What is Glaucoma Surgery?
Glaucoma surgery is a medical procedure designed to lower intraocular pressure (IOP) inside the eye. High eye pressure is the main risk factor that damages the optic nerve, the structure responsible for carrying visual signals to the brain. If left untreated, this damage can cause gradual, irreversible vision loss.
Surgery is usually recommended when:
- Eye drops and oral medications are not effective.
- Laser treatments fail to control eye pressure.
- The glaucoma is progressing quickly and vision is at risk.
The main goal of surgery is not to restore lost vision but to preserve remaining vision and prevent further optic nerve damage. Understanding the glaucoma surgery procedure helps patients know what to expect before and after surgery.
Types of Glaucoma Surgery
Several types of procedures are available. The choice depends on the severity of glaucoma, eye anatomy, patient age and overall health.
Trabeculectomy
- What it is: A traditional and widely used glaucoma surgery.
- How it works: The surgeon creates a tiny flap in the sclera (the white of the eye) and forms a small reservoir (bleb) under the conjunctiva. This allows excess fluid (aqueous humor) to drain, lowering eye pressure.
- When it's used: Often recommended in moderate to severe glaucoma cases or when medications fail.
Glaucoma Drainage Devices (Shunts or Stents)
- What it is: Small implants made of silicone or other safe materials.
- How it works: The device channels excess fluid from inside the eye to an external reservoir, where it is absorbed naturally by surrounding tissues.
- When it's used: In advanced or complex cases, or when trabeculectomy is not suitable.
Minimally Invasive Glaucoma Surgery (MIGS)
- What it is: A newer class of procedures that use tiny incisions and micro-instruments.
- How it works: MIGS surgeries enhance the eye's natural drainage system with minimal tissue damage. They often involve stents or microscopic shunts.
- Benefits: Faster recovery, fewer complications, and less risk of scarring compared to traditional surgery.
- When it's used: Early to moderate glaucoma, often combined with cataract surgery.
Laser Surgery
Laser techniques are often the first surgical step before incisional surgeries:
- Trabeculoplasty: Improves drainage through the trabecular meshwork.
- Iridotomy: Creates a tiny hole in the iris to relieve pressure in angle-closure glaucoma.
- Cyclophotocoagulation: Reduces fluid production by targeting the ciliary body.
30 Min-2 Hours
Surgery Duration
Local Anesthesia
Anesthesia Used
4-6 Weeks
Full Recovery Timeline
When is Glaucoma Surgery Recommended?
Glaucoma surgery is considered when other treatments, such as eye drops or laser therapy, no longer provide enough control over eye pressure. The main goal of surgery is to protect the optic nerve and preserve the remaining vision.
Common Situations Where Surgery is Needed:
- Uncontrolled Eye Pressure: Even with strong medications or laser procedures, the eye pressure remains higher than safe levels. Persistently high pressure increases the risk of further optic nerve damage.
- Progressive Vision Loss: Despite following treatment, the patient continues to lose vision. Surgery is then recommended to slow down or stop further damage.
- Severe Optic Nerve Damage: When the optic nerve already shows advanced damage, lowering the pressure more aggressively through surgery may be the only way to protect the remaining vision.
- Side Effects or Poor Tolerance to Medications: Some patients cannot tolerate eye drops due to allergic reactions, redness, irritation, or systemic side effects. In such cases, surgery offers a more sustainable solution.
How to Prepare for Glaucoma Surgery
Make surgery safe, smooth, and stress-free. Follow your surgeon's plan. The notes below are general and do not replace your doctor's advice.
Medical evaluation & tests
- Complete eye work-up: vision check, eye pressure check, visual fields, OCT scan (a painless 3-D picture of the retina and optic nerve).
- Health review: Our staff will go over your medical history, medicines, allergies, and do any needed tests (for example: blood work, ECG). Bring an updated medication list.
- If you are unwell: tell the staff if you have a cough, fever, cold sore, stye, or a red, painful eye. Your date may need to change for safety.
