There are several different treatments for glaucoma, including eye drops, laser treatment and surgery. The best treatment for you will depend on your circumstances.
Treatment can't reverse any loss of vision that has already occurred, but can help stop your vision getting any worse.
This page covers:
Your treatment plan
Your treatment plan
Your treatment largely depends on which type of glaucoma you have.
- primary open angle glaucoma is usually treated with eye drops, or laser treatment or surgery if drops don't help
- primary angle closure glaucoma often needs immediate treatment in hospital with medication to reduce the pressure in the eye, often followed by laser treatment
- secondary glaucoma may be treated with eye drops, laser treatment or surgery, depending on the underlying cause
- childhood glaucoma often requires surgery to correct the problem in the eye that led to the build-up of fluid and pressure
You will also often be advised to attend regular follow-up appointments to monitor your eyes and check that treatment is working. It's important not to miss any of these appointments.
The main treatments are described below.
Eye drops are the main treatment for glaucoma.
Types of eye drops
There are several different types that can be used, but they all work by reducing the pressure in your eyes.
The main types of eye drops are:
- prostaglandin analogues, such as latanoprost, bimatoprost, tafluprost and travoprost
- beta-blockers, such as betaxolol hydrochloride, levobunolol hydrochloride and timolol
- carbonic anhydrase inhibitors, such as brinzolamide and dorzolamide
- sympathomimetics, such as brimonidine tartrate
- miotics, such as pilocarpine
Eye drops can cause unpleasant side effects, such as eye irritation, and some aren't suitable for people with certain underlying conditions.
You may need to try several types before you find the one that works best for you. Sometimes you may need to use more than one type at a time.
Using eye drops
Eye drops are normally used between one and four times a day.
It's important to use them as directed, even if you haven't noticed any problems with your vision, because your sight is at risk if you don't stick to your recommended treatment.
To use eye drops:
- use your finger to gently pull down your lower eyelid
- hold the bottle over your eye and allow a single drop to fall into the pocket you have created in your lower lid
- close your eye and keep it closed for a few minutes
If you're using two different types of eye drops, allow at least five minutes between using the different types.
If eye drops don't improve your symptoms, laser treatment may be recommended.
This is where a high-energy beam of light is carefully aimed at part of your eye, to stop fluid building up inside it.
Types of laser treatment include:
- laser trabeculoplasty – a laser is used to open up the drainage tubes within your eye, which allows more fluid to drain out of your eye and reduces the pressure inside it
- cyclodiode laser treatment – a laser is used to destroy some of the tissue in the eye that produces aqueous humour (the liquid inside the eye), which can reduce pressure in the eye
- laser iridotomy – a laser is used to create holes in your iris (coloured part of the eye) to allow fluid to drain from your eye
Laser treatment is usually carried out while you're awake. Local anaesthetic drops are used to numb your eyes, although you may feel a brief twinge of pain or heat during the procedure.
You may still need to use eye drops after having laser treatment.
Surgery may be recommended as an alternative to laser treatment in some cases.
Types of glaucoma surgery include:
- trabeculectomy – the most common type of operation, it involves removing part of the eye drainage tubes to allow fluid to drain more easily
- trabeculotomy – similar to a trabeculectomy, but an electric current is used to remove a small part of the eye drainage tubes
- viscocanalostomy – an operation to remove part of the sclera (the white outer covering of the eyeball), so fluid can drain from your eye more easily
- deep sclerectomy operation – an operation to widen the drainage tubes in your eye, sometimes by implanting a tiny device inside them
- trabecular stent bypass – an operation to place a tiny tube into your eye to increase the drainage of fluid
Glaucoma surgery may be carried out under local anaesthetic (where you're awake) or general anaesthetic (where you're asleep).