Services
Glaucoma
Comprehensive glaucoma assessment and management — from medical therapy and laser treatment to minimally invasive and complex glaucoma surgery.
What is Glaucoma?
Glaucoma is a group of eye conditions characterised by progressive damage to the optic nerve — the nerve responsible for transmitting visual information from the eye to the brain. It is one of the leading causes of irreversible blindness worldwide, yet with early detection and treatment, vision loss can usually be prevented or slowed significantly.
In most cases, glaucoma is associated with elevated intraocular pressure (IOP), although some patients develop the condition with normal pressure (normal tension glaucoma). Because glaucoma typically causes no pain and initially affects peripheral vision, it often goes undetected until significant damage has occurred — making regular eye examinations essential.
Types of Glaucoma
Primary Open-Angle Glaucoma
The most common form. The drainage angle of the eye is open but functions poorly, causing IOP to rise gradually. Often has no symptoms until advanced.
Normal Tension Glaucoma
Optic nerve damage occurs despite IOP within the normal range. Vascular factors and optic nerve susceptibility play an important role.
Angle-Closure Glaucoma
The drainage angle is physically blocked. Can present as a sudden, painful attack (acute angle closure) or develop slowly. Laser iridotomy is often curative.
Ocular Hypertension
Elevated IOP without detectable optic nerve damage or visual field loss. Requires monitoring and may require treatment to reduce the risk of developing glaucoma.
Diagnostic Assessment
- Intraocular pressure measurement
- Visual field (perimetry) testing
- OCT optic nerve fibre layer analysis
- Optic disc photography and assessment
- Gonioscopy (drainage angle evaluation)
- Corneal thickness measurement (pachymetry)
Glaucoma runs in families
First-degree relatives of glaucoma patients have a 4–9× higher risk. Early detection is key.
Make an AppointmentTreatment Options
Medical Management (Eye Drops)
Pressure-lowering eye drops remain the mainstay of glaucoma treatment. A range of drop classes are available including prostaglandin analogues, beta-blockers, carbonic anhydrase inhibitors, and alpha-agonists. Our doctors carefully tailor the treatment regimen to each patient's needs, tolerability, and lifestyle.
Laser Treatment (SLT & Iridotomy)
Selective Laser Trabeculoplasty (SLT) is a safe, effective office-based laser treatment that improves the drainage of aqueous fluid from the eye, lowering IOP. Laser peripheral iridotomy (LPI) is used to treat angle-closure glaucoma by creating a small opening in the iris to restore normal fluid flow.
Minimally Invasive Glaucoma Surgery (MIGS)
MIGS procedures use microscopic devices and techniques to lower IOP with a shorter recovery and lower risk profile than traditional glaucoma surgery. These procedures are often performed in combination with cataract surgery. Options include iStent, Hydrus Microstent, and goniotomy procedures.
Complex Glaucoma Surgery
For advanced or refractory glaucoma, more complex surgical procedures may be required. Trabeculectomy creates a new drainage channel from the eye to lower IOP significantly. Glaucoma drainage devices (tube surgery) provide an alternative drainage pathway. Dr Bernardo Soares specialises in complex glaucoma surgery at the Royal Victorian Eye and Ear Hospital and Monash Health.
Our Doctors That Treat Glaucoma
All of our ophthalmologists manage glaucoma with medical and laser treatments. Dr Bernardo Soares additionally specialises in complex glaucoma surgery.
Dr Ross MacIntyre
BA (Chemistry), MD, FRANZCO
Corneal, Cataract & Refractive Surgery
General Ophthalmology
Dr MacIntyre is an internationally trained expert in the area of corneal, cataract and refractive surgery. Dr MacIntyre completed both his Bachelor of Arts degree in chemistry and Doctor of Medicine degree with Honours in New York. After a transitional internship at Columbia University he completed his registrar training in ophthalmology at Brown University. He subsequently undertook fellowship training in cornea, cataract, and refractive surgery at the Wilmer Eye Institute at Johns Hopkins in Baltimore. He pursued further training as a cornea fellow at the Royal Victorian Eye and Ear Hospital in Melbourne. During his training he has published articles in the medical literature and presented at both international and local scientific meetings. He is a diplomat of the American Board of Ophthalmology, a member of the Alpha Omega Alpha Honour Medical Society in the United States, and a fellow of the Royal Australian and New Zealand College of Ophthalmologists. Dr MacIntyre is a staff specialist at the Royal Victorian Eye and Ear Hospital, where he trains registrars and fellows, and provides public health care. He specialises in medical disease of the cornea and corneal transplant surgery.
