Before And After Glaucoma Surgery: What You Need To Know

Glaucoma surgery is generally recommended when eye drops and laser treatment are no longer keeping intraocular pressure (IOP) at a safe level. Its purpose is to protect the optic nerve from further damage, not to restore vision that has already been lost.

If your ophthalmologist has raised surgery as an option, knowing what happens at each stage makes the process considerably less daunting. This guide covers the weeks beforehand, the day itself, and what recovery realistically looks like.

For how surgery fits alongside drops and laser, see our guide to glaucoma treatment options. For fees, Medicare and private health cover, see glaucoma surgery cost.

Which procedure you will have

Your surgeon will recommend a procedure based on the type and severity of your glaucoma, your current eye pressure and how you have responded to previous treatment. The main options are laser procedures such as selective laser trabeculoplasty (SLT), minimally invasive glaucoma surgery (MIGS), trabeculectomy and drainage implants, each explained in our glaucoma treatment options guide.

What matters for this page is that preparation is broadly similar whichever procedure you have, while recovery differs considerably. Laser recovery is measured in days; incisional surgery in weeks. Where that difference matters, it is noted below.

What to expect before glaucoma surgery

Before surgery you will have a thorough preoperative evaluation with your glaucoma surgeon. This assesses the severity of your glaucoma, the health of your optic nerve and your overall eye health, and confirms which procedure is most suitable for you.

Eye Exams

Several tests are performed as part of the preoperative process:

•   Eye pressure measurement (tonometry) — measures the pressure inside your eye, confirming the diagnosis and assessing severity
•   Optic nerve evaluation — imaging examines the health of your optic nerve and detects damage caused by elevated IOP
•   Visual field test — evaluates your peripheral vision, where glaucoma typically causes loss first and often without you noticing

Your surgeon may also take measurements of the eye itself, particularly where a drainage device is being considered.

Medications and health checks

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

Tell your surgeon about everything else you take, including blood thinners, aspirin, anti-inflammatories and over-the-counter supplements. Some of these may need to be paused beforehand, and only your treating doctors can advise on that; do not stop anything on your own. Continue your usual glaucoma drops unless you are told otherwise.

Practical preparation

A few things are worth arranging in advance:

•   Someone to drive you home: you will not be able to drive yourself after the procedure
•   Time off work: ask your surgeon what to expect for your particular procedure, as laser usually needs very little and incisional surgery more
•   Fasting instructions: if sedation or general anaesthesia is planned, your clinic will confirm what applies
•   Help at home for the first few days: particularly if you live alone, since you will be using several eye drops on a schedule

Discussing Your Surgery Plan

Once your preoperative tests are complete, your surgeon will go through the recommended procedure with you. This is the point to ask about the surgery itself, the expected recovery and the anticipated outcomes, so that you can make an informed decision.

Questions worth raising: how many drops you are likely to need afterwards, how long before you can drive, and what the follow-up schedule will involve.

What happens on the day of surgery

You will be asked to arrive early to allow time for preparation. Most glaucoma surgeries are outpatient (day) procedures, meaning you return home the same day.

Anaesthetic drops are used to numb the eye, and depending on the procedure, a local anaesthetic may also be given around the eye. Sedation may be offered alongside or instead, based on your surgeon’s recommendation and your comfort level.

You stay awake for most glaucoma procedures but should not feel pain. The surgery itself is usually shorter than people expect; laser treatments take a few minutes, and incisional surgery is typically under an hour. Afterwards, you will be monitored briefly, an eye shield or pad may be applied, and you will be discharged with your drop schedule and a follow-up appointment.

What To Expect After Surgery

After glaucoma surgery, it is important to follow the specific guidelines you are given. Here is what recovery generally involves.

Immediate postoperative care

•   Medications: you will likely be prescribed anti-inflammatory drops and possibly antibiotics to reduce inflammation and prevent infection
•   Monitoring: your eye pressure will be checked in the days following surgery to confirm it is lowering as expected and the eye is healing properly
•   Follow-up appointments: scheduled across the first few weeks to track your progress and your IOP

Recovery Time

How long recovery takes depends largely on which procedure you had.

After laser procedures, most people return to normal activities within a few days to a week. Vision may be blurred briefly, and the eye can feel gritty.

After incisional surgery such as trabeculectomy or a drainage implant, healing takes longer. Vision is commonly blurred for several weeks and settles gradually. Appointments are frequent in the early period because your surgeon may need to guide how the eye heals, releasing sutures, for example, and follow-up continues for months, well after you are feeling well.

Blurred vision early on is expected. Sudden loss of vision is not, see the warning signs below.

