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Laser Trabeculoplasty
Selective Laser Trabeculoplasty (SLT) for Glaucoma
At NewView Eye Center, we offer Selective Laser Trabeculoplasty (SLT) as one of our leading treatment options for patients managing glaucoma throughout Northern Virginia. SLT is a safe, well-established, FDA-approved laser procedure performed right in our office that helps lower the fluid pressure inside the eye, protecting the optic nerve from further damage.
SLT is a type of laser therapy that improves the eye's natural ability to drain fluid. Short, low-energy pulses of light are delivered to specific pigmented cells in the trabecular meshwork, the spongy tissue responsible for draining fluid out of the eye. Stimulating these cells encourages the body's own healing process to improve fluid outflow and reduce eye pressure, without cutting or removing any tissue.
Understanding Glaucoma and How SLT Helps
Glaucoma is a group of eye diseases that damage the optic nerve, most often because the fluid pressure inside the eye is too high. It is one of the leading causes of irreversible vision loss, yet many people do not realize they have it until significant damage has already occurred. Vision loss typically begins with peripheral (side) vision and can progress to central vision if left unmanaged.
Who Is a Good Candidate for SLT?
SLT works best for specific types of glaucoma and certain patient situations. Our eye doctors evaluate each patient carefully to determine whether SLT is the right fit, or whether another approach would serve you better.
01
Open-Angle Glaucoma
The most common form of glaucoma and the primary condition SLT is designed to treat. The eye's drainage canals gradually become less efficient over time, causing pressure to build, and SLT directly targets this drainage system to restore more normal outflow.
02
Ocular Hypertension
Ocular hypertension means eye pressure is elevated, but no optic nerve damage has occurred yet. In these cases, SLT can serve as a preventive measure, helping to delay or prevent the onset of full glaucoma.
03
Patients Who Struggle with Eye Drops
Glaucoma eye drops must be used consistently, every day, to be effective. For patients who experience side effects, have difficulty with the routine, or face challenges affording ongoing medication, SLT offers a practical alternative that can reduce or sometimes eliminate the need for daily drops.
04
When SLT May Not Be the Right Choice
SLT is not appropriate for every patient or every type of glaucoma. It is generally not used for angle-closure glaucoma, eyes with significant scarring in the drainage angle, or eyes with active inflammation. Our eye doctors review your full history and measurements first.
SLT by the Numbers
20–30%
Typical reduction in eye pressure
1–5yrs
How long the effect typically lasts
5–10min
Laser treatment time per eye
1–3mo
Until the full effect develops
The SLT Procedure: What to Expect
SLT is a quick, in-office procedure that most patients find very comfortable. Knowing what happens before, during, and after your treatment can help you feel confident and prepared.
01
Preparing for Your Treatment
Our team walks you through what to expect and answers your questions. Anesthetic (numbing) drops are applied so you will not feel discomfort, and you may also receive a drop beforehand to help prevent a temporary pressure spike.
02
During the Procedure
You are seated at a laser instrument similar to the slit lamp used during routine exams. A small contact lens focuses the laser precisely on the trabecular meshwork, and most patients notice only a flashing light and mild warmth. Treatment typically takes about five to ten minutes per eye.
03
Immediately After SLT
Your eye pressure is checked about an hour later. Vision may be slightly blurry for a few hours and the eye mildly irritated or light-sensitive, so you will need a driver to take you home. Use any prescribed anti-inflammatory drops, avoid rubbing the treated eye, and continue your existing glaucoma drops unless your eye doctor advises otherwise.
04
Expected Results
Follow-up is typically scheduled within one to six weeks, and it generally takes one to three months for the full pressure-lowering benefit to develop. Most patients experience a reduction in eye pressure of approximately 20 to 30 percent, lasting between one and five years, and SLT can be repeated because it does not create scar tissue.
Safety, Risks, and Side Effects
SLT has an excellent safety record and is one of the gentler laser procedures used in ophthalmology. Most side effects are mild and resolve on their own within a few days. Expand each item to learn more.
After SLT, it is normal to experience some redness, mild light sensitivity, or a slight scratchy feeling in the treated eye. These effects typically resolve within a day or two and do not require special treatment beyond the prescribed drops.
In rare cases, a more significant or prolonged rise in eye pressure, or extended inflammation, can occur following SLT. These situations are uncommon and are generally manageable with medication. This is one reason we monitor your pressure in the hour immediately following the procedure and schedule follow-up visits soon after.
Careful patient selection is the most important step in keeping SLT safe. Our eye doctors take a thorough look at your eye anatomy, glaucoma type, and overall eye health before recommending any laser treatment. Detailed pre- and post-treatment instructions, along with consistent follow-up, are essential parts of the process.
Frequently asked questions
These answers address questions that come up often and are intended to help you make informed decisions about your glaucoma care.
That depends on how well your pressure responds and what your target pressure needs to be. Some patients are able to stop drops entirely after SLT, while others may reduce the number of drops they use. A smaller group may need to continue drops alongside SLT to reach the pressure level their eye doctor has determined is safe for their optic nerve. Your follow-up appointments will guide that decision over time.
No. Glaucoma is a chronic condition, and SLT is a management tool, not a cure. It helps control eye pressure to slow or stop the progression of optic nerve damage, but it does not restore vision that has already been lost or eliminate the need for ongoing monitoring. Glaucoma requires lifelong care and regular check-ups regardless of how well treatment is working.
SLT is considered a medically necessary procedure for glaucoma treatment and is typically covered by Medicare and most private insurance plans. Coverage specifics can vary, so our team can help verify your benefits before your appointment so there are no surprises.
If SLT does not lower your pressure adequately, or if your pressure rises again over time, there are other options available. SLT can sometimes be repeated. In other situations, your eye doctor may recommend a different laser approach, adjustments to your medication, or a referral for surgical evaluation. We work to find the right combination of treatments for each individual patient.
These are all different laser or surgical approaches to lowering eye pressure, but they work in different ways and are used for different types of glaucoma. SLT improves drainage through the trabecular meshwork and is primarily used for open-angle glaucoma. YAG Peripheral Iridotomy creates a small opening in the iris and is used for angle-closure glaucoma or eyes at risk for it. MIGS procedures, including goniotomy, involve tiny surgical approaches to improve drainage and are often performed at the time of cataract surgery. Your eye doctor will recommend the approach best suited to your specific diagnosis.
Glaucoma progression is usually detected through regular eye pressure measurements, optic nerve imaging, and visual field testing (a test that maps your peripheral vision), not through symptoms you would notice at home. This is why consistent follow-up care is so critical. If your pressure is not adequately controlled or your nerve shows signs of change, your treatment plan will be adjusted accordingly.
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