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Glaucoma is a serious chronic eye disorder that can lead to vision loss. It is a leading cause of blindness for those over 60.

If you're due for a routine eye exam or have symptoms like reduced peripheral vision, you should be checked for glaucoma.

Dr. Bruce Cohen and Dr. Nancy M. Buchser in St. Louis, MO, provide accurate diagnoses and effective treatment of glaucoma.

Understanding Glaucoma

Glaucoma is a group of eye diseases that affect the optic nerve. It is often (but not always) caused by excess fluid in the eye, which creates an increase in intraocular pressure that damages the optic nerve.

The most common type of glaucoma is primary open-angle glaucoma, which progresses slowly over many years due to the gradual clogging of the eye drainage channels. Other types of the eye disease include acute angle-closure glaucoma, which is rare but causes a rapid increase in eye pressure; secondary glaucoma, linked to underlying eye conditions; and congenital glaucoma, a rare type affecting very young children.

While there is no cure for glaucoma, early treatment can protect your sight. 

Who Is at Risk for Glaucoma?

Anyone who is over 60, has a family history of the eye disease, or is nearsighted may face a higher risk of developing symptoms. Other risk factors include eye trauma, heart disease, high blood pressure, and having thin corneas.

Glaucoma infographic

Source: American Optometric Association

Protect Your Sight Schedule an Exam at Cohen Eye Associates 

Bruce Cohen, MD, and glaucoma specialist Nancy M. Buchser, MD, are highly experienced in the diagnosis and treatment of ocular diseases, including glaucoma.

Don't risk permanent vision loss; if you experience a sudden change in vision or any other symptoms indicative of glaucoma, reach out to us immediately to book an exam. Or, if you are not currently undergoing regular eye exams, let our ophthalmology practice start providing the ongoing checkups you need. Schedule an appointment today either by using our online form or by calling our St. Louis, MO, practice. We serve patients from both the city and suburbs like Chesterfield, MO, a call: 

(314) 361-5003

Our Doctors

"Excellent care and service"


Carol Goodman

St. Louis, MO


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On time very professional wonderful support staff

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Enrico Di Cera

St. Louis, MO


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Excellent care and service in every respect. Highly professional staff. Dr. Cohen is great.

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Diagnosing Glaucoma

If you are experiencing glaucoma symptoms, vision loss, or other changes in your vision, book an eye exam as soon as possible. However, even if you are not experiencing symptoms, it is extremely important to undergo regular eye exams. That's because many symptoms won't present until some irreversible vision loss has occurred. 

Unless otherwise directed by an ophthalmologist, you should undergo a general eye exam:

  • Every five to 10 years between the ages of 20 and 40
  • Every two to four years between the ages of 40 to 54
  • Every one to three years between the ages of 55 and 64

During your exam, your ophthalmologist will review your medical history and perform a number of tests:

  • Tonometry: Measurement of eye pressure using a special device
  • Dilated Eye Exam and Imaging Tests: Assessment of the optic nerve using tools such as a slit lamp
  • Visual Field Test: Detection of any changes in your visual field using a simple eye chart and other tests
  • Pachymetry: Measurement of corneal thickness using ultrasound and other tools
  • Gonioscopy: Assessment of drainage using a slit lamp and a special lens
  • Nerve Fiber Test: Assessment of the thickness of the optic nerve fibers

How Often Should I Have an Eye Exam?

Eye exam frequency infographic

How Is Glaucoma Treated?

Your doctor at Cohen Eye Associates in St. Louis, MO, serving patients across the city and suburbs like Chesterfield, will customize a glaucoma treatment plan for you based on the stage of your condition and severity of your symptoms. It's important to understand that glaucoma is a chronic condition that cannot be cured, but it can be managed in a way that preserves your vision, especially with early detection. Open-angle glaucoma can be managed with: 

Eye Drops

These prescribed drops are designed to either decrease fluid production or increase drainage in order to maintain a healthy eye pressure. Eye drops are usually the first treatment that your doctor will recommend. 

