Glaucoma

Treatment

There are several different treatments for glaucoma, including eye drops, laser treatment and surgery. The best treatment for you will depend on your circumstances.

Treatment can't reverse any loss of vision that has already occurred, but can help stop your vision getting any worse.

This page covers:

Your treatment plan

Your treatment largely depends on which type of glaucoma you have.

For example:

primary open angle glaucoma is usually treated with eye drops, or laser treatment or surgery if drops don't help
primary angle closure glaucoma often needs immediate treatment in hospital with medication to reduce the pressure in the eye, often followed by laser treatment
secondary glaucoma may be treated with eye drops, laser treatment or surgery, depending on the underlying cause
childhood glaucoma often requires surgery to correct the problem in the eye that led to the build-up of fluid and pressure

You will also often be advised to attend regular follow-up appointments to monitor your eyes and check that treatment is working. It's important not to miss any of these appointments.

The main treatments are described below.

Eye drops

Eye drops are the main treatment for glaucoma.

Types of eye drops

There are several different types that can be used, but they all work by reducing the pressure in your eyes.

The main types of eye drops are:

prostaglandin analogues, such aslatanoprost, bimatoprost, tafluprost and travoprost
Beta-blockers , such asbetaxolol hydrochloride, levobunolol hydrochloride and timolol
carbonic anhydrase inhibitors, such asbrinzolamide and dorzolamide
sympathomimetics, such asbrimonidine tartrate
miotics, such aspilocarpine

Eye drops can cause unpleasant side effects, such as eye irritation, and some aren't suitable for people with certain underlying conditions.

You may need to try several types before you find the one that works best for you. Sometimes you may need to use more than one type at a time.

Using eye drops

Eye drops are normally used between one and four times a day.

It's important to use them as directed, even if you haven't noticed any problems with your vision, because your sight is at risk if you don't stick to your recommended treatment.

To use eye drops:

use your finger to gently pull down your lower eyelid
hold the bottle over your eye and allow a single drop to fall into the pocket you have created in your lower lid
close your eye and keep it closed for a few minutes

If you're using two different types of eye drops, allow at leastfive minutes between using the different types.

Laser treatment

If eye drops don't improve your symptoms, laser treatment may be recommended.

This is where ahigh-energy beam of light is carefully aimed at part of your eye, to stop fluid building up inside it.

Types of laser treatment include:

laser trabeculoplastya laser is usedtoopen up the drainage tubes within your eye, whichallows more fluid to drain out of your eye and reduces the pressure inside it
cyclodiode laser treatmenta laser is used to destroy some of the tissue in the eye that producesaqueous humour (theliquid inside the eye), which can reduce pressure in the eye
laser iridotomy a laser is used to create holes in your iris (coloured part of the eye) toallow fluid to drain fromyour eye

Laser treatment is usually carried out while you're awake. Local anaesthetic drops areused to numb your eyes, although you may feel a brief twinge of pain or heat during the procedure.

You may still need to use eye drops after having laser treatment.

Surgery

Surgery may be recommended as an alternative to laser treatment in some cases.

Types of glaucoma surgery include:

trabeculectomy the most common type of operation, it involves removing part of the eye drainage tubes to allow fluid to drain more easily
trabeculotomy similar to a trabeculectomy, but an electric current is used to remove a small part of the eye drainage tubes
viscocanalostomy an operation to remove part of the sclera (the white outer covering of the eyeball), so fluid can drain from your eye more easily
deep sclerectomy operation an operation to widen the drainage tubes in your eye, sometimes by implanting a tiny device inside them
trabecular stent bypass anoperation toplace a tiny tube into your eye to increase the drainage of fluid

Glaucoma surgerymaybe carried out under local anaesthetic (where you're awake) or general anaesthetic (where you're asleep).