Menu
Eye Specialist Clinic - Eye Centre Singapore
Glaucoma
Home
Conditions
Glaucoma
Treatment
Dr Steve Seah
Dr Steve Seah
Senior Consultant Opthalmologist
MBBS, FRCS(G),
M Med(Opthth)FRCS(Ed), FRCOphth, FAMS

Glaucoma Treatment and Surgery in Singapore

Glaucoma is a progressive eye condition that can damage the optic nerve and gradually affect vision over time. Since symptoms often develop slowly and may not be noticeable in the early stages, timely diagnosis and treatment play an important role in helping to preserve vision. Depending on the type and severity of glaucoma, treatment may involve medicated eye drops, laser procedures or surgery to lower pressure within the eye. At Steve Seah Eye Centre, care is guided by a detailed assessment of your condition to determine an approach that supports long-term eye health and visual function.

Glaucoma Treatment

What Are Glaucoma Eye Drops and When Are They Suitable?

Glaucoma eye drops are prescription medications used to lower pressure within the eye, also known as intraocular pressure (IOP). They are commonly the first treatment recommended for many individuals diagnosed with glaucoma and may also be prescribed for people with ocular hypertension, where eye pressure is elevated and there is a higher risk of developing glaucoma.

These medications work by controlling the movement of fluid inside the eye in one or both of the following ways:

  • Improving Fluid Drainage: Helping the eye's natural fluid, known as aqueous humour, drain more effectively
  • Reducing Fluid Production: Decreasing the amount of fluid produced within the eye

Types of Glaucoma Eye Drops

Different glaucoma medications work in different ways, and the type prescribed depends on your condition and treatment needs.

Prostaglandin analogs (Xalatan, Lumigan, and Travatan Z)

These are among the more commonly prescribed glaucoma medications and are designed to improve the eye's natural fluid drainage. They are often favoured because they usually require only once-daily use, which may make long-term treatment easier for some individuals.

Beta blockers (Timolol)

Beta blockers were at one time the drugs of first choice in treating glaucoma. Rather than improving fluid outflow, these medications work by reducing the amount of fluid produced within the eye, helping to lower pressure levels. They may not be suitable for everyone, particularly individuals with certain heart or respiratory conditions.

Alpha adrenergic agonists (Alphagan, iopidine)

Alpha agonists work by reducing fluid production while also encouraging better fluid drainage, allowing pressure inside the eye to be managed through more than one pathway.

Carbonic anhydrase inhibitors (Trusopt, Azopt, Diamox, Neptazane)

Similar to beta blockers, carbonic anhydrase inhibitors help lower eye pressure by reducing the amount of fluid produced within the eye. These medications are available as both eye drops and oral tablets, depending on the severity of the condition and treatment needs. They are usually used in combination with other anti-glaucoma eye drops.

Parasympathomimetics or Miotics (Isopto Carpine, Pilocar)

Parasympathomimetics are commonly used in narrow-angle glaucoma to help lower pressure inside the eye. These medications work by constricting the pupil, which helps widen the drainage angle and allows fluid to flow out of the eye more effectively.

Combined medications (Combigan, DuoTrav, Cosopt)

Combination medications contain two different anti-glaucoma agents within a single bottle. They may be recommended for individuals who require more than one type of medication, helping to simplify treatment routines and reduce the number of separate eye drops needed each day.

Protecting vision begins with early treatment.

Schedule a consultation to discuss treatment options before further damage occurs.

What Is Glaucoma Laser Treatment and When Is it Recommended?

Laser treatment may be recommended when eye drops alone are not effectively controlling eye pressure, or when a different treatment approach may be more suitable for your condition. These procedures work by either improving fluid drainage or reducing fluid production within the eye, helping to lower intraocular pressure and slow the progression of glaucoma.

Types of Glaucoma Laser Treatment

Different laser procedures are available depending on the type of glaucoma and how pressure inside the eye needs to be managed.

Argon Laser Trabeculoplasty (ALT)

ALT may be recommended for selected individuals with open-angle glaucoma. During the procedure, laser energy is directed towards the eye's drainage tissue, known as the trabecular meshwork, to encourage better fluid outflow. Improving drainage can help reduce pressure inside the eye and support better long-term glaucoma control.

Selective laser trabeculoplasty (SLT)

SLT uses lower-energy laser pulses to target specific cells within the eye's drainage system while minimising effects on surrounding tissue. Similar to ALT, it works by improving fluid drainage and lowering eye pressure. Compared with ALT, SLT generally causes less tissue disruption and may be repeated in selected patients if necessary.