Managing Pain And Discomfort

Mild discomfort or a gritty sensation is common after the procedure and should gradually improve as the eye heals. Your ophthalmologist will provide guidance on managing it, and on what to do if you notice concerning symptoms such as increasing pain or changes in vision.

Avoid rubbing the eye, and use only the drops you have been prescribed.

Activity restrictions

You will be advised to avoid certain activities while the eye heals:

•   heavy lifting, straining and strenuous exercise, all of which raise eye pressure
•   bending with your head below your waist
•   swimming, spas and dusty environments
•   contact sports
•   rubbing or pressing on the eye; an eye shield overnight is often recommended

Timeframes vary by procedure, so follow the specific advice you are given. These restrictions are temporary, but they matter, preventing pressure spikes during early healing is exactly what they are for.

When to contact your clinic

Contact your surgeon or clinic promptly if you notice:

•   sudden or worsening loss of vision
•   severe or increasing pain, rather than mild discomfort
•   significant redness, swelling or discharge
•   new flashes, floaters or a shadow across your vision

These are uncommon, but early assessment matters. If you cannot reach the clinic and your symptoms are severe, seek urgent medical care.

The difference before and after surgery

The change most people notice after glaucoma surgery is not in how they see, but in how the condition is managed.

Eye pressure is the main measure of success, and your surgeon will track it at every follow-up. Many people also find they need fewer glaucoma medications afterwards, and some come off drops entirely, though this varies with the procedure and how the eye heals.

What surgery does not do is improve vision that glaucoma has already taken. Sight lost to optic nerve damage does not return, and the vision you had before surgery is generally the vision you keep. Glaucoma also remains a lifelong condition afterwards: monitoring continues, and further treatment is sometimes needed if pressure rises again over time.

Frequently Asked Questions 

When will I see the results after glaucoma surgery?

You may begin to notice a reduction in IOP within the first few days, though the full effect of the procedure often takes around a month to settle. Your ophthalmologist will monitor your progress at follow-up appointments.

Is glaucoma surgery painful?

You should experience only mild discomfort following glaucoma surgery, typically manageable with the medication you are prescribed. Discomfort and sensitivity usually subside as the eye heals. If you have persistent or unusual pain, contact your doctor.

Are there risks associated with trabeculectomy?

Like all surgical procedures, glaucoma surgery carries risks, including infection, bleeding and changes in vision. Corneal decompensation can occur in rare cases, particularly where the anterior chamber is involved or where intraocular devices are placed close to the cornea. Your surgeon will discuss the risks relevant to your procedure and your eyes.

What is the success rate of glaucoma procedures?

Success and complication rates vary with the procedure, the severity of the disease and individual patient factors. Many people see a meaningful reduction in IOP, which helps preserve vision and slow progression. Studies comparing more invasive conventional surgeries have found similar complication rates between approaches, which is why a tailored treatment plan matters more than any single procedure being better overall.

Will I still need eye drops after surgery?

Often fewer, sometimes none, but it depends on the procedure and how your eye responds. Some people continue on a reduced regimen long term. Your ophthalmologist will review your medications at follow-up appointments and adjust them based on your pressure readings.

Can glaucoma surgery be performed on both eyes?

Yes, though the procedure is typically carried out on one eye at a time. This allows your surgeon to monitor how the first eye heals and make adjustments before operating on the second.

Can I drive after glaucoma surgery?

You should avoid driving during the initial recovery period, particularly if your vision is blurred or the eye is uncomfortable. Most people return to driving once vision stabilises, usually after a follow-up appointment confirms it is safe to do so.

Speak to a glaucoma surgeon

Understanding what happens before, during and after glaucoma surgery makes the process easier to approach with confidence. Preparation is straightforward, the procedure itself is usually quick, and recovery follows a predictable path, though it asks for patience, particularly after incisional surgery.

If you are considering glaucoma surgery or have questions about your treatment options, our glaucoma surgeons at Mornington Peninsula Eye Clinic can talk it through with you. Call (03) 9070 3580 to schedule a consultation.

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

Sources

Coulon SJ, Vanner EA, Gedde SJ. Outcomes of Glaucoma Reoperations in the Primary Tube Versus Trabeculectomy Study. Ophthalmology Glaucoma. 2023;6(4):422–31. Available from: https://www.ophthalmologyglaucoma.org/article/S2589-4196(23)00052-2/fulltext

Glaucoma Australia. Surgery. Available from: https://glaucoma.org.au/

healthdirect Australia. Glaucoma. Available from: https://www.healthdirect.gov.au/glaucoma