Oral Medications

Less commonly, patients may be prescribed oral medications to help maintain a healthy eye pressure.


Surgery may be recommended to reduce eye pressure if eye drops and medications are not improving your open-angle glaucoma symptoms, or if you're experiencing angle-closure glaucoma and need urgent treatment. 

Find What Treatment Is Right for You  Request a Consultation

Our eye doctors can help find the treatment that's right for you, based on how far your glaucoma has progressed and other factors contributing to your eye health. Whether you need a non-surgical or surgical solution, our team can help you manage your glaucoma symptoms effectively. Call or contact us online to meet our ophthalmologists at our St. Louis, MO, practice:

(314) 361-5003

"Looking forward to my next appointment."


Colleen Echterhoff

St. Louis, MO


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I had a great experience at Cohen Eye Associates. I was a little turned off by the general out-datedness of the office, but the staff is what won me over. Sarah (I think) was super helpful and informative when I asked lots of questions after not having an eye appointment for 5 years. Dr. Noonan was incredibly kind and patient. I will absolutely go back to this office next year to be her patient. At the end of my appointment I had to joy of hanging out with Peggy. She helped me pick out new glasses and fully explained my insurance coverage and how to best use it! Looking forward to my next appointment.

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Chontea Hale

St. Louis, MO


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Dr Noonan is awesome!! I’ve been her patient for more than 20 years and she’s the same today as she was when I first started seeing her! She’s so warm, patient, personal, knowledgeable, and extremely professional!! I just love her!! I wish we had more doctors like her these days. Sometimes, there’s a long wait to be seen, and I have been very irritated in the past, but when you get in her chair you tend to forget you had to wait. Or, you remember why. She just takes her time with everyone and you don’t feel rushed at all.

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Surgical Procedures Offered at Our Practice to Slow the Progression of Glaucoma

Our ophthalmologists offer several surgeries for glaucoma at our clinic, serving patients across St. Louis, MO, and surrounding suburbs like Chesterfield.  
Eye doctor with model of eye

Glaucoma Trabeculectomy Surgery

Trabeculectomy is a traditional glaucoma surgery that involves creating a new drainage channel in the eye to reduce intraocular pressure. During the procedure, a small flap is made in the sclera (the white part of the eye), allowing excess fluid to drain out, effectively managing glaucoma.

Eye surgery machine

Selective Laser Trabeculoplasty

Selective laser trabeculoplasty (SLT) uses laser energy to drain the tissues in the eye to reduce IOP. The selective laser targets certain cells in the trabecular network of the eye. The procedure uses a "selective" laser that has minimal heat energy absorption and only targets certain pigmented tissue in the eye. With this laser, thermal damage is minimized and less scar tissue forms. 

Eye doctor and patient

Express Shunt Surgery

Express shunt surgery, also known as the ExPRESS glaucoma filtration device procedure, involves implanting a tiny tube and a drainage device into the eye to enhance the outflow of aqueous humor, lowering intraocular pressure for patients with glaucoma. This is just one of the shunt procedures we offer at our practice. 

Patient getting eye exam


Goniotomy is a microinvasive glaucoma surgery (MIGS) procedure that involves the creation of small incisions in the trabecular meshwork of the eye using a Kahook Dual Blade tool. These incisions facilitate improved drainage of aqueous humor, helping to lower intraocular pressure for patients with glaucoma. 

When Was Your Last Eye Exam?

Whether you are suffering from primary open-angle glaucoma or a more urgent form of the eye disease, we are prepared to provide the treatment you need.

Get in touch with Cohen Eye Associates today to schedule a comprehensive evaluation. Glaucoma is known as the "silent thief of sight" because in many cases, sufferers have no indication of the condition until they have experienced a permanent compromise in their vision. Your absolute best defense against glaucoma is early detection. You can request a consultation online or give us a call.

