Services:

New Patient Exam

I focus on your chief eye concerns. Medical and surgical history and pertinent systemic review are completed. Allergies and present medications are recorded. A complete, dilated exam is performed. I use this information to assess your treatment plan. A summary letter is sent to you after our discussion.

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Visual Field Testing

This is the key study on the health of your peripheral vision. In general, glaucoma is first revealed by a loss of peripheral vision that can be detected by a visual field exam often before you are symptomatic. Visual field testing is done in my office with a specialized, automated computer system to study peripheral vision. It is not painful.

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OCT - Optical Coherence Tomography


We use the FD_OCT Fourier-Domain Optical Coherence Tomography system. In the FD_OCT technology the data information is acquired by a camera. The ultra-high speed and high resolution features enable the FD_OCT to visualize the retina and optic nerve tissue with extremely high clarity in a fraction of a second.

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Surgery for Glaucoma Control

Glaucoma surgeries require opening the sclera (the white of the eye) to allow fluid to pass behind the eyeball. This is called a trabeculectomy. Frequently a medication is used to prevent scar tissue formation and keep the passage open. Antimetabolites such as mitomycin C or 5-FU are available. Blood vessels behind the eye absorb the fluid and help lower the eye pressure. An ExPress Mini Shunt can be used with a trabeculectomy to enhance the success of the trabeculectomy surgery. Sometimes a drainage tube implant is required. This is usually reserved for more complicated glaucomas, such as for diabetics, uveitis, or repeat glaucoma surgeries. In this case the tube is connected to a plate that is put on the side of the eye. These surgeries can be done on an outpatient basis.

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Laser for Glaucoma Control

Sometimes glaucoma is treated with lasers. The iridotomy is done for angle closure glaucoma and creates a new passage through the iris tissue to drain fluid. This may lower eye pressure. The more common trabeculoplasty lowers pressure by changing the trabecular meshwork and allowing for better drainage. This treatment uses the SLT or ALT laser. A Diode laser, cyclophotocoagulation (CPC), lowers the production of fluid by treating the ciliary body and therefore lowers eye pressure. I am very experienced with all laser treatments. Laser treatments are done at a surgical center as an outpatient procedure.

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Glaucoma Medications

Most glaucoma treatment is aimed at lowering eye pressure to a level that is safe for you. Prescription eye drops have been shown to lower eye pressure and therefore preserve eyesight. It is often the first treatment used in glaucoma. I choose the medication for you based on its potency, efficacy and cost burden. For many patients, eye drops are all that are required to control eye pressure.

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More about Robert L. Shields, M.D., P.C.

Glaucoma Practice Goals - Medical Treatment and Consultation, Laser, Glaucoma Surgery with a state-of-the-art empathetic, experienced team understanding.

Fellowship Trained Glaucoma Specialist

Professional Societies:
American Academy of Ophthalmology (AAO)
American Glaucoma Society (AGS)
Colorado Society of Eye Physicians and Surgeons (formerly-CO Ophthalmological
Society) (CSEPS)

Professional Activities:
Private Practice: 1981 to Present
Associate Clinical Professor, University of Colorado Health Sciences Center
Pharmaceutical Research Investigator
Regional Lecturer

Education:
Board Certification: American Board of Ophthalmology - 1981
Fellowship: University of Wisconsin Medical School, Madison, WI - Glaucoma - 1980-1981
Residency: University of Colorado Medical Center , Denver, CO - 1976-1980
Internship: Presbyterian Medical Center, Denver, CO - Rotating - 1976-1977
Medical School: University of Colorado Medical Center, Denver, CO - 1972-1976

Personal:
Born: Denver, CO, February 1950
Married, one daughter, one son
Hobbies: Skiing, Photography, Hiking

Major Glaucoma Surgeries: Trabeculectomy, ExPress Mini Shunts,Tube Implants, Trabeculoplasty, Cyclophotocoagulation


I am pleased to have membership with the American Glaucoma Society (AGS), American Academy of Ophthalmology (AAO) and the Colorado Society of Eye Physicians and Surgeons (CSEPS). My work also includes being a glaucoma pharmaceutical research investigator and a regional lecturer on Glaucoma.

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