Dr. Callahan was professional, knowledgeable, and caring. She listened, explained clearly, and answered all my questions. It was refreshing. She also helped my son, and staff was friendly and kind.
Jeffrey Moore
Glaucoma Laser Surgery
Types of Glaucoma Laser Procedures We Offer
We offer a focused range of laser procedures selected based on your type of glaucoma, your drainage angle anatomy, and your overall eye health. Each procedure targets a specific part of the eye's fluid drainage system with a different goal in mind. Your eye doctor will explain which approach is most appropriate for you.
SLT uses gentle, precisely targeted laser pulses to stimulate the trabecular meshwork, the filtering tissue through which fluid drains out of the eye, so that it works more efficiently. Unlike older laser techniques, SLT selectively targets specific cells while leaving surrounding tissue intact, which means it can safely be repeated if pressure rises again in the future.
Most patients see a meaningful reduction in eye pressure within a few weeks, though the timing varies. The pressure-lowering effect typically lasts several years. Not every patient responds, and repeat treatments may produce a smaller or shorter response. We use added caution in eyes with heavy trabecular pigment or a history of uveitis (eye inflammation) because of a slightly higher risk of inflammation or a short-term pressure spike after treatment.
YAG PI creates a tiny opening near the outer edge of the iris, the colored part of your eye, to allow fluid to flow more freely between the front and back chambers of the eye. We recommend this procedure for patients with primary angle-closure suspect (PACS), primary angle closure (PAC), or primary angle-closure glaucoma (PACG), and for those at risk of sudden, painful pressure spikes called angle-closure attacks.
The opening is designed to be permanent, but it can occasionally narrow over time and may need to be enlarged or repeated. Placing the opening beneath the upper eyelid helps reduce any glare or visual disturbance that some patients notice. Common temporary effects include light sensitivity, mild brow ache, and seeing a faint glare or ghost image, most of which improve on their own over time.
- We typically use a pupil-constricting drop called pilocarpine before the procedure
- A pressure-lowering drop is often given before and after to prevent a short-term pressure spike
- The procedure takes only a few minutes and can significantly reduce your risk of an angle-closure emergency
MIGS refers to a group of surgical procedures that improve fluid drainage from inside the eye with a smaller recovery burden than traditional glaucoma surgery. Goniotomy, one of the MIGS procedures we perform, creates a direct opening in the drainage channel of the eye to allow fluid to exit more easily.
MIGS procedures are often considered when laser treatment alone has not achieved adequate pressure control, or when a patient is already having cataract surgery and additional pressure reduction would be beneficial. Your eye doctor will discuss whether a MIGS procedure is a good fit for your situation and what to expect in terms of recovery and results.
Alternatives and Complementary Treatments
Laser surgery is one important tool in glaucoma management, but it works alongside other treatment options. Depending on your diagnosis and how your condition progresses, your eye doctor may recommend medication, a different surgical approach, or a combination of treatments. Understanding all your options helps you make confident, informed decisions.
Eye drops remain a cornerstone of glaucoma treatment for many patients. Different classes of drops work in different ways, either by slowing fluid production inside the eye or by helping fluid drain out more efficiently.
- Prostaglandin analogs, which increase fluid drainage
- Beta blockers, which reduce fluid production
- Alpha agonists, which both reduce production and increase drainage
- Carbonic anhydrase inhibitors, which slow fluid production
We carefully consider the side effect profile of each medication and how consistently you are able to use drops when building your treatment plan. Some patients prefer laser as a way to reduce their dependence on daily eye drops.
For patients whose glaucoma cannot be adequately managed with laser treatment and medication, more involved surgical procedures may be necessary. These are typically considered when a larger or more durable reduction in eye pressure is required.
- Trabeculectomy, which creates a new drainage pathway in the eye
- Glaucoma drainage implants, which use a small tube to redirect fluid
- Lens extraction, which may deepen the drainage angle in certain types of angle-closure disease
More complex cases are referred to specialists with the expertise and resources to handle advanced glaucoma. We will work with you to coordinate that care and ensure a smooth transition.
