Advice after your nerve block for surgery
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What is glaucoma?
Glaucoma is the name given to a group of conditions which cause progressive damage to the optic nerve (the nerve responsible for vision), which in turn leads to defects in the field of vision. The intra-ocular pressure (pressure within the eye) is the key modifiable risk factor in glaucoma.
Glaucoma can lead to permanent blindness and worldwide it is the second leading cause of blindness. Once vision is lost it cannot be restored. However, there are treatments which can help to delay progression of this condition by lowering the eye pressure.
What does the surgery involve?
Either drops or laser treatment may be used to lower the pressure, however there is increasing evidence that surgery offers the best chance of preventing further loss of vision. Surgery is more successful if performed early in the course of the disease.
Trabeculectomy & non-penetrating glaucoma surgery (NPGS) are similar operations. In both, a flap valve is formed in the sclera (white wall of the eye) under the upper lid. This allows excess fluid from inside the eye to drain away under the loose skin covering the conjunctiva (a membrane cover the white part of the eye). After the operation you may see the ‘blister’ of fluid on the eyeball under the upper lid.
In Trabeculectomy, a small hole is made into the eye & a tiny ‘V’ of Iris is removed (Iridectomy). This allows the fluid in the eye to flow out. In NPGS, no hole is made into the eye. The normal drainage canal is opened & the fluid oozes out more gently. Both operations usually involve the use of chemicals to reduce scarring & allow the fluid blister to form.
Both operations take roughly the same length of time & are of similar complexity. The choice of which operation is best for you & why will be explained by your eye surgeon in clinic. After either operation, it may be necessary to slow down the fluid drainage. Usually this involves extra drops or tablets, sometimes the use of a contact lens or eye pad for a few days. In a few cases, the flow of fluid may need to be speeded up. This may involve the early removal or adjustment of some of the stitches in the eye, or an injection into the fluid blister.
On the day of the operation
Surgery will be done under local anaesthetic. You will be asked to come into hospital on the morning and should be able to go home a few hours afterwards and return to be seen in clinic, or on the ward, 1 or 2 days later.
After the operation
- You will require at least 2 types of eye drops for several weeks after surgery.
- You may have blurred vision in the eye for 2 or 3 weeks after surgery.
- You may resume normal activities after a week. Lifting, heavy work and running should be avoided for at least the first month after surgery. Swimming should be avoided for at least 6 weeks.
- To bring your glasses and all eye drops with you when you come back for follow-up appointments.
Possible problems after glaucoma surgery
- It is normal for the eye to feel slightly gritty and to water for a few days after the operation.
- Complications during surgery - Glaucoma surgery is delicate and can be difficult. Complications do occur, but these are unusual and very rarely sight-threatening.
- Infection - With modern techniques, the risk of serious infection is less than one in every thousand cases.
- Poor vision - It is important to realise that glaucoma surgery will not improve your vision. Indeed, vision may be slightly worse for a few weeks after the operation.
- Cataract - Glaucoma surgery can make a cataract worse. Although it does not cause the cataract, it may speed up its development. Cataract, of course, does not cause permanent blindness and vision can be restored by surgery.
If after leaving hospital, the eye becomes more painful, sticky and red or the vision worse, contact the hospital immediately.
Things should be avoid to do
- Don't rub or poke the eye. If the eye waters just dab the corner with a clean tissue.
- Don't use an eyebath until told it is safe to do so.
If you have any unexpected problems after the surgery, you should contact the eye treatment centre on the following numbers:
|
From 9am to 5pm Monday to Friday: |
0300 373 5884 |
| From 5pm to 9am and at weekends: | 0300 614 5000 and ask for the eye doctor on call |
Contact us
If you have any queries relating to this information, please contact the Ophthalmology service.
About this information
Service:
Ophthalmology
Reference:
QQ/047
Approval date:
5 August 2024
Review date:
1 July 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.