Glaucoma Specialist & Surgeon in Beirut
Glaucoma can progressively damage the optic nerve, often before a patient notices a change in vision. Pressure inside the eye (intraocular pressure) is the main modifiable risk factor, but the pressure that is appropriate for one eye may not be appropriate for another.
Dr Seif is fellowship-trained in glaucoma and anterior segment surgery. His practice covers the complete treatment spectrum, from diagnosis and monitoring to laser treatment, minimally invasive and canal-based procedures, trabeculectomy, glaucoma drainage devices and surgery in complex or previously operated eyes.
The objective is to protect remaining vision by controlling pressure to a level appropriate for the type, severity and rate of progression of the disease. Treatment does not reverse existing optic-nerve damage, so regular monitoring remains important even when pressure is controlled.
Understanding glaucoma
A glaucoma assessment may include intraocular pressure measurement, optic-nerve examination, examination of the drainage angle (gonioscopy), corneal thickness, visual field testing and optical coherence tomography (OCT). Previous tests are particularly useful because glaucoma is best understood by looking at change over time.
The treatment plan is based on the type of glaucoma, the extent and rate of damage, the target pressure, ocular anatomy, lens status and previous treatment.
Medication and laser treatment
Eye drops remain an important part of glaucoma treatment. Selective laser trabeculoplasty (SLT) can also improve drainage through the eye’s natural outflow system and may be used as an early treatment or later to reduce medication burden in appropriate patients.
Laser peripheral iridotomy is used for selected angle-closure mechanisms. Other laser treatments may be considered according to the type and stage of glaucoma.
Modern glaucoma surgery
Minimally invasive glaucoma surgery (MIGS) and canal-based procedures aim to improve drainage of fluid from the eye while minimizing disruption to surrounding tissues. They can be useful in appropriately selected eyes and may be performed alone or together with cataract surgery.
When glaucoma is more advanced or a lower target pressure is required, trabeculectomy or a glaucoma drainage device may provide a more appropriate degree of pressure reduction.
The decision is not simply between “new” and “traditional” surgery. It is about matching the expected pressure-lowering effect and risk profile of the operation to what that eye requires.
Cataract and glaucoma together
When cataract and glaucoma coexist, the two conditions should be planned together.
For some patients, cataract surgery can be combined with a MIGS or canal-based procedure. For others, a different glaucoma operation or a staged approach may be more appropriate.
The decision depends on glaucoma severity, target pressure, angle anatomy, medication burden, visual goals and the cataract/IOL plan.
Complex glaucoma and second opinions
A second opinion can be useful when glaucoma is progressing, pressure remains above target, previous surgery is no longer providing adequate control, or more than one surgical strategy is reasonable.
The aim is to define the disease mechanism and target pressure, review what has already been tried, and explain the available options clearly.
CATARACT & LENS SURGERY · ADVANCED ANTERIOR SEGMENT SURGERY · APPOINTMENTS