Before And After Glaucoma Surgery: What You Need To Know

Glaucoma surgery is a known treatment option for those experiencing moderate to severe glaucoma. It can significantly help manage intraocular pressure (IOP) and prevent damage to the optic nerve. If you need to lower your eyes’ IOP, it’s important to understand what to expect before and after glaucoma surgery.

This comprehensive guide will explore everything you should know about the process, from diagnosis to recovery, and the potential outcomes and benefits.

What Is Glaucoma?

Before we discuss the specifics of glaucoma surgery, it’s important to understand the condition itself. Glaucoma is a group of eye diseases that leads to irreversible damage to the eyes’ nerve, often due to increased intraocular pressure.

If not properly managed, this damage can lead to permanent vision loss. It is one of the leading causes of blindness in Australia and around the world.

There are several types of glaucoma, including normal-tension, open-angle, and angle-closure glaucoma.

Most people with glaucoma do not experience noticeable signs until significant damage has occurred, which is why regular eye check-ups are essential for early detection.

Why Glaucoma Surgery Is Necessary

When medication and laser treatments no longer effectively control the condition, glaucoma surgery may be necessary. The main goal of surgery is to lower the IOP to a level that prevents further damage to the optic nerve.

Surgery can also help reduce the need for ongoing medications, which some patients may find difficult to manage or may experience side effects.

Types Of Glaucoma Surgery

Several glaucoma surgical procedures are designed to address the condition in different ways. Below, we’ll explore the most common types of glaucoma surgeries performed today.

Laser Surgery

Selective Laser Trabeculoplasty (SLT) uses targeted laser energy to enhance fluid drainage in the eye, effectively lowering IOP. By employing shorter wavelengths of light, SLT is gentler on the eye compared to traditional laser treatments.

This makes it an ideal choice for patients with mild to moderate glaucoma, offering a better, more comfortable option with minimal disruption to the eye’s natural structure.

Minimally Invasive Glaucoma Surgery (MIGS)

MIGS refers to a group of innovative procedures designed to lower IOP with fewer risks and a faster recovery time than traditional glaucoma surgeries.

These techniques are less invasive, often involving small incisions or the insertion of tiny devices that improve fluid drainage from the eye, thereby helping to reduce pressure.

Typically suggested for people with mild to moderate glaucoma, MIGS offers a better alternative for those who may not be suitable candidates for more invasive procedures.

One of the key benefits of MIGS is the reduced recovery time. Many patients find that they can return to their normal activities within just a few days.

While it has shown promising results in terms of pressure reduction and long-term success, it may not be appropriate for all types of glaucoma.

What To Expect Before Glaucoma Surgery

Before undergoing glaucoma surgery, you’ll have a thorough preoperative evaluation by your glaucoma surgeon. This evaluation will assess the severity of your glaucoma, the health of your optic nerve, and your overall eye health.

The surgeon will also discuss your treatment options, including the potential upsides and downsides of the various procedures available.

Eye Exams

As part of the preoperative process, several key eye tests will be performed:

• Eye Pressure Measurement (Tonometry): This test measures the pressure inside your eye, helping to confirm the presence of glaucoma and assess its severity.
• Optic Nerve Evaluation: Your doctor will examine the health of your optic nerve through imaging tests to detect any symptoms of damage caused by elevated IOP.
• Visual Field Test: This test evaluates your peripheral vision, as glaucoma can lead to vision loss in the outer fields of your vision, often without noticeable symptoms.

Medications

Your doctor may prescribe specific medications before surgery to help lower your eye pressure.

It’s crucial to follow these instructions and inform your surgeon of any other medications you are taking to avoid possible interactions or complications during the surgery.

Discussing Your Surgery Plan

Once your preoperative tests are completed, your surgeon will discuss the most suitable surgical procedure for your condition.

This is the ideal time to ask any questions about the surgery itself, the expected recovery process, and the anticipated outcomes.

Your surgeon will ensure you feel informed and comfortable with the planned approach, empowering you to make confident decisions about your treatment.

What Happens On The Surgery Day

On the day of your surgery, you will be asked to arrive at the facility early to allow time for preparation.

Most glaucoma surgeries are outpatient procedures, meaning you will be able to return home the same day.

Depending on the specific type of surgery and your individual needs, the procedure will typically be performed under local anaesthesia.

Sedation may also be used, either alongside or in place of the local anaesthesia, based on your surgeon’s recommendations and your comfort level.

What To Expect After Surgery

After your glaucoma surgery, it’s important to follow specific guidelines to ensure a smooth healing. Here’s what you can expect during your recovery process.

