Questioned answered by Dr Simon Phipps
Why do some doctors start treatment with eye drops and others with SLT laser? How do I decide the best option for me?
Studies have shown eye drops or SLT laser can be effective in lowering eye pressure in the treatment of glaucoma. However a doctor may prefer initial treatment with drops or SLT laser based on factors such as patient lifestyle, pre-existing eye problems or disease, type of glaucoma, the severity of glaucoma and initial untreated intraocular pressure. In some instances the eye specialist may recommend both treatments(eye drops and SLT) be started simultaneously. Discussing these two treatment options with your doctor will help you decide which one to choose.
Can SLT laser harm my eyes?
SLT laser is generally a very safe treatment. The risk of permanent harm to the eye is extremely rare or possibly even non-existent. There maybe a very rare risk of the eye pressure rising for a prolonged period after SLT in patients with pigmentary glaucoma. If this occurs surgery maybe required to lower the eye pressure. Significant but rare and reversible complications from SLT which can reduce vision for a time but not permanently include inflammation of the eye, bleeding into the front of the eye, swelling of the retina and clouding of the cornea. With time these complications resolve and vision returns to normal. Occasionally glasses may need to be adjusted to bring vision back to normal.
I am scared to have the laser treatment done. Is it painful?
Thankfully SLT is generally not a painful procedure. Many patients report “feeling” the procedure as it is occurring but wouldn’t describe it as painful. In the rare instance that it does feel painful the doctor can help by reducing the power of the laser treatment during the treatment process.
What symptoms are considered normal after the SLT laser? Is it normal for my eyes to feel gritty and look red?
Sensitivity to light, blurry vision, eye redness and a gritty sensation are all normal after SLT treatment. These symptoms are usually mild and resolve over 2-3 days.
My friend had some eye drops to use for a few days after the laser - some antibiotics and anti inflammatory. But my doctor did not recommend any eye drops post laser. Why would that be the case?
Many doctors don’t routinely prescribe eye drops after SLT laser. However there may be instances related to a patients previous eye history or health or lifestyle demands where use of eye drops after SLT is recommended by the doctor. Generally the eye drops would only need to be used for one week after SLT.
Can I use lubricating eye drops to help with post laser symptoms such as irritated and dry eyes?
Yes. Lubricating eye drops can often help the eyes feel more comfortable after treatment.
Can I have SLT laser in both eyes on the same day?
Yes. In fact most doctors will routinely treat both eyes with SLT on the same day.
How often or how many times can SLT laser be repeated?
SLT can be repeated indefinitely every 12 to 24months. The treatment interval maybe more frequent initially if the doctor treats only one half or 50% of the eye. In this situation the other half of the eye(s) maybe treated only a few weeks later. Treatment intervals will vary depending on patient eye pressure and whether the glaucoma is stable. SLT can be effective for up to 5 years in some patients without need for more treatment.
Why would SLT laser not be suitable for me?
Some types of glaucoma are not suitable for SLT. In rare instances if you have pre-existing eye disease such as corneal disease or a history of uveitis(eye inflammation) SLT may not be suitable.
Selective Laser Trabeculoplasty is considered a safe and effective procedure with few risks. While glaucoma treatments cannot restore vision already lost from glaucoma, early detection and treatment of glaucoma offers the best chance of preserving your vision.
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