Glaucoma treatments and procedures

What each option is for, what happens, and what recovery looks like, so you can weigh choices with your doctor.

Written by Dr. M. Ali Tawfik Alyouzbaki, MD, OphthalmologistLast updated Sources citedEditorial policy

Every glaucoma treatment does one job: lower the pressure inside the eye enough to protect the optic nerve. Lowering pressure is the only proven way to slow glaucoma.[1] The options differ in how they do it, how much they lower pressure, and what they ask of you.

Not every option fits every eye. Office lasers take minutes; surgery is done in an operating room. At your visit you'll hear which options suit your glaucoma, and how and where each would be arranged.

Each option in detail

Comprehensive glaucoma evaluation

Who it's for
Anyone referred for high eye pressure, a suspicious optic nerve, narrow angles, a family history, or known glaucoma wanting a fresh look.
What happens
A full history, including medicines and steroid use. Then pressure checks, corneal thickness, gonioscopy, a dilated look at the optic nerve, OCT scans of the nerve and macula, and visual field testing.[5]
Recovery
No recovery. If your pupils are dilated, near vision blurs and light feels bright for a few hours.
Good to know
Some tests are repeated at the next visit. Visual fields often improve with practice, and a second test confirms the baseline.

Pressure-lowering eye drops

Who it's for
Most types of glaucoma and ocular hypertension, either as first treatment or alongside laser.
What happens
Drops either reduce how much fluid the eye makes or help it drain. Common groups are prostaglandin analogs, beta-blockers, alpha agonists, carbonic anhydrase inhibitors and rho kinase inhibitors, sometimes combined in one bottle.[5]
Recovery
None. A check a few weeks after starting shows how well a drop works for you.
Good to know
Drops only work if they go in every day. Tell your doctor about redness, stinging, cost problems or trouble getting drops in. Beta-blocker drops can affect breathing and heart rate in some people.

Selective laser trabeculoplasty (SLT)

Who it's for
Open-angle glaucoma and ocular hypertension, as a first treatment or to reduce or replace drops.
What happens
In the office, a lens is placed on the numbed eye and a gentle laser treats the drainage tissue. It takes a few minutes and doesn't cut the eye.[2]
Recovery
Most people go back to normal activities the same day. Mild ache, blur or light sensitivity can last a day or so. Pressure is checked afterward.
Good to know
In the LiGHT trial, about 74% of people treated first with SLT needed no drops at three years, and none needed glaucoma surgery.[2] The effect can wear off over years, and SLT can be repeated.

Laser peripheral iridotomy

Who it's for
Narrow or closed drainage angles, after an acute angle-closure attack, and often for the other eye after an attack.
What happens
A laser makes a tiny opening in the outer iris. Fluid can then pass through the iris, the iris falls back, and the drainage angle opens.[6]
Recovery
Usually done in the office in minutes. Expect some blur and ache for a day. Pressure is checked within a couple of hours.
Good to know
For people who only have narrow angles, the benefit is modest and the decision is made together, based on your risk.[3] A few people notice a line or glare afterward, which usually fades.

Minimally invasive glaucoma surgery (MIGS)

Who it's for
Mild to moderate open-angle glaucoma, often in someone who's also having cataract surgery.
What happens
Through the same small incisions used for cataract surgery, a tiny stent is placed or the drainage tissue is opened, to improve the eye's natural outflow.[5]
Recovery
Similar to cataract surgery: drops for a few weeks, and most daily activities resume within days.
Good to know
MIGS can lower pressure and reduce the number of drops needed. The drop in pressure is usually smaller than with traditional surgery, with a lower risk profile.

Cataract surgery in eyes with glaucoma

Who it's for
People with glaucoma who also have a cataract, and people with angle closure where the natural lens is crowding the drainage angle.
What happens
The cloudy or crowded natural lens is replaced with a thin artificial lens. In angle closure this opens the angle. It may be combined with MIGS.[4]
Recovery
Outpatient. Drops for several weeks, with visits the next day and in the following weeks.
Good to know
In the EAGLE trial, removing the lens early worked better than laser iridotomy for angle-closure patients with raised pressure, with better pressure control and quality of life.[4]

Trabeculectomy

Who it's for
Glaucoma that keeps progressing, or pressure that needs to be much lower than drops, laser or MIGS can achieve.
What happens
In the operating room, a small flap is made in the white of the eye so fluid can drain into a small blister, called a bleb, under the eyelid. Medicine is used to limit scarring.[5]
Recovery
Several weeks of drops and frequent visits. Avoid heavy lifting, bending and rubbing the eye until cleared.
Good to know
It can lower pressure substantially. Risks include low pressure, infection of the bleb years later, and faster cataract. Report a red, painful eye after a trabeculectomy right away.

