality of life, along with close integration with Lighthouse Guild International in Manhattan, NY. Whether you are monitoring early-stage disease, managing complex or refractory glaucoma, recovering from surgery, or seeking a second opinion, our team is here to provide expert care and guidance at every stage of your glaucoma journey.
At the Forefront of Early Detection & Management of Glaucoma To Prevent Irreversible Vision Loss or Blindness
We use the latest advancements in diagnostic technologies and pioneering telemedicine approaches, including tele-glaucoma innovations, to expand access to care and reach at-risk populations. Our team employs high-resolution optical coherence tomography (OCT), advanced visual field testing, and precision intraocular pressure monitoring to detect glaucoma in its earliest stages to help patients preserve and protect their vision. We also closely monitor individuals with ocular hypertension and glaucoma suspects, applying personalized risk assessments and evidence-based medical therapies to slow or prevent disease progression.
In addition to delivering exceptional clinical care, our program continues to set new standards in the treatment of glaucoma care and is committed to advancing the field through research, and device development, and education. Our physician-scientists played a key role in the development of novel FDA-approved sustained-release therapies, a new class of glaucoma treatments that offer the potential for long-term intraocular pressure control without the burden of daily eye drops.
As members of the American Academy of Ophthalmology’s Preferred Practice Pattern Committee, our ophthalmologists help shape national guidelines for comprehensive adult eye care. These guidelines recommend more frequent comprehensive medical eye examinations for individuals at increased risk for glaucoma underscoring the critical importance of early detection, risk-based screening, and comprehensive care to prevent vision loss and improve outcomes in high-risk populations.
Trusted Global Leaders in Evidence-Based Eye Care
We are one of only 13 centers worldwide designated as a Cochrane Eyes and Vision (CEV) Center for Evidence-Based Vision Care, a National Eye Institute (NEI)/National Institutes of Health (NIH)-funded distinction recognizing our commitment to advancing evidence-based medicine and eye care. Our contributions to research and determining the most effective treatments in patient care serve as a model for clinical sites around the world.
Diagnóstico y tratamientos avanzados
We offer access to the latest diagnostics and the most advanced medical, laser, and surgical treatments for the prevention, early detection, and management of the full spectrum of glaucoma and related optic nerve conditions.
Our program integrates state-of-the-art imaging technologies with precision monitoring to detect glaucoma in its earliest stages often before vision loss occurs. We use high-resolution optical coherence tomography (OCT) to evaluate the optic nerve and retinal nerve fiber layer, advanced visual field testing to monitor functional changes over time, and intraocular pressure assessment using tonometry and dynamic corneal measurements. We apply advanced biometric analysis for preoperative planning and utilize leading-edge imaging tools for detailed postoperative monitoring. These technologies enable individualized risk assessment and guide both medical and surgical decision-making, ensuring care is tailored to each patient’s disease progression and unique ocular anatomy. We are also leveraging artificial intelligence platforms to enhance diagnostic precision and support longitudinal monitoring over time.
When treatment is necessary, we offer a full spectrum of evidence-based options from topical medications and sustained-release therapies to in-office laser treatments and advanced surgical solutions. Our team specializes in minimally invasive glaucoma surgery (MIGS) and advanced angle procedures. These procedures are designed to lower intraocular pressure with less risk and faster recovery compared to traditional glaucoma surgeries. For advanced or refractory cases, we perform glaucoma drainage device implantation (Tube surgery), trabeculectomy, and complex filtration surgeries.
Our comprehensive approach also includes managing ocular surface disease to optimize surgical outcomes, as well as providing longitudinal care for glaucoma suspects and patients with optic nerve conditions that may mimic or coexist with glaucoma—such as optic disc anomalies and pseudo-glaucomatous cupping.
Montefiore Einstein Ophthalmology offers a comprehensive suite of advanced diagnostics and treatments for glaucoma, including:
Advanced Treatments
Investigación y publicaciones
Montefiore Einstein Ophthalmology advances the understanding and treatment of glaucoma through an integrated basic, translational, and clinical research program that spans early detection, disease classification, and advanced imaging with optical coherence tomography (OCT) for diagnosis and monitoring. Core efforts focus on refining surgical techniques and technologies—including minimally invasive glaucoma surgery (MIGS)—optimizing surgical outcomes, addressing refractive surgery considerations in glaucoma suspects, understanding health disparities in vulnerable populations, and incorporating artificial intelligence and emerging technologies into clinical decision-making. Our faculty helped establish new standards of care by leading clinical trials that resulted in novel FDA-approved medications and devices, co-invented the Trabectome®, the first FDA-cleared MIGS device, and played a central role in developing sustained-release glaucoma therapies that provide long-term intraocular pressure control without the inconvenience and potential side effects of daily eye drops.
