Glaucoma Treatment

Glaucoma screening and treatment is very important as most types of glaucoma have no symptoms. Glaucoma is a term that refers to a collection of diseases that can affect the optic nerve and cause vision loss. Vision loss affects the peripheral vision first and unless severe loss has occurred, then one is not aware that they have this condition. Complete examination including a check of the pressure of the eye is important in detecting and monitoring glaucoma. Additional testing includes visual field testing and computerized analysis of the optic nerve. Treatment is targeted at lowering the pressure of the eye and is typically achieved with medication eye drops or laser surgery.

Laser Surgery

Selective Laser Trabeculoplasty (SLT)

What is a selective laser trabecultoplasty?

Glaucoma Treatment | Laser SurgeryA selective laser trabeculoplasty (SLT) is a procedure used to help treat elevated intraocular pressure (IOP) in the setting of ocular hypertension or open angle glaucoma. The word angle in the term angle-closure refers to the connection between the iris (colored part of the eye) and the cornea (the clear outer layer on the front of the eye). This is where fluid drains from the eye. The angle is the drainage area of the fluid. IF the pressure in the eye is too high, the pressure can damage the optic nerve (the nerve connecting the eye to the brain) and lead to vision loss. The lower the eye pressure medication eye drops or a selective laser trabeculoplasty (SLT) can be used.

A selective laser trabeculoplasty helps stimulate drainage of fluid from the eye and thus lower the eye pressure.

When is it used?

A discussion with your eye surgeon will determine if you are a candidate or interested in having the procedure. Often a trial of medications will be used first to try to determine if you would have a good response (adequate amount of eye pressure lowered) to the treatment. Sometimes, the laser procedure will not reduce the eye pressure level to the desired level established by your surgeon and additional medications may still be necessary.

What happens during the procedure?

Your eye surgeon will put anesthetic eye drops in the eye followed by a special contact lens on the surface of the eye. Small laser pulses will then be directed at the angle. You may feel a quick pinch in your eye. The procedure is very quick, often complete in less than ten minutes.

What happens after the procedure?

You will remain in clinic after the procedure for about an hour to check on the pressure in your eye and to examine your eye after the surgical procedure. Your eye may be slightly blurry the day of the procedure, but there should be minimal, if any, pain and there are no restrictions to your activities.

What are the benefits of this procedure?

If the pressure is lowered to a satisfactory level, you may not need to use as many or any eye drops to control your pressure.

What are the risks associated with the procedure?

In general, the risks of selective laser trabeculoplasty are small compared to its potential benefit. It is rare, but possible to develop a corneal abrasion from the contact lens. A minor amount of blurring is fairly common and typically clears within a day or two. The eye pressure can go up in some people, but this is usually temporary.

Laser Peripheral Iridotomy (LPI)

What is a laser peripheral iridotomy?

A laser peripheral iridotomy (LPI) is a procedure used to help treat or prevent angle-closure glaucoma. The word angle in the term angle-closure refers to the connection between the iris (colored part of the eye) and the cornea (the clear outer layer on the front of the eye). This is where fluid drains from the eye. In angle-closure glaucoma, the iris has come forward towards the cornea, blocking the angle. The blockage prevents fluid from leaving the eye and cause cause the pressure in the eye to build up rapidly, which could cause vision loss.

A laser peripheral iridotomy helps restore the proper flow of fluid in the eye and reduce eye pressure. The procedure involves creating a small hole in the iris with a laser.

When is it used?

If you are in an attack of angle-closure glaucoma, you may be in pain and may have nausea and vomiting in addition to sudden loss of vision. The iridotomy is done as an emergency procedure in these cases.

Normally this procedure is performed as a preventative measure against an attack of angle-closure glaucoma. Your doctor will determine if you are at risk or having anatomically narrow angles with a special examination using a contact lens.

What happens during the procedure?

Your eye surgeon will put anesthetic eye drops in the eye followed by a special contact lens on the surface of the eye. A very short laser pulse will then be directed at the eye. You may feel a quick pinch in your eye and hear a snapping noise. The procedure is very quick, often over in a minute or two. If you have an angle-closure glaucoma attack, this is an emergency procedure. In an emergency, you may need oral or IV medicine in addition to eye drops.

What happens after the procedure?

If performed in a non-emergent situation, you will remain in clinic after the procedure for about an hour to check on the pressure in your eye and to examine your eye after the surgical procedure. Your eye may be slightly blurry the day of the procedure, but there should be minimal, if any, pain and there are no restrictions to your activities.

Often, if you are diagnosed with narrow angles, then your fellow eye will have similar anatomy and you may need to have the same laser procedure as a preventative measure.

What are the benefits of this procedure?

If you are at high risk for an angle-closure glaucoma attack, laser iridotomy might prevent an attack from ever happening.

What are the risks associated with the procedure?

In general, the risks of laser iridotomy are small compared to its potential benefit. It is rare, but possible to develop a corneal abrasion from the contact lens. A small amount of bleeding is fairly common and typically clears within a day or two. The eye pressure can go up in some people, but this is usually temporary.


Contact our office to learn more about our Glaucoma Treatment & Laser Surgery services or to make an appointment.

back to top