Lifestyle & medication adjustments
- Blood thinners and pain pills: ask before stopping anything. Your doctor may pause aspirin, clopidogrel, warfarin, some NSAIDs, or certain supplements that raise bleeding risk. Never stop on your own.
- Smoking: quitting several weeks before surgery lowers risks and helps healing. Even cutting down helps.
- Exercise and sleep: gentle daily activity and good sleep help recovery. Keep it light the day before surgery.
- Diabetes, blood pressure, or heart disease: ask how to take your usual morning medicines on surgery day (for example, insulin changes). Bring readings if you track them.
Home preparation
- Ride and support: you cannot drive yourself home. Arrange a trusted adult to take you home and stay with you the first evening.
- Set up a "recovery corner": chair or bed with extra pillows, tissues, hand sanitizer, a small trash bag, and a table for drops and a water bottle.
- Lighting and safety: remove trip hazards, add a night light, and keep pets and children away from your resting spot the first day.
- Stock up: fill any prescribed drops in advance (antibiotic or anti-inflammatory drops may start before or right after surgery, follow your plan).
The day before surgery
- Fasting rules (if sedation or general anesthesia): follow the exact times our team gives you for when to stop food and drinks. This is vital for safety.
- Hygiene: shower or bathe; avoid eye makeup. Do not use face creams or lotions near the eyes.
- Clothing: set out loose, front-button or zip-front clothes for easy changing.
- Questions: write down last-minute questions about the plan, drops, time off work, or the ride home.
The morning of surgery
- No makeup, false lashes, perfume, or aftershave. Skin should be clean and dry.
- Which drops to take: use only the prescribed antibiotic drop and skip glaucoma drops that morning, but follow your own surgeon's sheet.
- Regular medicines: take them only as directed by your doctor (a few pills may be paused; others you should take with a small sip of water).
- Arrival time: arrive early for check-in, consent, and a pre-op nurse review. Many glaucoma surgeries are day-case procedures.
- After-surgery plan: your first follow-up is often the next day. Keep your phone on and transport ready.
Quick do & don't checklist for Glaucoma Surgery
Do
- Follow fasting times exactly.
- Wear loose, comfortable clothing.
- Arrange a ride and a helper at home.
- Bring your medication list and eye drops.
Don't
- Stop any medicine unless your doctor says so.
- Wear eye makeup, lotions, perfume, or aftershave.
- Drive yourself to or from surgery.
What Happens During Glaucoma Surgery?
Glaucoma surgery is performed to lower eye pressure by improving the way fluid drains out of the eye. This helps protect the optic nerve and prevent further vision loss. While the exact method depends on the type of surgery, most follow a similar process.
Preparation and Anesthesia
- Before the operation, the eye is cleaned and prepared in a sterile environment.
- Local anesthesia (numbing injection or drops) is given so the patient feels no pain, though they may remain awake.
- In children or certain cases, general anesthesia may be used.
Creating an Access Point
- The surgeon makes a very small incision in the eye's surface.
- This allows access to the drainage system where the fluid (aqueous humor) normally flows.
Main Surgical Technique
Depending on the patien's condition, the surgeon may:
- Trabeculectomy: Create a tiny flap in the sclera (white of the eye) to let fluid drain into a small blister-like pocket under the eyelid.
- Glaucoma Implant Surgery: Place a small tube or device that redirects fluid to another drainage area.
- Laser Procedures: Use a laser to either open drainage channels or reduce fluid production.
Closure
- Once the main step is complete, very fine stitches may be used to secure the flap or incision.
- If a laser is used, no stitches are needed.
- The eye is then covered with a protective shield.
Recovery Room
- After surgery, the patient rests for a short time while their vital signs and comfort are monitored.
- Eye drops or medications are prescribed to reduce inflammation and prevent infection.
- Most patients go home the same day, though follow-up visits are necessary to check healing and eye pressure.
Who Performs the Glaucoma Procedure?
Glaucoma surgery is usually performed by ophthalmologists, specifically those who specialize in treating glaucoma.
