What is Glaucoma?
Glaucoma is a condition whereby the pressure inside the eye is elevated to a level at which it starts to damage the eye. This damage is generally detected by defects in your visual field test and/or a defect in the optic nerve at the back of the eye.
Operation – Trabeculectomy
The procedure known as ‘Trabeculectomy’ is an attempt to reduce the pressure inside your eyes back to a level where damage does not occur. If you consider the eye as a ball, fluid is pumped into the ball in one area and then fluid exits the ball from a second different area. If the exit of the fluid is held up, then the pressure inside the ball will rise and this is what occurs in glaucoma.
During the operation of trabeculectomy, a small valve like opening is made in part of your eye to allow fluid to exit the eye easier and quicker. This therefore reduces the pressure inside the eye.
The operation is usually performed under a local anaesthetic (where your eye will be numbed and you stay awake) or a general anaesthetic (where you will be asleep) as a day case patient. The surgery usually takes place upon the eye in the area beneath your upper eyelid
What will happen on the day of my operation?
You will come to the Opthalmic Surgical Unit to be prepared for your operation.
You will be able to go to the theatre wearing your own clothes. Dentures (if worn) need not be removed.
Please do not wear any face or eye make up on the day of the surgery.
In theatre, a Iocal anaesthetic will be given in the form of an injection.
After the injection, you will not feel any pain or discomfort.
Although you will be asked to refrain from talking during the operation as your eye moves when you talk, you can be assured that a nurse will be with, you during this time to ensure, that you remain comfortable.
Complications
The aim of surgery is to reduce the pressure inside your eye to stop or delay further glaucoma progression. The surgery is approximately 75% successful of significantly reducing the eye pressure and surgery success will inevitably depend on the individual patient and their particular eye. You may require to have the operation site ‘needled’ to try and increase the flow of fluid from your eye.
You may require a repeat trabeculectomy. The valve opening that has been created can allow too much fluid out of your eye and your eye can become soft. This may require padding your eye or placing a bandage contact lens (a special protection contact lens) in your eye, to reduce this over-drainage of fluid. A stitch may be required to be inserted into your eye to reduce the flow. If the over-drainage is severe, your eye may need reforming with fluid with a small operation.
Any operation on the eye can be complicated by infection, although this is rare. A serious infection can cause loss of vision or even loss of the eye. A haemorrhage may form around your eye following the anaesthetic. This would cause cancellation of the procedure and you would be asked to return in 2 to 3 weeks time to start again.
Your doctor will have advised a trabeculectomy as a result of glaucoma. Your follow up appointments post-operatively are very important and it is essential to attend these as required, otherwise the success of the operation may be jeopardized.
If you require a trabeculectomy in both eyes they will be operated upon on separate occasions, the interval between them depends on how your first eye reacted to the surgery.
After the operation
After the operation, you will be transferred back to the Day Case Unit.
You will be offered refreshments and approximately half an hour later you will be discharged home. Written and verbal information which offers advice regarding any restrictions/requirements following your operation will be given to you.
After the operation, you will have a pad on your eye for approximately 24 hours and you may be asked to wear a clear plastic shield after this for a week or two, particularly at night.
The operation is not painful, but you may feel a mild foreign body sensation as a result of the stitches in your eye. The stitches will dissolve on their own. Your vision in the eye will be blurred for several weeks and you will require new glasses once all the healing has taken place. This may take up to three months.
What is the next step?
You will return the following day, either to the Eye Clinic or the Ophthalmic Day Case Unit and a doctor will examine your eye.
You will be asked to stop your previous glaucoma drops in the operated eye and you will be given new drops to cover the operation. It is likely you will need to use these drops for up to three months.
After the operation, you may be required to be seen daily depending on how your eye has reacted to the surgery. Your doctor will advise you further regarding this.
Should you require a further supply of eye drops, you will be able to obtain them on prescription from your own GP.
For appointments for the Eye Clinic, you should go to the main Out-Patients department and report to Pink Reception.
About your pre-operative assessment
Before your operation, you will be contacted and asked to attend a pre-operative assessment appointment. Further information and details regarding your admission will be given to you then.
What does the pre-operative assessment involve?
The pre-operative assessment usually takes about 45 minutes. A nurse will go through your medical history and ask you a number of questions to assess whether you are able to have the operation as a day case patient. A day case patient means that your condition requires you to be in the hospital only for the length of your operation (and approximately 30 minutes afterwards for recuperation).
Your blood pressure and pulse will be recorded and you will be asked about any medication you are taking. We will also need to make sure that you are able to take the necessary care required after the operation.
Your tests will be carried out in a private room. A nurse, who will answer any questions which you may have about your operation, will be with you throughout.
What shall I bring with me to the assessment?
• Any drops, tablets or medicines which you are taking.
• Your present spectacles.
General advice and information
The Ophthalmic Day Surgery Unit is a specialised unit which cares for patients undergoing eye procedures on a day case basis.
The nursing staff are specifically trained in this area. The unit cares for men and women. There are separate toilet facilities for men, women and disabled patients.
Please bring this booklet with you to your Pre-admission Assessment you will receive an appointment by post, in the meantime, use this space below to write down any further questions to ask the doctor or the nurse when you come into hospital for your assessment.
Please do not worry about asking questions our staff will be happy to answer them.
Hospital policy
Smoking: The Trust operates a no smoking policy and your co-operation with this is appreciated.
Health & Safety: Our patients have poor vision, please consider their safety by co-operating with the following activities:
• try not to obstruct corridors
• to reduce the risk of injury to you and other patients, please avoid assisting others.
We hope you find this information is sufficient to help you decide whether to go ahead with the surgery.
Where is the opthalmic day surgery unit?
If you are registered disabled and have a ‘blue badge’:
• The nearest car park is Woodlands car park G which can be accessed from East Park near the Gastroenterology department.
• From car park G you can walk directly into the unit. This is sign-posted.
If you are not registered disabled/do not have a ‘blue badge’:
• Please park in the multi storey car park.
• Enter the hospital using the Main Entrance where you will find the retail stores.
• Turn right up the stairs, escalator or lift.
• Go straight on down the main corridor. • The Ophthalmic Day Unit can be found approximately 200 metres down this corridor.
Leaflet Number PL/719 (V3)
Author Nicky Kirby
Review Date 01/12/2027
