Glaucoma surgery: Restoring vision

Glaucoma, often referred to as the "silent thief of sight," is a serious eye condition that can lead to irreversible vision loss if left untreated. As an ophthalmologist specialising in glaucoma, I understand the concerns and anxieties that come with the prospect of needing surgery to manage this condition. Leading consultant ophthalmologist and oculoplastic surgeon Mr Konal Saha uncovers glaucoma surgery, explain its purpose and methods, and provide insights that will help you feel informed and empowered in your journey towards better eye health.

Understanding glaucoma and its progression

Glaucoma is primarily caused by increased pressure within the eye, which damages the optic nerve—the crucial link between the eye and the brain. This damage can lead to gradual vision loss, starting with peripheral vision and potentially progressing to blindness if not managed effectively.

When will surgery be considered?

In many cases, glaucoma can be managed with medications (eye drops) or laser treatments to reduce intraocular pressure. However, if these treatments are ineffective or if the condition is advancing despite treatment, surgery may be recommended. The goal of the surgery is to lower the intraocular pressure and thereby prevent further damage to the optic nerve.

What are the different types of glaucoma surgery?

There are several types of glaucoma surgery, each aimed at enhancing the drainage of fluid from the eye. Trabeculectomy is the most common procedure, where a small drainage hole is created in the sclera (the eye's white part) to facilitate the outflow of fluid, thereby reducing intraocular pressure. Another approach is tube shunt surgery, involving the implantation of a silicone or plastic tube to redirect aqueous humour to an external reservoir, effectively lowering pressure inside the eye.

Additionally, minimally invasive glaucoma surgery (MIGS) procedures use smaller incisions and less invasive techniques compared to traditional methods. These procedures are designed to either enhance existing drainage pathways within the eye or establish new ones using small stents or devices.

What to expect before, during, and after surgery

Before surgery, your ophthalmologist will conduct a thorough evaluation of your eyes and discuss the procedure in detail, addressing any questions or concerns you may have. During surgery, you will be given local anaesthesia to ensure you are comfortable throughout the procedure. The surgery itself typically lasts around 30 to 60 minutes, depending on the type and complexity.

After surgery, you may experience some discomfort, which can usually be managed with medication. It is important to follow your doctor's instructions regarding post-operative care, including the use of eye drops and attending follow-up appointments. Most patients can resume normal activities within a few days to weeks after surgery, depending on the type of procedure performed.

What are the benefits and risks of glaucoma surgery?

The primary benefit of glaucoma surgery is its potential to halt the progression of vision loss by lowering intraocular pressure. However, like any surgical procedure, there are risks involved, such as infection, bleeding, or changes in vision. Your ophthalmologist will discuss these risks with you in detail before surgery and take steps to minimise them.

Understanding glaucoma surgery can alleviate some of the anxiety associated with the procedure. By working closely with your ophthalmologist and being proactive about your eye health, you can make informed decisions that support your long-term vision and quality of life. If you have any concerns or questions about glaucoma surgery, don't hesitate to discuss them with your healthcare provider. Your eyesight is precious—let us work together to protect it.

If you would like to book a consultation with Mr Saha, do not hesitate to do so by visiting his Top Doctors profile today.