If you suspect you have glaucoma or have been diagnosed with it, you should contact an ophthalmologist or a glaucoma specialist. You can obtain referrals from your primary care physician or optometrist.
What to Expect After Glaucoma Surgery
Recovering from glaucoma surgery is a step-by-step process. Most patients notice gradual improvement over weeks to months. Following your doctor's advice and caring for your eyes properly will help you heal well and protect your vision.
The average glaucoma surgery recovery time is 4 to 6 weeks, though healing continues for several months.
The First Few Days
- What to expect: Mild discomfort, redness, watery eyes, or slightly blurry vision are common. Some patients also feel a scratchy sensation as the eye heals.
- Eye drops: Use the prescribed drops exactly as instructed. They reduce swelling, prevent infection, and help control eye pressure.
- Activity tips: Rest your eyes, avoid bending over or straining, and sleep with your head slightly raised if recommended.
Weeks 2-4
- Vision changes: Vision usually becomes clearer and more stable during this period.
- Protecting your eye: Avoid rubbing your eyes, lifting heavy objects, or doing strenuous activities such as running, swimming, or gym workouts.
- Check-ups: Your doctor may adjust medications and monitor eye pressure closely.
Weeks 5-6
- Resuming daily life: Most patients can return to normal household tasks, work, and light exercise.
- Protective habits: Wearing sunglasses outdoors can reduce sensitivity to light and protect the healing eye.
3-6 Months
- Long-term healing: The eye continues to settle, and the full benefits of surgery, better eye pressure control and stable vision, become more noticeable.
- Ongoing care: Some patients may still need eye drops or other treatments to maintain healthy pressure levels. Regular eye exams remain essential.
Key Points to Remember
- Healing is gradual and varies for each patient.
- Follow all post-surgery instructions, especially regarding eye drops.
- Avoid rubbing, straining, or exposing the eye to dust and water in the early weeks.
- Keep all follow-up appointments to track your recovery and prevent complications.
Benefits of Glaucoma Surgery
Glaucoma surgery offers several important advantages for patients living with this eye condition. The primary goal is to protect vision and maintain long-term eye health. Key benefits include:
- Effective Pressure Control: Surgery can lower intraocular pressure (IOP) more consistently than medications alone. This helps protect the optic nerve from further damage.
- Slowing or Preventing Vision Loss: By controlling IOP, surgery slows down or stops the progression of glaucoma-related vision loss, which is often irreversible once it occurs.
- Reduced Dependence on Medications: Many patients are able to reduce or completely stop the use of daily eye drops after surgery, lowering both cost and side effects linked to long-term drug use.
- Improved Comfort: Surgery may relieve discomfort caused by high eye pressure, such as eye pain, headaches, or blurred vision.
- Better Quality of Life: With stable vision and less reliance on drops, patients often experience greater independence in daily activities, including reading, driving, and working.
Risks of Glaucoma Surgery
Although glaucoma surgery is considered safe and effective, like any surgical procedure it carries certain risks. These risks may vary depending on the type of surgery performed and the individual's overall eye health. Common risks include:
- Eye Infection (Endophthalmitis): Rare but serious, this occurs when bacteria enter the eye during or after surgery. Prompt treatment is essential.
- Bleeding Inside the Eye: Small hemorrhages can occur during or after surgery, usually resolving with medical care, but in rare cases may affect vision.
- Cataract Formation: Surgery can sometimes speed up the natural development of cataracts, leading to cloudy vision that may later require cataract surgery.
- Scarring of Drainage Pathways: After surgery, scar tissue may form in the eye, reducing the effectiveness of fluid drainage and potentially requiring further procedures.
- Temporary or Permanent Vision Changes: Some patients experience blurred vision, double vision, or a slight decrease in visual clarity. While often temporary, in rare cases changes may persist.
Glaucoma Surgery Cost in India
The cost of glaucoma surgery in India varies depending on the type of surgery, surgeon's expertise, and hospital facilities. On average, it ranges from Rs. 18,000 to Rs. 55,000. To know the exact cost, please contact our support team.
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