Glaucoma Treatment Options in Australia: Eye Drops, Laser and Surgery

Glaucoma is a group of eye conditions that damage the optic nerve, and in most cases that damage is driven by pressure inside the eye. Treatment cannot bring back vision that has already been lost, but lowering intraocular pressure (IOP) can slow or stop further damage.

That single goal sits behind every option on this page. Australian eye specialists work through a sequence: eye drops first, then laser, then surgery if pressure stays uncontrolled; and where you sit on that sequence depends on the type of glaucoma you have, how far it has progressed and how your eyes respond.

This page covers each option at a summary level. For what procedures cost in Australia, see our guide to glaucoma surgery cost. For preparation, the day itself and recovery, see what to expect before and after glaucoma surgery.

When glaucoma treatment begins

Glaucoma rarely announces itself. Most people notice nothing until a meaningful amount of peripheral vision has already gone, which is why treatment usually begins after a routine eye examination rather than after symptoms appear.

Your ophthalmologist will confirm the diagnosis and establish a baseline before recommending anything, including measuring eye pressure, examining and imaging the optic nerve, and testing your visual field. Those same tests then track whether treatment is working.

Treatment is also shaped by which type of glaucoma you have. Open-angle glaucoma, the most common form, is managed differently from angle-closure glaucoma, which can come on suddenly and needs urgent attention. If you are still working out what the diagnosis means, our overviews of what glaucoma is and the types of glaucoma cover that ground, and what glaucoma vision looks like explains how sight is affected.

How glaucoma treatment escalates

Glaucoma treatment in Australia follows a stepped approach rather than a single decision.

Most people start on prescription eye drops. If drops bring pressure to a safe level and you can use them consistently, that may be all you ever need.

Laser treatment is the usual next step, either when drops are not lowering pressure enough, or when side effects or the daily routine make them hard to keep up. In some cases, laser is offered first rather than second.

Surgery is generally considered when drops and laser together are not holding pressure down, or when glaucoma is advanced enough that waiting carries real risk. Surgery can also reduce how many medications you need long term, which matters if managing multiple daily drops has been difficult.

At every step, the target is the same: bring IOP low enough to protect the optic nerve. None of these treatments restores vision that has already been lost.

Eye drops and glaucoma medication

Prescription eye drops lower pressure in one of two ways: by reducing how much fluid (aqueous humour) the eye produces, or by helping that fluid drain more freely.

Several classes are used in Australia:

•   Prostaglandin analogues: commonly prescribed first; improve fluid outflow, usually once daily
•   Beta-blockers: reduce fluid production
•   Alpha agonists: both reduce production and improve outflow
•   Carbonic anhydrase inhibitors: reduce fluid production
•   Combination drops: two agents in one bottle, to simplify a regimen

Drops only work while they are being used, and glaucoma gives you no symptoms to remind you, so consistency does most of the heavy lifting. If you are finding the routine difficult or missing doses, tell your ophthalmologist rather than stopping; there are usually alternatives, including simplifying to a combination drop or moving to laser.

Side effects vary by class and can include redness, stinging, irritation, changes to eyelash growth or iris colour and, less commonly, effects elsewhere in the body. Mention any other medications you take, as some interactions matter.

Laser Treatment for glaucoma

Laser procedures are performed in a clinic setting, take only a few minutes and generally involve less recovery than incisional surgery.

Selective laser trabeculoplasty (SLT)

SLT is used for open-angle glaucoma. It applies short, low-energy laser pulses to the trabecular meshwork, the eye’s natural drainage tissue, to improve outflow and lower pressure. Because it works at low energy, it causes minimal disruption to surrounding tissue, and it can often be repeated. The effect is not permanent, and pressure may drift up again over time, so monitoring continues either way.

Laser peripheral iridotomy

Iridotomy is used in angle-closure glaucoma, where the drainage angle is narrow or blocked. The laser creates a small opening in the iris so fluid can move more freely, relieving or preventing a sudden rise in pressure. It may also be performed preventively in eyes assessed as being at risk.

How well laser works varies with the type of glaucoma, how advanced it is and individual eye anatomy. Some people still need drops afterwards, though often fewer.

Glaucoma surgery options

Surgery is the step taken when pressure stays too high despite medication and laser. All of the procedures below aim to create or improve a drainage pathway for fluid leaving the eye. They are covered here at a summary level — for preparation, the day itself and recovery, see before and after glaucoma surgery.

