What is glaucoma?

The optic nerve carries images from the retina (light-sensitive layer at the back of your eye) to your brain, allowing you to see.

Glaucoma is the name given to a group of conditions that cause damage to the optic nerve where it leaves your eye. Glaucoma can cause loss of vision.

Glaucoma is usually caused by an increase in pressure in your eye

Sometimes the optic nerve can be damaged, even though the pressure in your eye is within the normal range.

What are the benefits of surgery?

The aim is to lower the pressure in your eye to delay further damage to the optic nerve. This should prevent further loss of vision.

Are there any alternatives to surgery?

You can use eye drops to lower the pressure.

Laser treatment may be suitable for you but is often less effective than surgery in lowering the pressure in your eye.

There are other types of glaucoma surgery, including the following:

• tube-shunt surgery
• trabecular stent bypass
• deep sclerectomy
• viscocanalostomy
• trabeculotomy

Depending on the type of glaucoma you have, some of these types of surgery may not be suitable for you.

What does the operation involve?

Various anaesthetic techniques are possible, including a general anaesthetic or a local anaesthetic that is injected around your eye to numb it.

The operation usually takes 45 to 75 minutes.

Your surgeon will make a small flap and draining hole in the lining of the white of your eye. The fluid will drain out into a space in the outer lining of your eye and collect just under your eyelid.

How can I prepare myself for the operation?

Keeping in the same position

If the operation is performed under a local anaesthetic, you will need to lie still and flat during the operation. If you cannot lie still and flat, let your surgeon know.

Your face will be covered with a cloth to allow your surgeon to work on a clean surface. Air will be blown gently towards your nose. If you are claustrophobic (afraid of being in small spaces), let your surgeon know

Lifestyle changes

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

What complications can happen?

General complications of any operation

• bleeding
• infection
• allergic reaction to the equipment, materials or medication
• chest infection

Specific early complications

• heavy bleeding inside your eye during or after surgery
• bleeding into the front of your eye which makes vision worse
• inflammation in your other eye
• too much fluid draining or low pressure within the eye following surgery
• sharp rise in eye pressure

Specific late complications

• developing a cataract
• reduced vision over time
• failure of the operation

Consequences of this procedure

• pain

How soon will I recover?

You should be able to go home after a few hours.

Your surgeon will need to check your eye the day after the operation. They will see you several times in clinic during the first few weeks and may perform minor adjustments.

Most people will need about 2 weeks off work.

Do not swim, lift anything heavy or bend so your head is below your waist until you have checked with your surgeon.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery from the operation, with their glaucoma under better control.

Summary

Glaucoma is a common problem, causing damage to the optic nerve where it leaves your eye. If eye drops do not help enough, glaucoma surgery can be performed to reduce the risk of further damage to the optic nerve.

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