Tube shunt surgery

Who it's for
Advanced or hard-to-control glaucoma, eyes with scarring from earlier surgery, and some secondary glaucomas such as neovascular or uveitic glaucoma.
What happens
A small, soft tube carries fluid from inside the eye to a plate placed on the outer wall of the eye, under the eyelid tissues.[5]
Recovery
Similar to trabeculectomy: several weeks of drops and close follow-up.
Good to know
Some people still need drops after a tube. Double vision and tube exposure are uncommon complications.

Long-term monitoring

Who it's for
Everyone with glaucoma, ocular hypertension or a glaucoma suspect finding.
What happens
Regular pressure checks, visual fields and OCT scans, compared with your own baseline. Early on, fields may be done more often to find anyone who is getting worse quickly.[5]
Recovery
None.
Good to know
How often you're seen depends on how advanced and how stable things are. Skipping visits is how slow change gets missed.

Recovery and results vary from person to person. You'll get instructions specific to your eye and your procedure.

Comparing the options

A general overview, not a recommendation. Your choice depends on the type and stage of glaucoma, your other eye conditions and your preferences.

OptionOften used forHow it's doneTypical recoveryMain trade-off
Eye dropsMost glaucoma typesDaily drops at homeNoneDaily routine, side effects and cost
SLT laserOpen-angle glaucoma, ocular hypertensionOffice laser, minutesSame dayEffect can fade; can be repeated
Laser iridotomyNarrow or closed anglesOffice laser, minutesAbout a dayModest benefit if angles are only narrow
MIGSMild to moderate open-angle glaucomaSmall incisions, often with cataract surgeryDaysSmaller pressure drop than traditional surgery
Lens extractionAngle closure with a crowding lens; cataractOutpatient surgeryDays to weeksSurgical risks of cataract surgery
TrabeculectomyProgressing or advanced glaucomaOperating roomSeveral weeksClose follow-up; bleb infection risk
Tube shuntAdvanced, scarred or secondary glaucomaOperating roomSeveral weeksMay still need drops

The angle-closure path

Angle closure is a plumbing problem at the front of the eye: the iris blocks the drain. So treatment starts by opening the drain, not just lowering pressure.[7]

  1. Confirm the angle

    Gonioscopy in a dim room, sometimes with anterior segment OCT or ultrasound imaging.[6]

  2. Open the angle

    Laser iridotomy, or lens extraction when the lens is crowding the angle and pressure is high.[4]

  3. Treat what's left

    If pressure stays high, drops, laser or surgery are added as in open-angle glaucoma.

  4. Recheck the angle

    Gonioscopy is repeated over time, because the angle can narrow again.

Practical help

Getting drops in, every day

Many people find drops harder than expected. This routine helps the drop stay in the eye and less reach the rest of the body.

  1. Wash your hands, and shake the bottle if the label says to.
  2. Tilt your head back and gently pull the lower lid down to make a small pocket.
  3. Look up, and let one drop fall into the pocket. One drop is enough.
  4. Close your eye for one to two minutes, pressing lightly at the inner corner next to the nose.
  5. Wait at least five minutes before a different drop, so the first isn't washed out.
  6. Set a daily reminder, and bring your bottles to every visit.

If you still miss the eye, ask about drop aids, preservative-free options, combination drops, or SLT laser.

Sources and references

  1. Heijl A, Leske MC, Bengtsson B, et al; Early Manifest Glaucoma Trial Group. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120(10):1268-1279. View source
  2. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al; LiGHT Trial Study Group. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet. 2019;393(10180):1505-1516. View source
  3. He M, Jiang Y, Huang S, et al. Laser peripheral iridotomy for the prevention of angle closure: a single-centre, randomised controlled trial. Lancet. 2019;393(10181):1609-1618. View source
  4. Azuara-Blanco A, Burr J, Ramsay C, et al. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016;388(10052):1389-1397. View source
  5. Gedde SJ, Bowden EC, Challa P, et al; American Academy of Ophthalmology Preferred Practice Pattern Glaucoma Committee. Primary Open-Angle Glaucoma Preferred Practice Pattern. Ophthalmology. 2026;133(4):P1-P103. doi:10.1016/j.ophtha.2025.12.029 View source
  6. Gedde SJ, Chopra V, Vinod K, et al; American Academy of Ophthalmology Preferred Practice Pattern Glaucoma Committee. Primary Angle-Closure Disease Preferred Practice Pattern. Ophthalmology. 2026;133(4):P153-P201. doi:10.1016/j.ophtha.2025.12.030 View source
  7. Wright C, Tawfik MA, Waisbourd M, Katz LJ. Primary angle-closure glaucoma: an update. Acta Ophthalmol. 2016;94(3):217-225. View source

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