Trabeculectomy

The long-established option for more advanced glaucoma. A small flap is created in the sclera (the white of the eye), with a reservoir beneath the conjunctiva, giving fluid a new route out. It can achieve substantial pressure reduction and requires close follow-up while the eye heals.

Minimally invasive glaucoma surgery (MIGS)

A group of newer techniques using small incisions and tiny implanted devices to improve drainage. MIGS generally carries lower risk and a shorter recovery than trabeculectomy, and is typically offered for mild to moderate glaucoma. It is not suitable for every type or severity.

Drainage devices and tube shunts

Where other approaches are unsuitable or have not worked, a small tube can be implanted to drain fluid to a reservoir on the surface of the eye. These are more often used in severe or complex glaucoma, and follow-up is similar in intensity to trabeculectomy.

Combined cataract and glaucoma surgery

Cataracts and glaucoma frequently occur together. Where both are present, a MIGS procedure can often be performed during cataract surgery, addressing clarity of vision and eye pressure in a single operation.

Costs differ considerably between these procedures. Our glaucoma surgery cost guide covers Australian fees, Medicare and private health cover.

How your treatment plan is decided

There is no default glaucoma treatment. Your ophthalmologist weighs several things together:

•   the type of glaucoma and how far it has progressed
•   your current eye pressure and the target pressure for your eyes
•   how your eyes have responded to previous treatment
•   other health conditions and medications
•   how realistic a daily drop routine is for you
•   changes in your optic nerve and visual field over time

Two people with the same diagnosis can reasonably end up on different plans. Plans also change, what controls pressure now may not in five years, and treatment is adjusted as monitoring shows. The most useful thing you can do is keep your appointments and raise problems early, while there are still options open.

Ongoing monitoring

Glaucoma is a long-term condition, so treatment does not end once pressure is controlled. Regular reviews check eye pressure, examine the optic nerve and repeat visual field testing to confirm nothing is progressing quietly. How often you are seen depends on how stable your glaucoma is and how advanced it was at diagnosis, your ophthalmologist will set an interval and adjust it as needed.

General health habits, staying active, not smoking, managing blood pressure and diabetes, support eye health, but they do not substitute for treatment. Our guide to preventing glaucoma covers that in more detail.

Frequently Asked Questions About Glaucoma Treatment

Can glaucoma be cured?

No. Glaucoma cannot be cured, and vision already lost cannot be restored. It can usually be managed, treatment that lowers eye pressure can slow or halt further optic nerve damage, particularly when it starts early. See can glaucoma be reversed for more.

How often do I need to use glaucoma eye drops?

It depends on which drop you are prescribed, some are once daily, others two or three times a day. Use them exactly as directed and at consistent times, because pressure control depends on it.

Are there side effects from glaucoma medications?

Yes, though they vary by drug class. Redness, stinging, irritation and changes to eyelash growth or iris colour are among the more common. Raise anything that bothers you with your ophthalmologist rather than stopping treatment on your own.

How effective is laser treatment for glaucoma?

SLT lowers pressure effectively for many people with open-angle glaucoma, but results vary with the type of glaucoma, its severity and individual eye anatomy. The effect can fade over time, so monitoring continues, and some people still use drops afterwards.

How often should I see an ophthalmologist for glaucoma?

That depends on how stable and how advanced your glaucoma is. Your ophthalmologist will recommend a review interval and change it if your pressure or visual fields shift.

Talk to an eye specialist about your options

Glaucoma treatment in Australia is a sequence rather than a single choice, drops, then laser, then surgery, adjusted over years as your eyes respond. What stays constant is the goal: keeping intraocular pressure low enough to protect the optic nerve and preserve the vision you have.

If you have been diagnosed with glaucoma, or it has been a while since your last eye examination, call Mornington Peninsula Eye Clinic on (03) 9070 3580 to arrange an appointment with a glaucoma specialist.

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

References 

1. Glaucoma Australia. Treatment. Available from: https://glaucoma.org.au/
2. healthdirect Australia. Glaucoma. Available from: https://www.healthdirect.gov.au/glaucoma
3. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO). Glaucoma. Available from: https://ranzco.edu/
4. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. The Lancet. 2019;393(10180):1505–16.