Supported by prestigious NIH-funded grants, our physician-scientists are conducting breakthrough studies on human retinal ganglion cell (RGC) differentiation, axon growth, and pathfinding using advanced organoid and microphysiological models to close critical knowledge gaps in early optic nerve development and mechanisms of RGC degeneration in blinding diseases such as glaucoma. This work underpins the creation of innovative datasets, diagnostic tools, and therapeutic strategies aimed at RGC-protective drugs, replacement therapies, and regenerative treatments that could ultimately restore vision for adults and children. Additional investigations include a low-cost glaucoma calculator for risk stratification, evaluation of cataract surgery’s impact on glaucoma care, analyses of trabeculectomy techniques, shared decision-making, accuracy of medical record coding, and the utility of OCT global metrics in advanced disease, as well as functional MRI studies of visual cortex changes and research into genetic and molecular biomarkers to enable personalized glaucoma care.
The Montefiore Glaucoma Division has been a leader in establishing data collaboratives that advance research across multiple U.S. institutions. By leveraging data from millions of patient visits both within and beyond Montefiore, our teams have created a robust foundation for a flourishing range of research initiatives.
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The Impact of Workflow Modifications in an Electronic Medical Record on Tertiary Service Referrals for Patients with Visual Impairment in New York City.
Allen OS, Fields LS, Sweeney MJ, Als SL, Seiple WH, Shrivastava A. The Impact of Workflow Modifications in an Electronic Medical Record on Tertiary Service Referrals for Patients with Visual Impairment in New York City. Clin Ophthalmol. 2025;19:3693-3702 https://doi.org/10.2147/OPTH.S532586
The study was designed to determine if integrating a mandatory, automated electronic medical record (EMR) prompt could increase referral rates for vision rehabilitation (VR) in patients with permanent visual impairment. The researchers aimed to overcome common clinical barriers, such as physician "referral fatigue" and the complexity of identifying eligible patients during busy clinics at Montefiore Medical Center along with neighboring academic centers in the greater NY are -
The Relationship Between Corneal Biomechanics and Intraocular Pressure Dynamics in Patients Undergoing Intravitreal Injection - PubMed
Dackowski EK, Moon JY, Wang J, Shrivastava A, Schultz JS. The Relationship Between Corneal Biomechanics and Intraocular Pressure Dynamics in Patients Undergoing Intravitreal Injection. J Glaucoma. 2021 May 1;30(5):451-458. doi: 10.1097/IJG.0000000000001833. PMID: 33710068.
Intravitreal injections result in a rapid volume expansion within the globe resulting in an immediate, sharp rise in intraocular pressure (IOP). This study was designed to investigate whether corneal biomechanical properties—specifically Corneal Hysteresis (CH) and the Corneal Resistance Factor (CRF)—could predict which patients would experience the highest pressure spikes and how quickly their pressure would return to normal -
Pickleball and Ball Sports-Related Ocular Trauma in the United States - PubMed
Shah J, Pathuri S, Shrivastava A, Ong J, Zheng J, Acar IF, Plotnik J, Golnik K, Salevitz MI, Suh A, Lee AG. Pickleball and Ball Sports-Related Ocular Trauma in the United States. Eye (Lond). 2026 Jan 16. doi: 10.1038/s41433-025-04192-4. Epub ahead of print. PMID: 41545712.
The study was conducted to characterize the national patterns, incidence, and demographics of ocular trauma related to "other ball sports"—specifically pickleball, dodgeball, and kickball. Using data from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023, the researchers aimed to identify which populations are most at risk and whether there has been a significant change in injury rates over the last decade. -
Ethnoracial and Geographic Representation in United States Glaucoma Clinical Trials (2004-2023) - PubMed
Shah J, Pathuri S, Zheng J, Khan B, Okome K, Schultz JS, Shrivastava A. Ethnoracial and Geographic Representation in United States Glaucoma Clinical Trials (2004-2023). Ophthalmol Glaucoma. 2025 Oct 8:S2589-4196(25)00211-X. doi: 10.1016/j.ogla.2025.09.011. Epub ahead of print. PMID: 41072577.