What to Expect During Your Laser Procedure
Understanding what happens on the day of your procedure can help ease any anxiety you may have. Glaucoma laser procedures are performed in our office and typically take less than 30 minutes from start to finish. Most patients are surprised by how comfortable and straightforward the experience is.
Before your laser treatment, we perform a thorough eye examination and measure your current eye pressure. We also use a technique called gonioscopy to examine your drainage angle directly, and we may measure your corneal thickness to ensure we are interpreting your pressure readings accurately.
You can generally eat and drink normally before the procedure and continue your regular medications unless we instruct you otherwise. Please arrange for someone to drive you home, as your vision may be temporarily blurred and you should not drive immediately after treatment.
- Avoid wearing a contact lens in the eye being treated on the day of your appointment
- We often use pressure-lowering drops before and after the procedure to minimize the risk of a post-treatment pressure spike
- For YAG PI, we apply pilocarpine to prepare the pupil before the laser is used
We apply numbing drops to your eye so you will not feel pain during the procedure. A small contact lens is placed gently on your eye to help focus the laser precisely on the target area. You will be seated at a device similar to the slit lamp used during a routine eye exam.
You may see bright flashes of light and hear soft clicking sounds as the laser delivers measured pulses of energy. Most patients feel only mild pressure or a slight sensation of warmth. Sedation is rarely needed, and you will be awake and able to communicate with your eye doctor throughout the treatment.
The laser application itself usually lasts only a few minutes. Total time in the treatment room, including preparation and post-procedure pressure checks, is typically between five and twenty minutes per eye.
After the treatment, we remove the contact lens, check your eye pressure, and monitor you briefly before you leave with your driver. We will review what to expect over the next few days and answer any questions before you go.
Recovery and Aftercare Following Laser Surgery
Recovery from glaucoma laser surgery is generally mild and short. Most patients return to their regular activities within a day or two. Following our aftercare instructions carefully helps your eye heal well and gives the treatment the best chance of working effectively.
It is common to notice some mild scratchiness, light sensitivity, or a feeling of pressure in the treated eye for a few hours after the procedure. These sensations are temporary and generally not cause for concern.
- Mild redness that typically fades within a day or two
- Blurred vision that gradually clears over several hours
- Watering or tearing as your eye adjusts
- A dull ache that usually responds to over-the-counter pain relief
- After YAG PI, some patients notice brief glare or a streak of light that often improves over time
We typically prescribe a short course of anti-inflammatory eye drops for several days after treatment to minimize swelling and discomfort. If you have a history of steroid-related pressure increases, please let us know so we can adjust this plan accordingly.
Continue using your regular glaucoma medications unless we specifically tell you to change them. As we track your pressure over the following weeks, we may be able to reduce or adjust your drop regimen if the laser has lowered your pressure effectively.
Most patients can return to normal daily activities the day after laser surgery. For the first day or two, avoid rubbing the treated eye and protect it from dust, wind, and other irritants.
Keep soap and water away from your treated eye for at least 24 hours. Avoid swimming pools, hot tubs, and vigorous exercise for a few days to reduce the risk of inflammation. Do not wear a contact lens in the treated eye until your eye doctor confirms it is safe to do so, typically the following day at the earliest. We will schedule a follow-up visit within one to six weeks to measure your pressure and assess how well the treatment is working.
The duration of the pressure-lowering effect varies from person to person. Many patients who have SLT see results that last for several years. If pressure begins to rise again, repeating SLT may be an option, though the response to a second treatment can sometimes be smaller or shorter in duration.
Regular monitoring is essential after any glaucoma laser procedure so that we can detect changes early and adjust your treatment plan before vision is affected.
Risks and When to Seek Urgent Care
Glaucoma laser procedures are generally safe and well tolerated, but like any medical treatment, they carry some risks. We review these with you thoroughly before scheduling any procedure so that you can make a fully informed decision. Knowing what is normal and what requires prompt attention gives you confidence during your recovery.
