Glaucoma Surgery & Treatment

Glaucoma is a common condition where increased pressure within the eye causes damage to the optic nerve. It can affect anyone but is more common in those aged 60+. The condition is the result of increased fluid in the front element of the eye and, if not treated, can lead to loss of vision. The optic nerve is the link between the eye and the brain. For optimal vision, this pathway must work uninhibited. In the early stages of glaucoma, most people are asymptomatic, meaning that the only way the condition is diagnosed is through regular eye checks. While this can occur in anyone, the condition is known to be hereditary. This means if an immediate member of your family has glaucoma then this places you at a higher risk of developing the condition.

Before Glaucoma Treatment

You may experience severe eye pain, see halos around lights, be nauseous or vomiting, have a headache or loss of vision.

After Glaucoma Treatment

If treated right away your symptoms will subside and there should not be any damage to your vision.

How Do I Know if I Need Glaucoma Surgery?

The most common form of glaucoma, known as open-angle glaucoma, usually affects both eyes. The early stages don’t cause any noticeable symptoms. The condition is caused by a blockage that affects the circulation of the aqueous humor (the fluid in the eye) that flows in and out of the eye. This causes the pressure within the eye to rise. The condition usually develops slowly over several years, first affecting the peripheral vision. 

Because of the slow progression, many people aren’t aware that their vision’s becoming impaired. For this reason, it’s normally picked up during a regular eye test or when your medical doctor determines you may be at risk and refers you to a glaucoma specialist. 

While it’s unclear as to why some people develop the condition, the following are known to be risk factors:

  • Your ethnicity: Glaucoma is more common in those of Asian, African, Caribbean, and Hispanic descent.
  • Your age: The condition becomes more common as you age. It’s less common in those aged under 40 (although not unknown, and, rarely, children can also be affected).
  • Your family history: It’s known to be hereditary, so the risk factor is increased if a member of your immediate family has been diagnosed.
  • You suffer from the following medical conditions: Hypertension (high blood pressure), diabetes, heart disease, or sickle cell anemia.
  • You’ve been diagnosed with the following eye conditions: Thin corneas, high eye pressure, severe near or far-sightedness, or have a significant history of poor vision.
  • You regularly take high doses of certain steroid medications: Such as prednisolone. 

Other, less common, forms of glaucoma include:

  • Closed-angle glaucoma: This occurs when the drainage of the eye fluid suddenly becomes blocked, causing a rapid increase in pressure within the eye. It’s caused by the iris (the colored part of the eye) changing position. It tends to happen in one eye and, when it occurs very quickly, is a medical emergency. When one eye has been affected the other eye is also at risk.
  • Secondary glaucoma: This is due to a separate underlying condition, such as uveitis (an inflammatory condition of the eye), cataracts, or diabetes.

Childhood glaucoma: Also called congenital glaucoma, it’s a rare condition that develops at a young age. It’s caused by an abnormality of the eye.

What Happens During Glaucoma Surgery?

There are a variety of surgical treatments, all of which aim to reduce the pressure within the eye. If glaucoma eye surgery is deemed appropriate then a specialist has a range of options available. The choice will be determined by the type of glaucoma, its severity, and any other health issues you have.

Glaucoma laser surgery and eye surgery treatment possibilities include:

  • Selective laser trabeculoplasty (SLT): A form of glaucoma laser surgery used to treat open-angle glaucoma, whereby the surgeon increases the fluid drainage from the eye. A small incision is made near the iris to achieve this.
  • Laser iridotomy: Another type of glaucoma laser surgery, the pressure within the eye is reduced by making a small opening in the iris itself. This is commonly used in cases of closed-angle glaucoma.
  • Filtering surgery: This is a glaucoma surgical procedure that involves the removal of a tiny area of the eye wall (sclera) to allow the fluid to drain. It’s used for all types of glaucoma—the most common type is called a trabeculoplasty.
  • Shunt procedure: Again, an option for all glaucoma types, it involves the placement of a tiny tube within the eye through which the fluid can drain.

Selective laser trabeculoplasty is a popular choice to treat the most common form of glaucoma. It’s often the procedure of choice when eye drops and/or other medications have failed to lower the internal eye pressure to an adequate degree, or the side effects are too severe. It’s safe and fast, with a high success level. However, there is a likelihood that it will have to be repeated in the future.