The study aimed to characterize trends in how race, ethnicity, and geography are reported and represented in U.S.-based glaucoma clinical trials. Given that glaucoma disproportionately affects certain minority populations and individuals in underserved regions, the researchers sought to determine if trial enrollment accurately reflects the actual epidemiologic burden of the disease. -
Fornix-based versus limbal-based conjunctival trabeculectomy flaps for glaucoma - PubMed
Theventhiran AB, Kim G, Yao W. Fornix-based versus limbal-based conjunctival trabeculectomy flaps for glaucoma. Cochrane Database Syst Rev. 2021 Aug 26;8(8):CD009380. doi: 10.1002/14651858.CD009380.pub3. PMID: 34437715; PMCID: PMC8407098.
The study aimed to determine if the location of the conjunctival incision (at the limbus for fornix-based vs. further back for limbus-based) influences the long-term success of trabeculectomy. Researchers specifically analyzed differences in intraocular pressure (IOP) control, surgical failure rates, and the incidence of complications like bleb leaks or infections. -
Refractive surgery for the glaucoma suspect - PubMed
Hein JC, Tauber J, Shrivastava A. Refractive surgery for the glaucoma suspect. Curr Opin Ophthalmol. 2023 Jul 1;34(4):290-295. doi: 10.1097/ICU.0000000000000954. Epub 2023 Mar 29. PMID: 36995100.
This analysis is a comprehensive clinical review that addresses the complexities of performing elective refractive procedures on patients at risk for glaucoma. The article was written to provide perioperative guidelines for evaluating and managing "glaucoma suspects"—patients who may have elevated intraocular pressure (IOP) or suspicious optic nerves but do not yet have confirmed disease. The primary goal is to help surgeons navigate the "relative contraindication" of glaucoma in refractive surgery by highlighting how these procedures can interfere with future glaucoma monitoring
Our Glaucoma Team
Our multidisciplinary team of world-renowned doctors includes board-certified, fellowship-trained ophthalmologists with subspecialized expertise in glaucoma. We specialize in the diagnosis and management of the full spectrum of glaucoma and related optic nerve conditions, using the most advanced medical, laser, and surgical techniques to preserve vision, prevent disease progression, and enhance quality of life.
Programas e iniciativas comunitarias transformadoras
Our program is recognized for its collaborative approach and comprehensive clinical care—extending beyond the walls of Montefiore Einstein into the community through targeted outreach initiatives designed to preserve vision, slow disease progression, prevent both vision loss and blindness, and enhance quality of life—particularly among vulnerable populations. Key efforts include community education, telemedicine-based strategies for the early detection and management of glaucoma and other eye diseases, and our partnership with Lighthouse Guild International’s Technology Peers for Accessible Living (Tech Pals) program, which bridges generations through personalized technology mentorship for individuals with vision loss. This unique initiative pairs blind or visually impaired young adults with older adults to foster digital literacy and independence. Through these and other initiatives, we continue to expand access to care, preserve continuity, and reduce disparities—advancing eye health across the communities we serve.
About Glaucoma
Glaucoma, the second leading cause of irreversible blindness worldwide, represents a group of complex eye conditions characterized by progressive optic neuropathy, or damage to the optic nerve, the structure responsible for transmitting visual information from the eye to the brain. This damage is often, but not always, associated with elevated intraocular pressure (IOP). Over time, glaucoma can lead to irreversible vision loss, typically beginning with peripheral vision and potentially progressing to central vision loss if left untreated. In the United States, the most common form is primary open-angle glaucoma, which usually develops gradually and often without noticeable symptoms in its early stages. Other types include angle-closure glaucoma, normal-tension glaucoma, congenital glaucoma, and secondary glaucomas related to trauma, steroid use, systemic disease, eye inflammation, or other ocular conditions. Because glaucoma typically progresses silently, regular screening and early detection are critical to preserving vision. Once diagnosed, management focuses on lowering intraocular pressure through medications, laser treatments, or surgery to slow or prevent further optic nerve damage.