What Is Glaucoma Laser Treatment?
Glaucoma is a group of eye conditions in which the optic nerve becomes damaged, often, though not always, in association with raised pressure inside the eye (intraocular pressure). Because early glaucoma usually causes no symptoms, treatment is aimed at lowering eye pressure to slow or prevent further loss of vision rather than restoring sight that has already been lost.
Laser treatment is a non-surgical, non-invasive way of achieving this. It is carried out in a clinic or outpatient setting using a fine beam of light directed into the eye through a special lens. There are no cuts or stitches, and most people go home shortly afterwards. Several types of laser may be used, depending on the type of glaucoma:
- Selective laser trabeculoplasty (SLT), sometimes written as selective laser trabecular plasty (SLTP), gentle laser energy is applied to the eye’s natural drainage channel (the trabecular meshwork) to help improve fluid outflow and lower pressure. This is commonly used for open-angle glaucoma and ocular hypertension.
- Laser peripheral iridotomy (YAG laser), a tiny opening is made in the outer edge of the iris to improve fluid movement within the eye. This may be recommended for narrow or closed drainage angles, including after an episode of acute angle closure.
- Cyclodiode laser, used in more advanced or complex glaucoma to reduce fluid production inside the eye, usually when other treatments have not achieved adequate pressure control.
Laser is one option within a wider treatment pathway that also includes eye drops, minimally invasive glaucoma surgery (MIGS), cataract surgery, which itself can lower pressure in some eyes, and traditional drainage surgery. Which route is most appropriate depends on your diagnosis, your pressure targets and how much damage is already present.
Who May Benefit From Laser Treatment for Glaucoma?
Laser treatment is not suitable for everyone, and a full assessment is always needed first. It may be considered if you:
- have been newly diagnosed with primary open-angle glaucoma or ocular hypertension and would prefer to avoid or delay daily eye drops
- find eye drops difficult to instil, irritating, or hard to remember
- have side effects from drops, such as redness, stinging or allergy
- have eye pressure that remains above target despite medication
- have narrow drainage angles or have had an episode of acute angle closure
- need additional pressure lowering while awaiting or considering surgery
Guidance from NICE (NG81: Glaucoma: diagnosis and management) supports offering 360° selective laser trabeculoplasty as an initial treatment option for many adults with newly diagnosed chronic open-angle glaucoma or ocular hypertension, with drops used if further pressure lowering is needed. Ms Diana Urbaneja will discuss whether this applies to your particular situation.
Symptoms that warrant specialist assessment
Most people with glaucoma notice nothing at all in the early stages, which is why routine optician checks matter. Seek prompt advice if you experience sudden eye pain with blurred vision, halos around lights, a red eye with nausea or vomiting, or a rapid change in vision, as these can indicate acute angle closure and require urgent care.
Conditions Laser Treatment May Address
- Primary open-angle glaucoma
- Ocular hypertension (raised eye pressure without nerve damage)
- Pigmentary and pseudoexfoliative glaucoma
- Narrow angles and primary angle closure
- Acute angle closure, following initial stabilisation
- Glaucoma inadequately controlled by eye drops
- Difficulty tolerating or adhering to topical medication
Potential Benefits
Outcomes vary between individuals, and no procedure can guarantee a particular result. However, glaucoma laser treatment may:
- help lower intraocular pressure and support long-term pressure control
- reduce or delay the need for daily eye drops in some patients
- help reduce the risk of further optic nerve damage and visual field loss
- avoid the recovery time associated with incisional surgery, as it is performed in clinic
- be repeated in future in many cases, where clinically appropriate
- reduce the risk of an angle closure attack, in the case of laser iridotomy
It is important to understand that laser treatment manages glaucoma rather than curing it. Vision already lost cannot be recovered, and lifelong monitoring is still required.