SLT is performed by a glaucoma specialist. Your eyes will be numbed with eye drops and a special contact lens placed on the eye. This surgeon uses a high-energy laser to make up to 100 minuscule burns to the trabecular meshwork within the eye. It takes less than 10 minutes to perform and there is very little discomfort. Most people report seeing some brief flashes of light while the treatment is carried out. Afterward, you should be able to go home.

How Can A Glaucoma Specialist Help With This Condition?

Glaucoma is usually picked up during a routine eye exam. Sometimes your medical doctor might refer you if he or she feels you may be at risk. If you’re diagnosed with the condition then regular monitoring will be necessary. The tests for glaucoma are simple to carry out and painless. The specialist will use drops that dilate the pupil, allowing them to examine your optic nerve in detail. Images will be taken so they can be compared in the future. You’ll also undergo tests that test your peripheral field of vision and carry out an eye pressure test. The latter is known as tonometry. The first course of action to treat the condition is usually eye drops, medication, or a combination of the two. 

 How eyedrops and medication work

 Eye Drops work in one of two ways. They either increase the flow of fluid from the eye or decrease the creation of it. Either way, this helps reduce the pressure.  Oral medication can also do the same, with carbonic anhydrase inhibitors or beta-blocker being the most commonly used. This drug route often has unwanted side effects. These include redness and stinging of the eyes, blurred vision and irritation, and allergies. In some cases, the drugs can affect the cardiovascular system. It’s important to tell your glaucoma specialist about any other medication you take to prevent undesirable drug interactions.

 Glaucoma surgery and glaucoma laser surgery options

If the above-mentioned side effects become too much or the eye drops and medication fail to adequately treat the problem then your specialist is likely to recommend surgery. Each person’s condition is unique and your surgeon will discuss the best option for you. Whether this involves microsurgery or laser surgery it may mean that you no longer need to use drops and/or medication to control the glaucoma. Surgical options all work to reduce the pressure within the eye through increasing the drainage. 

 Procedures are determined as:

  • A trabeculoplasty: To open up the drainage of the eye
  • An iridotomy: Creates a tiny hole in the iris that helps the fluid to flow freely
  • A cyclophotocoagulation: The middle layer of the eye is treated to lower the production of fluid
  • A trabeculectomy: A filtering procedure created by the removal of a tiny area of the eye wall
  • A shunt: The placement of a small tube within the eye through which the fluid can drain.

Not all procedures are suitable for all types of glaucoma, nor are they the right option for each individual. Your surgeon will determine the optimal solution in conjunction with you. Whatever option is chosen, you’ll need regular monitoring afterward to ensure the treatment is working. In some cases, glaucoma laser surgery is carried out more than once to confirm its continued efficiency.

Glaucoma Eye Drops


Glaucoma Drainage Implant


What is glaucoma?

Glaucoma is an eye disease in which the optic nerve is damaged. Usually, high pressure inside the eye causes the damage. The damage can lead to a loss of vision. However, early treatment can prevent blindness.

How does it occur?

A clear, watery fluid called the aqueous humor normally circulates in your eye. When the flow of this fluid out of the eye becomes blocked, the pressure increases inside the eye. The increased pressure can damage the optic nerve.

There are two main types of glaucoma, depending on how the flow of fluid is blocked:

  • Open-angle glaucoma is caused by a gradual blockage in the area that drains fluid from the eyes into the drainage channels. It is the more common type of glaucoma in the US and Europe. It usually affects both eyes.
  • Closed-angle glaucoma is a blockage caused by a change in the position of the iris (the colored part of the eye). The change in position causes the iris to block the drainage channels. This type of glaucoma usually happens in one eye at a time. If you get glaucoma in one eye, you are at risk for having the same problem in the other eye. When this type of glaucoma happens suddenly, it is called acute closed-angle glaucoma and is a medical emergency.

Glaucoma tends to run in families. It occurs most often after age 35, but sometimes children have it. Glaucoma is a common eye problem in people over age 60. It is more common among black people than white people.

What are the symptoms?

Open-angle and other chronic forms of glaucoma often have no symptoms in the early stages. In later stages, you will begin to notice a loss of vision. Side vision is affected first.

Symptoms of acute closed-angle glaucoma include:

  • severe eye pain
  • seeing halos around lights
  • nausea and vomiting
  • headache
  • loss of vision.

How is it treated?

The goal in the treatment of glaucoma is to reduce the pressure in your eyes. This may be done with eye drops, oral medication, laser surgery, or other types of surgery. Some eyedrops reduce the amount of fluid made by your eye. Others increase the amount of fluid that flows out. Surgery relieves pressure inside the eye by opening up the drainage channel or by making another opening through which the fluid can drain.