Immediate Postoperative Care

To help you recover effectively, your doctor will provide detailed instructions. Here’s what you need to know:

• Medications: You will likely be prescribed anti-inflammatory medications, eye drops, and possibly antibiotics to reduce inflammation and prevent infection.
• Monitoring: Your eye pressure will be carefully monitored in the days following surgery to ensure it is lowering as expected and that your eye is healing properly.
• Follow-Up Appointments: A series of follow-up appointments will be scheduled within the first few weeks to track your progress, check your intraocular pressure (IOP), and ensure your recovery is on track.

Recovery Time

The recovery period can vary depending on the type of surgery you had. Laser surgeries typically have a shorter recovery time, with many patients returning to normal activities within a few days to a week.

Managing Pain And Discomfort

It’s common to experience mild discomfort or a gritty sensation in your eyes after the procedure. This should gradually improve as your eye heals.

Your ophthalmologist will provide specific guidelines on how to manage any discomfort, as well as guidance on what to do if you notice any concerning symptoms, such as increased pain or vision changes.

Restrictions

You’ll likely be advised to avoid certain activities for some time to ensure proper healing. Stay away from strenuous activities such as heavy lifting, intense exercise, or contact sports for several weeks after surgery to prevent strain on your healing eye.

These restrictions are temporary but essential to support the healing process and reduce the risk of complications.

Frequently Asked Questions (FAQs)

1. When will I see the results after glaucoma surgery?

While you may begin to notice a reduction in IOP within the first few days after surgery, the full effects of the procedure can materialise fully after the first month.

Your ophthalmologist will monitor your progress closely during follow-up appointments to ensure your recovery is on track and your IOP is lowering as expected.

2. Is glaucoma surgery painful?

You should experience only mild discomfort following glaucoma surgery, which is typically manageable with prescribed medications.

Any discomfort or sensitivity usually subsides as your eye heals. If you experience any persistent or unusual pain, your doctor will guide you on managing it effectively.

3. Are there any risks associated with conventional trabeculectomy surgery?

Like all surgical procedures, glaucoma surgeries carry some risks. The incidence of serious complications, such as infection, bleeding, or significant vision changes can occur.

Corneal decompensation may occur in rare cases, particularly after involving the anterior chamber or when intraocular devices are placed close to the cornea, such as mitomycin C in standard trabeculectomy surgery or the placement of Ahmed Glaucoma Valves (AGVs).

4. What is the success rate of glaucoma procedures?

The success and complication rates of glaucoma surgery vary based on the procedure, disease severity, and individual patient factors. Many patients see a significant reduction in IOP, helping preserve vision and slow progression.

Different studies have compared more invasive conventional surgeries and found similar complication rates. That’s why finding a tailored treatment approach is necessary.

5. Can glaucoma surgery cure the condition?

While glaucoma surgery can be highly effective in controlling IOP and preventing further damage to the optic nerve, it is not a cure for glaucoma. Ongoing monitoring and treatment may still be necessary to manage the condition in the long term.

6. Can glaucoma surgery be performed on both eyes?

Yes, glaucoma surgery can be performed on both eyes. However, the procedure is typically carried out on one eye at a time.

This approach allows your surgeon to monitor the healing process and make adjustments before surgery on the second eye, ensuring the best possible outcome for both eyes.

7. Who is a good candidate for MIGS?

Minimally Invasive Glaucoma Surgery (MIGS) is typically recommended for those with mild to moderate glaucoma who may not require or be suitable for more invasive glaucoma surgeries.

Your eye doctor will assess your diagnosis, IOP levels, and treatment history before recommending the best approach.

8. Can I drive after glaucoma surgery?

It is generally advised to avoid driving during the initial recovery period after glaucoma surgery, especially if you experience blurred vision or discomfort.

Most patients can return to driving once their vision stabilises, typically after a follow-up appointment with the surgeon.

Conclusion

Glaucoma surgery can be a life-changing procedure, significantly improving the quality of life for those with moderate to severe glaucoma.

While the process can seem complicated, understanding what to expect before and after glaucoma surgery can help you feel more confident in your treatment plan.

With proper care, many patients experience positive treatment outcomes, and the risk of complications remains low. Speak with a glaucoma surgeon about your case to determine the best path for your vision.

If you’re considering glaucoma surgery or have questions about the best treatment options, we’re here to help. Our team of experienced glaucoma surgeons in Melbourne is committed to providing personalised care to help you achieve the best possible outcomes.

Contact Mornington Peninsula Eye Clinic today at (03) 9070 3580 to schedule a consultation and take the first step towards preserving your vision.

We’ll work closely with you to determine the most effective treatment plan tailored to your needs.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Sources

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Lin A P. Acute Angle-Closure Glaucoma (AACG) [Internet]. Dersu I Irak, editor. Medscape. 2025 [cited 2025 May 9]. Available from: https://emedicine.medscape.com/article/1206956-overview?form=fpf

Winderl A Marturana. A Guide to Glaucoma Surgery [Internet]. Health. 2023 [cited 2025 May 9]. Available from: https://www.health.com/condition/glaucoma/glaucoma-surgery