Glaucoma is a group of eye diseases that affect the optic nerve. This condition generally affects peripheral vision first but can lead to blindness over time.
Causes of glaucoma vary, meaning that there are several treatment options depending on your individual case. Medication and surgery can help prevent or slow further vision loss, although there’s no cure.
Eye drops and other medications are usually considered first-line treatment for glaucoma. The goal of these medications is to help remove excess fluid from the eye to avoid a buildup of pressure, which affects the optic nerve.
Sometimes medications aren’t enough to effectively treat glaucoma, and your doctor may recommend laser therapy or surgery. Surgery is a common approach to treating glaucoma when conservative measures have failed.
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Read on to learn what to expect from the common surgical procedures used to treat glaucoma.
Trabeculectomy surgery is used for a type of glaucoma called open-angle. This common glaucoma happens when fluid in the eye is not able to drain properly, causing the pressure in the eye to increase.
A trabeculectomy is a major procedure. It takes around an hour or less to complete. It may be done under local (you’ll be awake) or general (you’ll be asleep) anesthesia.
During the procedure, your surgeon will begin by either numbing the area or administering general anesthesia. They’ll then make an incision in the top of your eye beneath your eyelid to create a channel, or “bleb,” to drain the excess fluid. They’ll then place stitches to hold open the bleb.
Following the procedure, your surgeon will place a patch over your eye, and you’ll be able to go home. You’ll need to wear the patch until at least the next day when you’ll return to the surgeon for a follow-up appointment.
Your surgeon will remove your stitches when your eye is ready, usually around 2 weeks later.
Glaucoma implant surgery, also known as a tube shunt, may be recommended if you have neovascular or congenital glaucoma, though it may also be an option for people with other types of glaucoma.
This procedure can take 1 to 2 hours and involves implanting a tiny tube, or shunt, in the eye.
The tube implants lower pressure in the eye by allowing extra fluid to drain. It’s typically done on an outpatient basis with a local anesthetic. The surgery is typically done under light sedation, but occasionally general anesthesia is required.
MIGS uses micro-incisions and microscopic-sized equipment to relieve pressure in your eye. This
MIGS is only used for mild cases of glaucoma, but it’s rising in popularity and availability. However, while MIGS is a shorter surgery and has less risk of complications, some experts argue that it isn’t as effective as gold standard procedures like the trabeculectomy and that there isn’t enough long-term data yet.
The tiny, specialized equipment needed to perform MIGS is also very expensive, which can be prohibitive for some patients when not covered by insurance.
Cyclophotocoagulation is a laser treatment for glaucoma and works by reducing both pressure and fluid production in the eye.
CPC targets the eye’s ciliary processes, meaning the ways fluid is produced. This is because many cases of glaucoma are associated with excess fluid in the eye, leading to increased pressure.
You’ll remain awake during CPC. A local anesthetic is used to numb your eye, and the procedure will only take a few minutes. There are several different types of CPC, some of which are more invasive than others.
The changes the laser makes to your eye during CPC may not last. The ciliary processes can recover in some cases, meaning they might go back to causing too much fluid and pressure.
Whether you need surgery for glaucoma depends on several factors, including:
- whether other glaucoma treatments have worked
- how severe your glaucoma is
- other co-occurring eye conditions you have (and other chronic health conditions)
Keep close tabs on your vision changes when you have glaucoma, attend regular doctor appointments, and bring up any new symptoms right away. Because vision loss due to glaucoma is permanent, it’s important that you’re proactive.
Talk with your doctor about whether surgery may be the best next step in your glaucoma treatment plan.
As with any medical procedure, there are risks and complications that can happen with glaucoma surgery. In most cases, glaucoma surgery is effective at managing vision loss, though it isn’t a cure.
After surgery, it may take up to a few weeks for swelling and soreness in the eye to fully heal. Complications after surgery can include:
- eye dryness
- eye pain or discomfort
- low pressure in the eye
- loss of vision
Aftercare instructions will vary depending on what procedure you have. Always follow your doctor’s care instructions, attend follow-up appointments, and take any medications as directed.
Further treatment options
Other approaches for treating glaucoma include medications, laser therapies, and low vision aids to manage vision loss.
Glaucoma is treatable, but it can’t be fully prevented or cured. Getting a prompt diagnosis can help preserve your vision, so you should prioritize attending routine eye examinations.
Maintaining healthy habits can benefit your overall eye health.
- not smoking (or ceasing smoking)
- eating a balanced diet
- exercising regularly
- getting plenty of sleep
- maintaining healthy blood pressure and cholesterol levels
- protecting your eyes in the sun
Glaucoma is a common eye disease that can lead to permanent vision changes and loss. Timely diagnosis and treatment are essential for the best possible outcome. Glaucoma is treated with a combination of medication (often eye drops), laser therapy, and surgeries.
There may not be any symptoms at all in the early stages of glaucoma, so it’s important to get regular eye examinations to screen for this and other eye conditions.
Surgery for glaucoma is considered safe and effective. There are several different types of procedures, which aim to reduce fluid and pressure in your eye.
Talk with your doctor about whether surgery might be your next best step, especially if conservative treatments haven’t worked.