Make sure your health care provider tells you about possible side effects of any medication you are taking. If you have concerns, call your provider.

How long will the effects last?

Loss of vision caused by glaucoma is permanent. This is why glaucoma needs to be diagnosed and treated early to stop further damage to the optic nerve.

If your health care provider prescribes medication to control the pressure, you may need to take it for the rest of your life.

How can I take care of myself?

  • Take your medication as prescribed.
  • Carefully follow your health care provider’s recommendations for follow-up visits and pressure measurements.
  • Call your health care provider if you have any side effects from your medication.

How can I help prevent glaucoma?

Glaucoma cannot be prevented. However, blindness can be prevented if glaucoma is treated before pressure in the eye has damaged the optic nerve too much.

You may be able to help prevent glaucoma from becoming severe if you:

  • Have a regular eye exam. How often you need to see the eye doctor will depend on how severely your optic nerve was damaged.
  • At your eye exam, make sure the pressure in your eye is measured and that your optic nerve is examined.
  • Learn about your family history. Chronic open-angle glaucoma often runs in families.
  • See your health care provider at once if you see halos around lights or notice any changes in your vision.

Is glaucoma hereditary?

While the exact cause of some glaucoma is not always apparent, it’s known that the most common type—open-angle glaucoma–is hereditary. This means that if you have an immediate family member with the condition (father, mother, sibling) then your risk of developing the condition is increased by four to nine times, according to the Glaucoma Research Foundation.

Can glaucoma be cured?

At present, there is no cure for glaucoma. Treatment involves slowing the process to the extent that no vision loss occurs. However, the condition is the subject of much research, with the aim of one day finding a cure. Current strategies being explored include gene therapy and optic nerve cell regeneration. These studies and trials take years to complete. As it stands the advanced laser and surgical solutions for treating glaucoma are the most successful methods on offer for slowing or stopping the progression of the disease.

How to treat glaucoma

There are several options to treat glaucoma. Following a diagnosis, the first line of attack is usually that of prescription eye drops and/or oral medication. The sooner treatment begins the better. While it won’t cure the condition it will slow or prevent its progression.

Other options to treat glaucoma are laser treatment or microsurgery. There are several different options, each of which aims to lower the pressure within the eyes by enabling the fluid to drain more freely.

Anyone with or at risk of glaucoma should undergo regular eye exams to monitor the disease.

What does glaucoma look like?

During the early stages of glaucoma development, there are normally no symptoms. Indeed, it’s believed that half of the people affected aren’t aware they have the condition. As it worsens the peripheral (side) vision starts to be affected, especially that which is closest to your nose. The problem is that as the progression is very slow, it’s almost imperceptible—at least at first. 

However, as it worsens you may become aware that you can’t see things to the side anymore, might have blurred vision, or you might see rainbow-colored halos around bright lights. If the condition isn’t treated it will progress to complete and irreversible loss of vision. In most cases, the condition occurs in both eyes.

Other, rarer forms of glaucoma can cause acute symptoms, such as. 

  • Redness
  • Intense eye pain
  • Seeing halos around lights
  • Loss of vision
  • Hazy or blurred vision
  • Headache
  • Nausea and vomiting
  • Tenderness around the eyes

If this should occur you must immediately seek professional help as this is a time-critical medical emergency. If you don’t have a regular ophthalmologist to contact, carry out an online search for glaucoma specialist near me or best glaucoma specialist near me. Failing that you should present at the nearest ER (emergency room)

What is the first sign of glaucoma?

Usually, there are no initial noticeable signs that you have glaucoma. This is because it commonly develops slowly over several years. However, for those that do notice symptoms they might include:

  • Blurred vision
  • Seeing rainbow-colored circles around lights
  • Noticing that your peripheral vision has diminished

What is glaucoma surgery?

Glaucoma surgery is carried out via laser or microsurgery. There are different types of treatments, the most suitable of which will be determined by a glaucoma specialist. Advanced technologies are used that will reduce the cause of glaucoma—increased pressure within the eye. This is done either by creating a small duct through which the eye fluid can drain effectively or improving the integrity of the natural drainage of the eye.

Some specialist ophthalmologists offer more treatments than others. Discussing the best option for you could mean that your eye doctor decides to refer you to a clinician who can carry out the optimal treatment for your condition.