Glaucoma treatment

Treatment of glaucoma aims to lower eye pressure (intraocular pressure) to limit damage to the optic nerve. Treatment options depend on the type of glaucoma but include eye drops, laser treatment, and in some cases, surgery.  

Treatment for glaucoma

Glaucoma treatments vary depending on the type and severity of the eye condition.  

Eye drops are commonly used to treat glaucoma. There are different types of medicated eye drops, but all aim to reduce the pressure in the eye. They work to reduce the amount of fluid (aqueous humour) or improve fluid drainage from the eye. Your ophthalmologist (eye specialist) will follow up with you to check they're working.

Eye drops for glaucoma

Most people will need to take eye drops long term or for the rest of their life.

Eye drops are used as primary open angle glaucoma treatment, secondary glaucoma treatment, and for acute angle closure glaucoma.

Glaucoma laser treatment

Laser surgery uses a high energy light beam to target a part of the eye to reduce pressure. There are different laser treatment options for glaucoma.

• Selective laser trabeculoplasty and argon laser trabeculoplasty are treatments that use a laser to open the drainage channels in the eye, allowing fluid to drain away.
• Laser iridotomy and iridoplasty may be used for acute angle closure glaucoma. Both target the iris to allow fluid to drain away. 
• Cyclodiode laser treatment destroys some of the eye tissues that produces fluid, reducing the pressure. 

You'll be given a local anaesthetic to numb your eyes if you have a laser procedure. Afterwards, your vision might be blurry, and you'll take eye drops to help prevent infection. 

Glaucoma surgery

For adults with glaucoma, surgery may sometimes be needed if other treatments have not been effective. For children with congenital glaucoma, surgery is likely to be required to fix the underlying problem with the drainage of fluid from the eye. 

This is usually trabeculectomy surgery, done under local or general anesthetic. In this procedure, a new drainage channel is created in the eye which allows fluid to escape. A small pocket called a bleb is created under the eyelid where the fluid can collect, allowing it to drain slowly. This reduces the pressure in the eye. Sometimes, other types of surgical treatments are used such as:

• Aqueous shunt implantation – in this procedure a device called an aqueous shunt is placed inside the eye, to help aqueous fluid drain out. The device can also called a glaucoma drainage implant, tube implant, or glaucoma tube shunt.
• Minimally invasive glaucoma surgery (MIGS) – this describes a range of techniques that aim to be lower risk than trabeculectomy and aqueous shunt. A device, implant, or other technique might be used, but all aim to reduce the fluid and pressure in the eye to limit damage to the optic nerve.   

Glaucoma medication

Some people are prescribed oral medication to improve drainage of fluid from the eye or reduce its production, reducing the build-up. This can include beta-blockers and carbonic anhydrase inhibitor.

If you experience any side effects, such as blurred vision, from the medication, speak to your GP or eye doctor immediately.

Preventing glaucoma

Although you can’t prevent glaucoma, you can limit the loss of vision it causes by having regular eye exams. These will pick up on the earliest signs that there may be a problem so that you can get prompt treatment. Eye tests are particularly important for detecting glaucoma as you may not notice early symptoms such as gradual loss of peripheral vision. 

It’s also a good idea to have an active, healthy lifestyle, as recommended by the NHS. Regular exercise can help you manage some of the risk factors for glaucoma, like diabetes and high blood pressure. 

It’s also important to use protective eyewear when you’re doing sports or DIY because eye injuries can cause secondary glaucoma.

Risk factors

Anyone can be diagnosed with glaucoma, but some known factors may mean you or your family are at increased risk, such as:

• Age – glaucoma is more common the older you are.
• Ethnicity – if you’re of African, Caribbean, or Asian origin, there's a greater risk of developing glaucoma.
• Family history of glaucoma – if a parent or sibling has or had glaucoma, you’re more likely to get it too.
• Other conditions – sometimes glaucoma is associated with other conditions, for example, being short-sighted, longsighted, diabetic, and having heart disease.
• Medicines – taking a high dose of steroids for a long time can be a factor.
• Eye injury – for example, due to a sports or DIY injury. This can cause glaucoma immediately or contribute to it developing much later.

Frequently asked questions

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.