A temporary rise in eye pressure within the first few hours after treatment is one of the more common side effects, which is why we monitor you closely before you leave the office. We use preventive drops to reduce this risk, and most pressure increases resolve quickly with medication.
- Mild inflammation that improves with prescribed anti-inflammatory drops
- Slight grittiness or discomfort for a day or two
- Temporary blurring that clears as the eye settles
- Light sensitivity that typically resolves within 24 hours
- Brow ache or mild headache for a day or two after YAG PI
Although uncommon, some patients experience persistent inflammation, a sustained pressure increase, or an opening from YAG PI that narrows over time and requires re-treatment. SLT can occasionally trigger an elevated pressure response that needs additional management. These situations are manageable when caught early, which is why follow-up visits are so important.
We carefully weigh the benefits and risks before recommending any laser procedure, and we tailor our approach to your individual eye health history.
Contact our office right away if you experience severe eye pain, a sudden change in vision, or intense redness after your procedure. These symptoms may indicate a complication that requires urgent evaluation. If you are unable to reach us promptly or it is after hours, go to the nearest emergency department.
- Sharp or worsening pain that does not improve with over-the-counter pain relief
- Sudden decrease in vision or new blind spots
- Significant swelling or discharge from the eye
- Halos or rainbow-colored rings around lights that persist or worsen
- Nausea or vomiting along with eye discomfort
Frequently Asked Questions
These questions address common decisions and situations that patients often face after learning about glaucoma laser surgery. If you have a question that is not covered here, please do not hesitate to ask our team.
Yes, for many patients with ocular hypertension or early open-angle glaucoma, SLT is a reasonable first-line option rather than a last resort. Whether it is the right starting point for you depends on your pressure level, optic nerve status, and personal preferences around daily drop use. Your eye doctor will discuss the pros and cons of both approaches so you can make a decision that fits your lifestyle.
The timeline depends on the procedure. SLT results often build gradually over a period of days to weeks, and your follow-up appointment is scheduled specifically to measure this response. YAG PI takes effect immediately in terms of opening the drainage angle, though its impact on pressure is evaluated over time. If your pressure has not reached a safe level by your follow-up visit, we will talk about next steps right away.
Many patients are able to reduce the number of drops they use, but this depends on how much the laser lowers your individual pressure. Some patients still need at least one medication to keep pressure at a consistently safe level. We reassess your drop regimen at each follow-up visit and make adjustments based on your results, so do not stop or change your drops on your own without guidance from your eye doctor.
In many cases, yes. Same-day bilateral SLT or YAG PI is common and safe for appropriate patients. However, some patients benefit from treating one eye first to see how the eye responds before proceeding with the other. Your eye doctor will consider your overall health, the specific procedure, and any individual risk factors before making this recommendation.
If pressure increases after a successful SLT, repeating the procedure is often an option because SLT is designed to be repeatable. A second treatment may produce a smaller or shorter response than the first, but it can still be meaningful. If repeat laser is not sufficient or appropriate, your eye doctor will discuss other treatment options, including adjusting your medication regimen or considering a MIGS procedure. Regular monitoring is what allows us to catch rising pressure early and respond before damage occurs.
In most cases, prior cataract surgery does not prevent glaucoma laser treatment. However, it can influence which procedure is most appropriate and how the eye is likely to respond. For example, the anatomy of the drainage angle may look different after lens removal, which affects how we approach SLT or YAG PI. Your eye doctor will review your full surgical history as part of your pre-treatment evaluation to ensure the safest and most effective plan.
Explore Your Glaucoma Treatment Options at NewView Eye Center
If you have been diagnosed with glaucoma or told you are at risk, you do not have to navigate your options alone. Our experienced eye doctors at NewView Eye Center are here to evaluate your condition, walk you through each available treatment, and build a plan focused on protecting your vision for the long term. We are proud to serve patients across Northern Virginia with personalized, expert care rooted in a mission of excellence. Reach out to our team today to schedule a consultation and take the next step toward better eye health.
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