Transscleral Cyclophotocoagulation (TCP)

TCP is often considered for more advanced or difficult-to-control glaucoma cases where additional pressure reduction may be needed. The laser targets the ciliary body, which is responsible for producing fluid inside the eye. By reducing fluid production, the procedure can help lower intraocular pressure.

Laser peripheral iridotomy (LPI)

LPI is commonly used for individuals with angle-closure glaucoma or for those who may be at higher risk of developing it. During the procedure, a small opening is created in the iris using laser energy to improve fluid movement within the eye and reduce the risk of pressure build-up. The treatment itself is usually completed within a few minutes for each eye.

Every stage of glaucoma management matters when it comes to protecting your sight.

Schedule a consultation to discuss treatment options ranging from eye drops and laser procedures to surgical care.

What Is Glaucoma Surgery and When Is it Recommended?

When medications and laser procedures are no longer able to achieve adequate pressure control, surgery may be considered as the next step. The goal of surgery is not to restore vision already affected by glaucoma. Instead, it aims to reduce pressure and help preserve the remaining healthy vision.

Types of Glaucoma Surgery

Several surgical procedures may be considered when medications and laser treatment are no longer providing sufficient control of eye pressure. Below are some of the surgical approaches that may be recommended as part of glaucoma management

Here are some of the surgical procedures that SSEC offers:

Trabeculectomy with Anti-Metabolites

Glaucoma Surgery

Trabeculectomy is one of the most established surgical procedures used in glaucoma management and is often considered when other treatments are no longer adequately controlling eye pressure.

During the procedure, a small drainage pathway is created in the white part of the eye, known as the sclera, to allow fluid to drain more effectively. Anti-scarring medications such as mitomycin C (MMC) may also be used during surgery to reduce scar formation and help improve the long-term function of the drainage pathway.

Phacoemulsification combined with Trabeculectomy

Cataract and glaucoma can sometimes occur together, particularly in older individuals. For selected patients with both conditions, cataract surgery and glaucoma surgery may be combined into a single procedure.


Potential benefits of combining both procedures may include:

  • One operation instead of two separate procedures
  • Reduced overall recovery time
  • Fewer hospital visits
  • Lower overall treatment burden

Deep Sclerotomy

Deep sclerotomy is a non-penetrating glaucoma procedure commonly used in selected cases of open-angle glaucoma. During the procedure, a small section of tissue within the sclera is removed to create an alternative drainage space and improve fluid outflow.

Because the eye is not fully penetrated during surgery, this technique may help reduce the risk of certain complications associated with more invasive procedures.

The earlier glaucoma is addressed, the greater the opportunity to help preserve your vision.

Schedule a consultation to find out which treatment approach may be suitable for your condition.

Glaucoma Drainage Implants

Glaucoma drainage implants may be considered for individuals who are not suitable candidates for trabeculectomy, particularly if there is a higher risk of scarring or if previous glaucoma surgery has not achieved adequate pressure control. Also known as glaucoma shunts or drainage devices, these implants create an alternative pathway for fluid inside the eye to drain more effectively.

Glaucoma drainage implants are available in different designs and may be selected based on your individual eye condition and treatment needs. Below are some of the implants used in our clinic.

Baerveldt Implant (Advanced Medical Optics)

The Baerveldt Implant is a larger glaucoma drainage device designed to improve fluid drainage and help lower pressure within the eye. Its larger surface area may contribute to more sustained pressure control and studies comparing different implant types have suggested that the Baerveldt Implant may provide a longer-lasting pressure-lowering effect in selected patients.

Research conducted by Dr Seah also found that, in Asian patients with complicated glaucoma, Baerveldt implants achieved stable intraocular pressure reduction with a low incidence of complications during the intermediate follow-up period.

Ex-Press Glaucoma Shunt (Alcon)

The Ex-Press Glaucoma Shunt is a miniature stainless steel device designed to create a controlled pathway for fluid drainage and help regulate pressure within the eye. It provides an alternative approach to managing glaucoma by standardising fluid outflow during and after implantation. The procedure itself generally involves a shorter surgical duration and the device can often be implanted within a relatively short time. The Ex-Press Glaucoma Shunt is also MRI-safe.

What to Expect Before, During, and After Surgery?

The surgical journey can vary depending on the type of glaucoma procedure being performed, but understanding what to expect at each stage may help you feel more informed and prepared.

What to Expect Before

Before surgery, your ophthalmologist will review your medical history, perform detailed eye assessments and discuss the planned procedure with you. You may also receive instructions regarding medications, prescribed eye drops and fasting requirements if sedation is needed. Arranging for someone to accompany you home afterwards is recommended.

