If I Have Glaucoma, Do I Need Surgery?

Glaucoma is one of the most common age-related eye conditions. It’s also a leading cause of blindness in adults over 60. 

Often called The Silent Thief of Sight, glaucoma doesn’t present any symptoms in the early stages of the condition. Once it does cause visual symptoms, the damage to the eye is irreversible. 

That means that any vision lost is irreversible and gone forever. However, there are treatments for glaucoma that slow the progress of the eye condition and prevent further vision loss.

If you’re diagnosed with glaucoma, your eye doctor will likely want you to start treatment immediately. However, if you have glaucoma detected in the early stages, you may not immediately need more intensive treatments like surgery. 

Patients with mild cases of glaucoma may be able to manage the condition with medication. To understand how different treatments for glaucoma work, it’s essential to first talk about what glaucoma is and what causes it. Keep reading to learn more about glaucoma and the best ways to treat it!

What is Glaucoma?

Glaucoma is a term that describes several eye conditions that all cause damage to the optic nerve. The optic nerve connects your eye to your brain. 

If the optic nerve becomes damaged, it can’t send the necessary information about what you’re seeing to your brain to process it. Eventually, this will lead to peripheral vision loss. You’ll notice tunnel vision as more damage occurs.

A buildup of fluids in the eye almost always causes glaucoma. Fluids flow in and out of your eyes to keep them healthy. When the necessary fluids become unable to drain, it causes a buildup of pressure. 

High intraocular pressure, or IOP, strains the optic nerve and damages it. The most common form of glaucoma is called open-angle glaucoma.

The primary drainage channel, or angle, is open in open-angle glaucoma. This is the channel created by the gap between your iris and cornea. 

But the smaller drainage channels around the eye, called the trabecular meshwork, are somehow blocked. The blockages caused lead to a very gradual increase in intraocular pressure.

The only way to spot open-angle glaucoma in the early stages of the condition before it causes vision loss is through regular eye exams. You may not show any symptoms, but your ophthalmologist can examine your eyes. 

They may notice that your intraocular pressure levels are elevated with visible signs of damage to the optic nerve. How often you should have eye exams depends on your age and other factors like your family history. 

However, most people should schedule annual eye exams after turning 60. You may want more frequent eye exams if you know you’re at a higher risk for glaucoma. 

Non-Surgical Glaucoma Treatment Options

After receiving a glaucoma diagnosis, most ophthalmologists will recommend immediate treatment. If you have high intraocular pressure without signs of optic nerve damage, or only very minor damage, they may only recommend non-surgical therapies. 

These treatments may be sufficient in keeping your intraocular pressure low and preventing further damage.


Most glaucoma patients receive medication to control their intraocular pressure, whether they have mild or severe glaucoma. The most common form for these patients is eye drops. 

Some patients are also prescribed oral medication. If you have severe glaucoma, eye drops may be one part of your treatment plan, along with surgical intervention. 

But most glaucoma patients will take some form of medication as part of their treatment.

Laser Therapy

If medication alone isn’t keeping your intraocular pressure low enough, there are other non-surgical options that your eye doctor may recommend. One of these treatments is called a laser trabeculoplasty. 

A laser trabeculoplasty is a minimally invasive procedure performed in-office at New England Eye Center. You’ll have your eyes numbed to ensure you don’t feel any pain. 

Then, your ophthalmologist shines a laser beam through a lens into your eye. This laser concentrates energy on your trabecular meshwork. It clears some of the blocked channels to allow fluid to drain more efficiently, helping to lower and manage your intraocular pressure levels. 

Surgical Treatment

When medication and laser therapies aren’t sufficient in controlling your intraocular pressure, your eye doctor may recommend surgical intervention. There are several kinds of glaucoma surgeries. 

Which one your doctor recommends depends on your unique needs and how severe your glaucoma and intraocular pressure levels are. The following are the primary options for glaucoma surgery.


A trabeculectomy creates a small hole in the eye along with a little flap in the white of your eye. The flap creates a little bubble called a bleb under the eyelid. 

The fluid then drains into the bleb before being reabsorbed by the eye, easing some of the buildup of fluid in your eye and lowering your intraocular pressure to a more manageable level.

Drainage Devices

Several kinds of drainage devices can be implanted into your eye to aid in fluid drainage. These devices are usually shaped like little tubes. 

The device is placed in the white of your eye and attached to a small reservoir to keep fluid as it drains and allows it to be reabsorbed. These devices essentially function like a bleb but may be able to hold more liquid to lower intraocular pressure more effectively.


MIGS stands for Minimally Invasive Glaucoma Surgeries. Minimally invasive glaucoma surgeries are procedures that don’t require much time to perform and don’t have extensive recovery periods. 

They’re best for patients with mild to moderate glaucoma, as patients with severe glaucoma usually require more intensive surgery. MIGS usually involves tiny drainage devices or cyclophotocoagulation, a technique that uses a laser to target fluid-producing cells. 

Do you have glaucoma? Learn more about your treatment options by scheduling an appointment at New England Eye Center in Boston, MA!

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