Qualifications
- —BA (Chemistry)
- —MD
- —Diplomate American Board of Ophthalmology
- —FRANZCO
Fellowships
- —Wilmer Eye Institute, Johns Hopkins University
- —Royal Victorian Eye and Ear Hospital
Professional Memberships
- —Royal Australian and New Zealand College of Ophthalmologists (RANZCO)
- —American Academy of Ophthalmology
- —American Society of Cataract and Refractive Surgery
- —European Society of Cataract and Refractive Surgery
- —Cornea and Contact Lens Society of Australia
- —Alpha Omega Alpha Medical Honour Society (AOA)
Public Appointments
- —Staff Specialist, Royal Victorian Eye and Ear Hospital
Dr Xavier Fagan
MBBS FRANZCO
Medical Retina & Ocular Inflammatory Disorders
General Ophthalmology
Dr Fagan is a Melbourne based ophthalmologist. He completed his undergraduate medical degree with honours at The University of Melbourne in 2004. Resident medical years were spent at St. Vincent's Hospital Melbourne and The Royal Melbourne Hospital. Dr Fagan commenced his ophthalmology registrar training at the Royal Victorian Eye and Ear Hospital in 2007 and finished in 2011. This provided comprehensive medical and surgical ophthalmology training. He achieved success in the final examinations by receiving the K G Howsam medal for best performing doctor in Australia and New Zealand. He subsequently undertook 18 months of fellowship training in medical retina and ocular inflammatory disorders at the same institution. As part of this fellowship he has published articles in the medical literature and presented at international and local scientific meetings. As a consultant ophthalmologist, Dr Fagan has public hospital appointments at the Austin and Royal Victorian Eye and Ear Hospitals. This involves providing public health care and he is actively involved in training of future colleagues. He has an appointment as a clinical lecturer with The University of Melbourne in the faculty of Medicine, Dentistry and Health Sciences.
Qualifications
- —MBBS (Hons)
- —FRANZCO
Awards
- —K G Howsam Medal — Best Performing Ophthalmology Candidate in Australia and New Zealand
Academic
- —Clinical Lecturer, University of Melbourne
Public Appointments
- —Austin Hospital
- —Royal Victorian Eye and Ear Hospital
Dr Bernardo Soares
MBBS FRANZCO
Medical & Surgical Glaucoma
General Ophthalmology
Dr Bernardo Soares is an experienced Melbourne Eye Surgeon who specialises in Cataract and Glaucoma Surgeries. Holding public positions at the Glaucoma Unit at the Royal Victorian Eye and Ear Hospital and at Monash Health. He is passionate about complex glaucoma and cataract surgery, ophthalmic teaching and surgical training of future colleagues as well as glaucoma collaborative care. Dr Soares has numerous publications in peer-reviewed journals and constantly presents his work at local and international conferences. He is a Fellow of the Royal Australian and New Zealand College of Ophthalmology, The International Council of Ophthalmology and the Brazilian Council of Ophthalmology.
Qualifications
- —MBBS
- —FRANZCO
- —Fellow, International Council of Ophthalmology
- —Fellow, Brazilian Council of Ophthalmology
Public Appointments
- —Glaucoma Unit, Royal Victorian Eye and Ear Hospital
- —Monash Health
Dr Jonathan Goh
MBBS FRANZCO
Medical Retina
General Ophthalmology
Dr Jonathan Goh is a fellowship trained comprehensive ophthalmologist who sub-specialises in the management of medical retina diseases (diabetic retinopathy, age-related macular degeneration, retinal vein occlusions) whilst also managing general ophthalmic conditions (cataracts, pterygia, chalazia and glaucoma). Dr Goh obtained his medical degree (MBBS, BMedSci), Postgraduate Diploma of Surgical Anatomy (PGDipSurgAnat) and Masters of Surgery (MS) from the University of Melbourne. His Masters of Surgery was awarded for his research in age-related macular degeneration (AMD). He completed his ophthalmology training at the Royal Victorian Eye and Ear Hospital with further subspecialty training in medical retina diseases. Dr Goh has published and presented his findings nationally and internationally in age-related macular degeneration, diabetic retinopathy, and dry-eye disease. Publicly, he works as a consultant ophthalmologist at the Royal Victorian Eye and Ear Hospital, Austin Hospital and Western Health. Dr Goh has a passion for teaching and is actively involved in teaching junior medical staff and is currently the registrar Medical Retina term supervisor at The Royal Victorian Eye and Ear Hospital. He has previously held the Registrar of the Court (2020) position for organising the final ophthalmology examinations that trainees undertake before they are granted their ophthalmology fellowship and recognised as medical specialists.