Consultation and Assessment
Before any treatment is recommended, you will have a detailed consultation. This usually includes:
- a discussion of your symptoms, general health, medications and family history of glaucoma
- measurement of intraocular pressure and corneal thickness
- examination of the optic nerve and the drainage angle (gonioscopy)
- visual field testing to map your peripheral vision
- optical coherence tomography (OCT) imaging of the optic nerve and, where relevant, the anterior segment
- a clear explanation of your diagnosis, target pressure and all reasonable options, including drops, laser, MIGS and surgery, with their risks and benefits
You will have time to ask questions before deciding, and consent is taken only once you feel fully informed.
How the Procedure Is Performed
The setting and procedure depend on the specific type of glaucoma laser required:
- Clinic-Based Outpatient Laser (SLT & Iridotomy): Performed seated at the slit lamp in our outpatient clinic. Numbing anaesthetic drops are applied without needles or incisions, and treatment takes just a few minutes per eye.
- Theatre-Based Laser (Cyclodiode): Performed in the operating theatre, typically using a gentle local sub-Tenon anaesthetic injection to ensure complete comfort during treatment.
- Laser pulses are applied through a specialised lens. You may see bright flashes and hear faint clicks; most people describe mild discomfort rather than pain.
- Your eye pressure is usually rechecked before you leave, and anti-inflammatory drops may be prescribed for a short period.
Neither procedure requires an overnight stay, and you will return home the same day. Vision may be temporarily blurred afterwards, so you should arrange for someone to drive you home.
Recovery and Aftercare
Recovery is usually straightforward, though it varies from person to person. Most people return to normal activities the same day or the following day.
- Mild grittiness, light sensitivity, redness or blurred vision for a day or two is common.
- Continue your existing glaucoma drops unless specifically advised otherwise.
- The pressure-lowering effect of trabeculoplasty develops gradually, often over several weeks, so a follow-up pressure check is arranged.
- Further reviews assess whether the target pressure has been reached and whether medication can be reduced.
- Long-term monitoring with pressure checks, imaging and visual fields continues, as glaucoma is a chronic condition.
Seek prompt advice if you develop significant or worsening eye pain, marked redness, a sudden drop in vision, or persistent haloes around lights.
Risks and Considerations
Laser treatment for glaucoma is generally considered low risk, but no procedure is entirely without risk. Possible issues include:
- temporary discomfort, blurring, glare or light sensitivity
- short-lived inflammation inside the eye
- a transient rise in eye pressure shortly after treatment
- an insufficient pressure-lowering response, meaning drops or surgery may still be needed
- a reduction in effect over time, though repeat treatment is often possible
- less commonly, effects on the cornea, iris or lens, or visual symptoms such as a line or glare after iridotomy
Suitability always depends on your individual assessment, including the type of glaucoma, the appearance of your drainage angle and the state of your optic nerve. Alternatives, including medication, MIGS, cataract surgery with premium intraocular lenses where appropriate, and conventional glaucoma surgery, will be discussed with you. Further patient information is available from the Royal College of Ophthalmologists.
Why Choose Ms Diana Urbaneja?
Ms Diana Urbaneja is a Consultant Ophthalmologist with a sub-specialist interest in glaucoma and cataract surgery, bringing over 16 years of experience in ophthalmology. Her training includes three glaucoma fellowships, among them a fellowship at Moorfields Eye Hospital, and international fellowship experience.
- Glaucoma Lead for Cwm Taf Morgannwg Health Board
- More than 5,000 cataract operations performed
- Research into acute angle closure glaucoma using anterior segment OCT
- Member of the Paul Glaucoma Implant European investigation group
- Access to modern glaucoma diagnostics and evidence-based management, including SLT, MIGS and premium intraocular lens cataract surgery
Care is patient-centred: treatment plans are tailored to your diagnosis, lifestyle and preferences, and options are explained in plain language.
Areas Served
Ms Diana Urbaneja provides glaucoma and cataract care for patients across South Wales, with both private and NHS practice, and regularly sees patients travelling from Bridgend and Cardiff.
01
Consultation
IOL options explained
02
Laser
In-clinic treatment
03
Follow-up
Pressure or vision check appointment
At a glance
Anaesthetic
Topical drops
Procedure time
~5-15 min, depending on laser type
Stay
Same day, no admission
Recovery
Same day
Follow-up
Pressure or vision check appointment