(314) 361-5003

Man at eye exam

"An excellent clinician."

"Dr. Cohen is an excellent clinician with decades of experience who truly cares about his patients. My husband and I are blessed to have Dr. Cohen taking great care of us and our eyes. Thank you." Kimberly Seiber, 5-Star Google Review

Reducing the Risk

Following these guidelines may lower your risk of developing glaucoma or experiencing any resulting vision loss:

eye exam

Undergo Regular Eye Exams

Simply put, this is the single best way to prevent glaucoma from compromising your vision. Book an appointment with our St. Louis, MO, practice today if you aren't undergoing regular exams.


Stop Smoking

Smoking can lead to high blood pressure, diabetes, and cataracts. All of these conditions can increase the risk of glaucoma.

Couple exercising

Exercise Regularly

An active lifestyle is an excellent way to maintain good cardiovascular health, which can help prevent glaucoma.

Senior woman relaxing on couch

Avoid Stress

Taking time to relax is good for your heart, which is in turn good for your ocular health.

Woman getting ready to eat apple

Eat a Healthy Diet

Keeping your weight and blood pressure in check through a healthy diet is an excellent means of prevention.

Senior man taking pill

Take Your Meds

If you are taking prescription medication for glaucoma, make certain you are using it as directed.

Insurance Coverage

Glaucoma treatments are usually covered by medical insurance. Cohen Eye Associates accepts many HMO and PPO plans, and is a participating Medicare provider. We also offer affordable financing through CareCredit® for qualifying patients. If you're unsure of your coverage, our friendly staff can answer your questions and file the appropriate forms on your behalf. 

Meet Glaucoma Specialist Nancy Buchser

Avoiding compromised vision due to glaucoma requires personalized guidance from a qualified physician. That's why Cohen Eye Associates is proud to have glaucoma specialist Nancy Buchser on our team.

Dr. Buchser has completed extensive and prestigious training in her field in order to provide patients throughout St. Louis, MO, and its suburbs, like Chesterfield, with outstanding eye care. She earned her medical doctorate with research distinction and completed her subsequent internship at the University of Miami. Next, Dr. Buchser completed an ocular pathology fellowship and a glaucoma research fellowship at the University of Miami's Bascom Palmer Eye Institute. She went on to complete a residency in ophthalmology at the University of Pittsburgh Medical Center. She later took part in glaucoma fellowship training at Washington University, here in St. Louis, MO.

Dr. Nancy M. Buchser is a member of the American Academy of Ophthalmology, American Glaucoma Society, and St. Louis Ophthalmological Society.

Dr. Nancy Buchser

"Dr. Nancy Buchser is the best!"

"Dr Nancy Buscher is the best!! I have taken my daughter to three Ophthalmologists since she was very young and we had to recently make a switch. Dr Nancy was awesome. Not only is she smart and observant and was able to solve some long term unresolved issues that my daughter had, but she is very nice and professional, as well." K, 5-Star Google Review

Book Your Exam Now

Whether you are experiencing changes in your vision or simply haven't undergone an exam in awhile, we want to help you maintain your ocular health. You can request a consultation online or call our offices directly to book an appointment.

Answers to Frequently Asked Questions about Glaucoma

Glaucoma is a complex condition, and there are many misconceptions about what it is and how it is treated. Dr. Buchser and Dr. Cohen believe patient education is essential to successful eye care, which is why they want to help you understand every aspect of this condition and how it affects you. Below, we have compiled answers to some of the most frequently asked questions about primary open-angle glaucoma, closed-angle glaucoma, and other forms of the disease:

Do you recommend surgery?

Whenever it is safe to do so, we make conservative eye care treatment a priority. In other words, Dr. Buchser and Dr. Cohen will not recommend surgery unless your need is urgent or medications are not successful in controlling your IOP. During your eye exam, they will conduct a detailed assessment of your ocular health in order to determine the most effective and conservative approach to meeting your needs.

