Procedure guide · Ophthalmology (glaucoma)
Glaucoma surgery lowers the pressure inside the eye to protect the optic nerve from further damage. It does not bring back sight that has already been lost. The NHS lists surgery alongside eye drops and laser treatment. Surgery is usually considered when other treatment has not controlled the pressure. The heavy follow-up after surgery is the main planning issue for a visitor.
What is glaucoma surgery?
Glaucoma is a group of conditions that damage the optic nerve. The NHS explains that treatment aims to slow the damage and help stop vision getting worse. It notes there are several different types of glaucoma operation.
The commonest is trabeculectomy. Cambridge University Hospitals describes how the surgeon makes a small opening in the white of the eye near the upper eyelid. This creates a new drainage channel. Fluid drains into a small blister-like reservoir under the eye’s surface covering, called a filtering bleb. An anti-scarring drug called mitomycin C may be used to help keep the channel open. The operation can be done under local or general anaesthetic.
What surgery can and cannot do
Cambridge University Hospitals states plainly that trabeculectomy will not improve your sight. Its aim is to reduce the risk of further damage to the optic nerve. If it works, you may need fewer glaucoma drops.
Who may be suitable for glaucoma surgery?
Cambridge University Hospitals explains that surgery is considered when glaucoma drops do not control eye pressure well enough. The type of operation depends on your form of glaucoma, the state of your eye and any earlier surgery. A glaucoma specialist decides whether surgery, laser or a change of drops is right for you.
What reports should you send before advice is given?
A glaucoma specialist will want to see how your eye pressure and vision have changed over time. Useful records include:
- Eye pressure readings over the past months or years, with dates
- Visual field test printouts, ideally a series rather than one test
- Optic nerve scans such as OCT reports
- A list of every glaucoma drop you use or have tried, and any side effects
- Notes of earlier laser treatment or eye surgery, including cataract surgery
- Your general medicines, especially blood thinners
How should you plan the trip?
Trabeculectomy is not a one-visit procedure. Cambridge University Hospitals describes regular clinic visits after surgery. It also describes stitch adjustment or removal and, for some patients, an injection to stop scar tissue blocking the new channel. Drops are used frequently in the early period.
- Assessment: pressure checks, visual fields and scans in India
- Surgery: under local or general anaesthetic
- Early follow-up: several clinic visits while the drainage settles
- Adjustments: stitches may be adjusted or removed
- Before flying: ask the surgeon when it is safe for you to travel
- Home: a glaucoma clinic at home that agrees to continue your care
An attendant helps with frequent drops and getting to appointments. Before you commit, confirm that an eye specialist at home will see you after you return. The NHS stresses that glaucoma follow-up appointments should not be missed.
What should you ask the hospital?
- Which operation do you recommend for my type of glaucoma and why?
- Will you use an anti-scarring drug and what are its risks?
- How many follow-up visits will I need before I can fly?
- Who will adjust or remove stitches if that is needed after I leave?
- What drops will I need afterwards and can I get them at home?
- Will you write to my eye doctor at home with full notes?
IndiaMedica helps you share records and compare plans. The treating glaucoma specialist decides what is suitable and when it is safe to fly.
Questions people ask
Will glaucoma surgery improve my vision?
No. Cambridge University Hospitals says trabeculectomy will not improve your sight. The aim is to lower eye pressure and reduce the risk of further optic nerve damage. Vision is often blurred at first after surgery. Your specialist can explain what to expect for your eye.
What are the risks of trabeculectomy?
Cambridge University Hospitals lists bleeding, infection, inflammation, eye pressure that is temporarily too high or too low and cataract. Rarely, sight can worsen and not recover. The operation may also need repeating if it does not work. Ask your surgeon to explain your own risks.
Will I still need eye drops after surgery?
Possibly. Drops are used often in the early weeks to control inflammation and scarring. If the operation works you may need fewer glaucoma drops later. The NHS notes that many people with glaucoma use drops daily, so check that you can obtain yours at home.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.