SPECIALTY — GLAUCOMA
Understanding glaucoma & your treatment options
Glaucoma is one of the leading causes of irreversible blindness in the world — yet most people have no idea they have it until significant vision has already been lost. Early detection, careful monitoring, and expert treatment are the keys to preserving your sight.
What is glaucoma?
Glaucoma is not a single disease — it is a group of eye diseases that cause damage to the optic nerve, the bundle of nerve fibers that carries visual information from the eye to the brain. When the optic nerve is damaged, the brain stops receiving signals from affected areas of the eye, resulting in vision loss that begins silently at the edges of your sight and, if left untreated, can progress to complete blindness.
What makes glaucoma particularly dangerous is that it causes no pain and no early symptoms. By the time most people notice any change in their vision, the disease has already caused permanent, irreversible damage. There is currently no cure for glaucoma — but with the right treatment, its progression can be significantly slowed, and most patients are able to maintain functional vision for life.
Once vision is lost from glaucoma, it cannot be restored. This is why regular eye exams — even when your eyes feel perfectly fine — are so important. Early detection truly saves sight.
Glaucoma in the United States
Americans currently living with glaucoma
of those affected are unaware they have it
leading cause of blindness worldwide
Glaucoma is notoriously difficult to diagnose — there is no single test that definitively confirms it. Diagnosis requires a comprehensive eye exam that evaluates eye pressure, the health of the optic nerve, the thickness of the cornea, the drainage angle of the eye, and visual field testing. Even with all these tools, early glaucoma can be subtle and easy to miss, which is why fellowship-trained glaucoma specialists play such a critical role in its detection and management.
Types of glaucoma & normal tension glaucoma in Hawai’i
The most common form is primary open-angle glaucoma, where the drainage system of the eye becomes less efficient over time, gradually raising eye pressure and damaging the optic nerve. Other types include angle-closure glaucoma, pigmentary glaucoma, pseudoexfoliation glaucoma, and normal tension glaucoma, among others.
The primary goal of treatment for all forms of glaucoma is to lower eye pressure to protect the optic nerve — but it is a common misconception that you must have high eye pressure to have glaucoma. Many people develop optic nerve damage even when their eye pressures fall within the “normal” range.
Here in Hawai’i, normal tension glaucoma is particularly prevalent due to our large Asian population, who are at significantly higher risk. In these cases, eye pressures may never have been elevated — making routine comprehensive eye exams even more critical for early detection.
Who is at highest risk?
While glaucoma can affect anyone, certain factors significantly increase your risk. You should be screened regularly if you have any of the following:
Glaucoma treatments
Dr. Yim is a fellowship-trained glaucoma surgeon with advanced expertise in the full spectrum of modern glaucoma treatments — from the least invasive approaches to complex surgical interventions. His philosophy is to find the most effective treatment with the least impact on your quality of life, with the goal of reducing or eliminating the need for daily glaucoma medications whenever possible.
Laser treatment for glaucoma
Dr. Yim specializes in laser-based glaucoma therapies, including selective laser trabeculoplasty (SLT) and laser peripheral iridotomy (LPI). These in-office procedures are often used as a first-line treatment or as an alternative to eye drops, offering effective pressure lowering with minimal recovery time and no incisions.
Minimally invasive glaucoma surgery (MIGS)
MIGS represents the most significant advancement in glaucoma surgery in decades. These micro-scale procedures use tiny devices and incisions to improve the natural drainage of the eye, lowering pressure with dramatically less risk and recovery time than traditional glaucoma surgery. Dr. Yim is an expert in multiple MIGS techniques and is one of a select group of surgeons who teaches these procedures to ophthalmologists across the country.
Combined cataract & MIGS surgery
For patients who have both cataracts and glaucoma, Dr. Yim offers the opportunity to address both conditions in a single procedure. By combining cataract removal with a MIGS procedure, many patients experience meaningful reductions in eye pressure — and in some cases, are able to eliminate the need for glaucoma eye drops entirely. This combined approach minimizes the number of surgeries a patient needs while maximizing the benefit to their vision and glaucoma control.
Glaucoma medications & drops
Eye drops remain a cornerstone of glaucoma management, and Dr. Yim works closely with each patient to find the most effective, well-tolerated medication regimen. His surgical expertise means that when drops alone are not enough — or when the burden of daily medications affects quality of life — he has the full range of surgical options available to reduce or replace that dependency.
A national leader in MIGS education. Dr. Yim is recognized throughout the country as an educator and expert in minimally invasive glaucoma surgery. He teaches MIGS techniques to ophthalmologists and glaucoma specialists nationwide, and serves as a speaker and consultant for multiple surgical device companies — bringing the very latest advances in glaucoma surgery directly to his patients here in Hawai‘i.
