In some embodiments, an ophthalmic laser system may be provided that does not include a traditional laser console. Instead, the treatment device may be configured to house the treatment light source within the device handle. Additionally, in some embodiments, the handheld treatment device may include a user interface, such as dials and buttons, for adjusting various parameters of the therapeutic light. With certain embodiments, the self-contained handheld treatment device may be operated independent of an AC power source. For example, in some embodiments, the handheld treatment device may be battery powered. Additionally, the handheld treatment device may be disposable or may utilize replaceable distal tips in certain embodiments. Certain embodiments may be particularly designed for transscleral cyclophotocoagulation. Also, treatment guides are provided that may be configured to couple with a treatment device to align the device with a target tissue of the eye.

An imaging probe comprises a camera or endoscope with an external detector array, in which the probe is sized and shaped for surgical placement in an eye to image the eye from an interior of the eye during treatment. The imaging probe and a treatment probe can be coupled together with a fastener or contained within a housing. The imaging probe and the treatment probe can be sized and shaped to enter the eye through an incision in the cornea and image one or more of the ciliary body band or the scleral spur. The treatment probe may comprise a treatment optical fiber or a surgical placement device to deliver an implant. A processor coupled to the detector can be configured with instructions to identify a location of one or more of the ciliary body band, the scleral spur, Schwalbe's line, or Schlemm's canal from the image.

An initial treatment pattern defining an initial volume of ocular tissue to be modified for treating glaucoma is designed. An initial laser treatment is delivered by scanning a laser beam across ocular tissue at an initial placement in the eye in accordance with the initial treatment pattern to thereby photo disrupt the initial volume of ocular tissue. A postoperative measure of intraocular pressure (IOP) is evaluated relative to an IOP criterion to determine if the treatment was successful. If the treatment was not successful, meaning the IOP criterion was not satisfied, then a subsequent treatment pattern that defines a subsequent volume of ocular tissue to be modified, and/or a subsequent placement in the eye is determined. A subsequent laser treatment is delivered by scanning a laser beam across ocular tissue at the subsequent placement within the eye in accordance with the subsequent treatment pattern to thereby photo disrupt the subsequent volume of ocular tissue.

A device for visualizing an irido-corneal angle of an eye through a window of a patient interface configured to be placed on the eye includes and optics structure and at least one imaging apparatus. The optics structure is configured to engage with the patient interface to provide a line of sight through the window in the direction of the irido-corneal angle, and to subsequently disengage from the patient interface. The imaging apparatus is associated with the optics structure and aligned with the line of sight to enable capturing an image of the eye including the irido-corneal angle.

An imaging probe comprises a camera or endoscope with an external detector array, in which the probe is sized and shaped for surgical placement in an eye to image the eye from an interior of the eye during treatment. The imaging probe and a treatment probe can be coupled together with a fastener or contained within a housing. The imaging probe and the treatment probe can be sized and shaped to enter the eye through an incision in the cornea and image one or more of the ciliary body band or the scleral spur. The treatment probe may comprise a treatment optical fiber or a surgical placement device to deliver an implant. A processor coupled to the detector can be configured with instructions to identify a location of one or more of the ciliary body band, the scleral spur, Schwalbe's line, or Schlemm's canal from the image.

An imaging probe comprises a camera or endoscope with an external detector array, in which the probe is sized and shaped for surgical placement in an eye to image the eye from an interior of the eye during treatment. The imaging probe and a treatment probe can be coupled together with a fastener or contained within a housing. The imaging probe and the treatment probe can be sized and shaped to enter the eye through an incision in the cornea and image one or more of the ciliary body band or the scleral spur. The treatment probe may comprise a treatment optical fiber or a surgical placement device to deliver an implant. A processor coupled to the detector can be configured with instructions to identify a location of one or more of the ciliary body band, the scleral spur, Schwalbe's line, or Schlemm's canal from the image.

A laser delivery system is configured to delivery light energy to soften and realign the tissue of the eye in order to increase accommodation and treat glaucoma. The laser system can be configured to increase a circumlental space of the eye and increase movement of a posterior vitreous zonule in order to increase accommodation. The light energy may comprise wavelengths strongly absorbed by collagen of the sclera. In many embodiments a heat sink is provided to couple to the conjunctiva and the heat sink comprises a material transmissive to the light energy absorbed by collagen, for example Zinc Selenide. The heat sink can be chilled to inhibit damage to the conjunctiva of the eye. In many embodiments, one or more layers of the epithelium of the eye remain substantially intact above the zone where the eye has been treated when the heat sink has been removed.

Systems for treatment of glaucoma comprise an excimer laser, a plurality of fiber probes, and a processor. Each fiber probe is attachable to the excimer laser to treat a subject having glaucoma by delivering shots from the laser. The processor is configured to monitor and limit a variable number of shots delivered by each fiber probe, the number of shots delivered by each fiber probe programmable within a range. Methods of treating glaucoma include programming a fiber probe to deliver a number of shots from an excimer laser. The fiber probe is inserted into an eye of a subject having glaucoma and adjusted to a position transverse to Schlemm's canal in the eye. A plurality of shots is applied from the excimer laser source while the probe is in the transverse position, thereby treating glaucoma by creating a plurality of perforations in Schlemm's canal and/or the trabecular meshwork.

Transcorneal and fiberoptic laser delivery systems and methods for the treatment of eye diseases wherein energy is delivered by wavelengths transparent to the cornea to effect target tissues in the eye for the control of intraocular pressure in diseases such as glaucoma by delivery systems both external to and within ocular tissues. External delivery may be affected under gonioscopic control. Internal delivery may be controlled endoscopically or fiberoptically, both systems utilizing femtosecond laser energy to excise ocular tissue. The femtosecond light energy is delivered to the target tissues to be treated to effect precisely controlled photodisruption to enable portals for the outflow of aqueous fluid in the case of glaucoma in a manner which minimizes target tissue healing responses, inflammation and scarring.

The invention provides personalized laser probes for use in laser systems, wherein each laser probe includes one or more characteristics tailored to a given user to thereby improve performance of and outcome of a laser treatment procedure.