I'm not experiencing symptoms, but should I have a glaucoma exam?

If you are under age 40 and haven't been told you're at risk of glaucoma, it's a good idea to undergo a comprehensive eye exam every 5 to 10 years. Your doctor will test for glaucoma during this exam. Regardless of your ocular health, you should undergo a comprehensive exam at age 40. Based on the results of the exam, your doctor can recommend how often to undergo regular exams.

Can glaucoma be cured?

Glaucoma is chronic, meaning it cannot be completely resolved. However, it can be controlled in a way that will minimize vision loss. This typically involves taking either oral meds or eye drops that can optimize intraocular pressure by improving the outflow of fluids from the eye. Healthy lifestyle practices such as a nutritious diet, regular exercise, and abstinence from tobacco can also help to delay the development of glaucoma or prevent it from compromising your vision.

Can I use cannabis to control my glaucoma?

The American Academy of Ophthalmology doesn't recommend using cannabis as a treatment for glaucoma. However, glaucoma is a condition that qualifies for medical cannabis in Missouri. That means that if you have been diagnosed with glaucoma, you can register for a medical marijuana card and purchase cannabis. However, it is important to understand that cannabis doesn't come with recommended doses. As with any drug, it is best to consult a physician before you begin taking it. If you have questions about using medical cannabis as an open-angle glaucoma treatment, our doctors are open to having an honest discussion concerning the benefits, risks, and other aspects of this option. 

Will I need surgery?

If you are diagnosed with closed-angle glaucoma and conservative treatments like topical and oral meds are not effective in maintaining healthy eye pressure, we can explore the possibility of surgery. This involves making alterations to the tissues of the eye or inserting a drainage device to improve the outflow of fluid and avoid high intraocular pressure. The results ultimately lower your risk of partial vision loss or blindness.

Is it always a matter of high intraocular pressure?

No. There is a condition called normal-pressure glaucoma in which IOP that would be considered normal causes damage to the optic nerve. To date, it is unknown what causes this condition or why a normal IOP would damage the optic nerve. Those who are most likely to develop normal-pressure glaucoma are those with a family history of the condition, people of Japanese descent, people with low blood pressure, and people with systemic heart disease.

Do you recommend surgery?

Whenever it is safe to do so, we make conservative eye care treatment a priority. In other words, Dr. Buchser and Dr. Cohen will not recommend surgery unless your need is urgent or medications are not successful in controlling your IOP. During your eye exam, they will conduct a detailed assessment of your ocular health in order to determine the most effective and conservative approach to meeting your needs.

"Dr. Buchser and her staff are thorough and personable."


Christine Owens

St. Louis, MO


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Dr. Buchser and her staff are thorough and personable. My vision is much improved since I started receiving care here about a year ago. Dr. Buchser looks at my overall eye health, not only my vision. I'm very impressed with her care. My cousin and my friend both receive care from this office. Now my husband and I go here, as well. You won't find higher quality care anywhere.

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St. Louis, MO


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Dr. Noonan and her staff are always so attentive and professional. Some comments about long waits??? The only real "wait" I experienced was for my eyes to dilate. Good eye exams take time. I have never felt rushed through my exam like in less professional doctor's offices!

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The doctors at Cohen Eye Associates, Limited

Cohen Eye Associates, Limited

At Cohen Eye Associates in St. Louis, MO, our team offers a full-service optical shop to address all of your vision needs. We can provide you and your family a range of eye care services, from LASIK and cataract surgery to glaucoma treatment. Our doctors are members of national professional organizations including:

  • American Academy of Ophthalmology
  • American Medical Association
  • American Society of Cataract and Refractive Surgery
  • American Glaucoma Society
  • American Optometric Association

To schedule an appointment with our eye care specialists, contact us online or call us at (314) 361-5003.

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