The main types of glaucoma are:

Primary open-angle glaucoma (POAG)

This is the most common form of glaucoma in the UK. It develops gradually due to the fluid in the eye (also known as aqueous humour) not draining properly through the trabecular meshwork - the eye’s natural drainage system, located around the edge of the iris.

Angle-closure glaucoma

Occurs when the drainage angle between the iris and cornea becomes narrowed or closed. You may experience pain, redness, and blurred vision and, in rare cases, require urgent treatment.

Normal-tension glaucoma (NTG)

In this type of glaucoma, optic nerve damage occurs despite IOP being within the normal range.

Secondary glaucomas

These result from causes such as ocular inflammation, trauma, steroid use or previous surgery.

The primary aim of glaucoma treatment is to lower intraocular pressure in order to slow or prevent further damage to the optic nerve.

Topical medications (eye drops)

Eye drops (and/or laser) are usually the first-line treatment. Different classes of medication work by either:

• Reducing production of the aqueous humour, or
• Increasing aqueous outflow

Although glaucoma can’t be cured, treatment can significantly reduce the risk that the disease progresses.

If topical treatment doesn’t control the IOP, or if you can’t tolerate the side effects, alternative options may be recommended. These include:

Laser treatment

Selective Laser Trabeculoplasty (SLT) is a minimally invasive outpatient procedure that enhances drainage of the aqueous humour. It’s often recommended as a first-line treatment.

Minimally Invasive Glaucoma Surgery (MIGS)

Procedures such as iStent implantation may be considered, especially if you’re already undergoing cataract surgery.

Your consultant will discuss the most appropriate option based on your individual situation

Your consultant will explain each option clearly and guide you toward the treatment that’s best suited to you, considering your eye pressure, the stage and type of glaucoma you have, any previous treatments, and your general health.

iStents are tiny titanium implants - usually placed in pairs - that are used as part of minimally invasive glaucoma surgery (MIGS).

These stents create a small bypass within the eye’s natural drainage system, helping fluid drain more easily and lowering eye pressure. While an iStent won’t cure glaucoma or reverse any existing damage, it can help prevent the condition from worsening.

iStents are often implanted during cataract surgery. If you have both glaucoma (mild to moderate open-angle) and cataracts, your consultant may recommend combining the procedures so the stents can be fitted at the same time. This is carried out as a day‑case procedure, using local anaesthetic in the form of topical eye drops, so you should only need to be in hospital for around half a day and won’t need to stay overnight.

The iStent implantation typically adds about five to ten minutes to standard cataract surgery and is performed through the same corneal incision.

After the procedure, you’ll spend a short time in recovery, and a protective shield will be placed over your eye. This should stay in place until the following morning. Once your surgeon is happy with your recovery, you’ll be discharged. Please make sure someone is available to drive you home.

As the local anaesthetic wears off, your vision will gradually return, although your eye may feel sore. You can take over‑the‑counter pain relief if you need it. We’ll arrange a follow‑up appointment one to two weeks later to check that your eye is healing well.

SLT is a non‑invasive, outpatient treatment often used in mild to moderate open‑angle glaucoma, ocular hypertension and suspected open-angle glaucoma. It may be offered:

• As first-line treatment
• As an alternative for patients who struggle with eye drops
• In addition to the main treatment when additional IOP reduction is required

SLT works by targeting the trabecular meshwork. During the procedure, your consultant applies very short pulses of low‑energy laser light to pigmented cells in this area. These cells respond by becoming more active, which helps fluid drain more effectively. As drainage improves, the pressure inside your eye gradually reduces.

The treatment itself usually takes just 10–15 minutes. Afterwards, your intraocular pressure will be checked 30-60 minutes after your treatment. If everything looks stable, you’ll be able to go home with a short course of (anti-inflammatory) eye drops to use for five days. You will need someone to drive you home after your treatment.

It’s normal to have slightly blurry vision or mild discomfort for a few hours, but this usually settles quickly. We’ll arrange a follow‑up appointment one to two weeks later to make sure your eye is healing well.

The pressure-lowering effect may take between six and eight weeks to reach its maximum. The effect can diminish over time, and the procedure may be repeated if appropriate.

To book an initial self-pay consultation for glaucoma treatment, please contact our Private Patient team by calling 01580 363158 or request a callback by completing our online enquiry form.