Qualifications
- —MBBS
- —BMedSci
- —PGDipSurgAnat
- —MS (Surgery)
- —FRANZCO
Academic
- —Masters of Surgery awarded for research in age-related macular degeneration
- —Medical Retina Supervisor, Royal Victorian Eye and Ear Hospital
Public Appointments
- —Royal Victorian Eye and Ear Hospital
- —Austin Hospital
- —Western Health
Dr David Sousa
MBBS FRANZCO
Vitreoretinal Surgery
Dr David Sousa graduated from the Faculty of Medicine of the University of Lisbon in 2013. He completed his Ophthalmology specialty training in Portugal, followed by Vitreoretinal fellowships in Manchester, United Kingdom and Melbourne, Australia. Dr Sousa currently works as a Vitreoretinal Surgeon in Melbourne at The Royal Victorian Eye and Ear Hospital, and in Geelong at the University Hospital and St John of God Hospital. Dr Sousa specialises in the treatment of vitreoretinal conditions including diabetic retinopathy, age-related macular degeneration, retinal detachment, epiretinal membrane, macular hole, and complex lens surgery. Dr Sousa obtained his PhD in 2021 and is currently involved in multiple research projects at Centre for Eye Research Australia, including retinal imaging biomarkers, artificial intelligence, neuroprotection and development of novel surgical devices.
Qualifications
- —MBBS
- —FRANZCO
- —PhD (Centre for Eye Research Australia)
Research
- —Multiple peer-reviewed publications in retinal imaging, artificial intelligence and neuroprotection
- —Regular speaker at international conferences
Public Appointments
- —Royal Victorian Eye and Ear Hospital
- —University Hospital Geelong
Dr Rogan Fraser
FRANZCO
Neuro-Ophthalmology
General Ophthalmology
Dr Rogan Fraser practices comprehensive, general ophthalmology with an interest in neuro-ophthalmology. He graduated from the University of Melbourne with a Doctor of Medicine in 2015 where he was on the Dean's Honours list. Prior to that, he practised as an optometrist in regional Victoria for a number of years, which is where his passion for personalised compassionate and full scope eyecare was developed and honed. Dr Fraser undertook his ophthalmology training through the Royal Victorian Eye and Ear Hospital, and in his final year was appointed the Chief Registrar. He currently works as a consultant in the Neuro-ophthalmology unit at the Eye and Ear, as well as in that hospital's emergency department. In this capacity he supervises and teaches both ophthalmology and neurology trainees. He is a visiting lecturer for Monash and Deakin universities, and has been a faculty member of surgical, and neuro-ophthalmology conferences throughout Australia. He is a Fellow of the Royal Australian and New Zealand College of Ophthalmologists, and a member of both the Neuro-Ophthalmology Society of Australia, and the UK Neuro-Ophthalmology Society.
Qualifications
- —FRANZCO
Academic
- —Visiting Lecturer, Monash University
- —Visiting Lecturer, Deakin University
Professional Memberships
- —Neuro-Ophthalmology Society of Australia
- —UK Neuro-Ophthalmology Society
Public Appointments
- —Neuro-ophthalmology Unit, Royal Victorian Eye and Ear Hospital
- —Emergency Department, Royal Victorian Eye and Ear Hospital
Concerned About Glaucoma?
Early diagnosis is essential to preserving your vision. Contact us today to arrange a comprehensive glaucoma assessment.