What to Expect During

Most glaucoma procedures are performed as day surgery under local anaesthesia with sedation to help you stay comfortable. Depending on your condition, the procedure may involve creating a new drainage pathway, inserting a drainage implant or performing laser treatment to lower eye pressure. A protective eye shield or patch is usually placed over the eye after the procedure.

After Surgery and Recovery

Some temporary blurring of vision, mild discomfort or light sensitivity may occur during recovery. Follow-up appointments and prescribed eye drops play an important role in supporting healing and monitoring eye pressure. You may also be advised to avoid rubbing the eye, strenuous activities and heavy lifting while recovery is ongoing.

Potential Risks and Side Effects of Glaucoma Surgery

As with any medical procedure, glaucoma surgery carries potential risks.

These may include:

  • Infection
  • Bleeding
  • Temporary blurred vision
  • Low eye pressure
  • Scarring affecting drainage
  • Need for additional procedures
  • Bleeding

Your ophthalmologist will discuss possible risks and expected outcomes according to your individual situation.

Taking Steps to Protect Your Long-term Vision

Because vision loss from glaucoma cannot typically be reversed, timely assessment and treatment play an important role in helping to preserve your remaining eyesight and slow further progression.

At Steve Seah Eye Centre, care is led by Dr Steve Seah, an experienced ophthalmologist with extensive expertise in glaucoma management and surgery. If you have concerns about glaucoma or changes in your vision, do not wait for symptoms to become more noticeable. Schedule a consultation and take an early step towards protecting your long-term eye health.

More About Glaucoma

Frequently Asked Questions (FAQs) About Glaucoma Treatment

Glaucoma cannot usually be cured and vision loss caused by optic nerve damage is generally irreversible. However, with early diagnosis and appropriate treatment, glaucoma can often be managed to help slow progression and preserve remaining vision.

Glaucoma surgery is typically performed under local anaesthesia, often together with medication to help you relax. You should not feel pain during the procedure, although mild discomfort, irritation or a scratchy sensation may occur during the recovery period.

Glaucoma surgery typically takes anywhere from 10 to 90 minutes. The exact time depends on the type of procedure and complexity of the case.

Many glaucoma procedures are performed as day surgery, which means you can usually return home on the same day. Your ophthalmologist will advise if additional observation or hospital stay is required.

Laser treatment is generally less invasive and works by improving fluid drainage or reducing fluid production within the eye. Surgery typically involves creating a new drainage pathway or placing a drainage device and may be considered when medications or laser treatment are no longer providing adequate pressure control.

For individuals diagnosed with glaucoma, follow-up appointments are typically scheduled every three to 12 months, depending on the severity of the condition and how well eye pressure is being controlled. Since glaucoma is a long-term condition, ongoing monitoring is important and may include regular eye pressure measurements, visual field assessments and examinations of the optic nerve.

Yes. Glaucoma can affect one or both eyes, although the severity and progression may differ between each eye.

Glaucoma often develops gradually and may not cause noticeable symptoms in its early stages. Early diagnosis and treatment may help slow progression, reduce the risk of further optic nerve damage and preserve vision over the long term.

Yes, glaucoma surgery is generally claimable and may be covered by insurance in Singapore as it is considered a medically necessary procedure aimed at helping to prevent further vision loss. Depending on your eligibility, a combination of national healthcare schemes and private insurance plans may help offset hospital and surgical expenses.

Dr Steve Seah

Meet Our Glaucoma Surgeon in Singapore

Dr Steve Seah
Senior Consultant Opthalmologist MBBS, FRCS(G), M Med(Ophth), FRCS(Ed), FRCOphth, FAMS

Dr Steve Seah is a senior consultant ophthalmologist with over 30 years of clinical experience in the management of glaucoma, cataracts and refractive conditions. He previously served as Head of the Glaucoma Service at the Singapore National Eye Centre and also led the Glaucoma Research Unit at the Singapore Eye Research Institute, reflecting his longstanding involvement in both clinical care and glaucoma research.

His experience spans a broad range of glaucoma treatments, including medication management, laser therapy, complex glaucoma surgery and glaucoma drainage implant procedures, alongside cataract and refractive surgery.

Begin Your
Eye Treatment
Journey Now

At Steve Seah Eye Centre, we are committed to providing trusted, specialised and personalised eye care.

To schedule a consultation, contact us at 6565 6888 or drop us a message and we’ll be in touch shortly.

Eye Surgery Clinic
One Orchard Boulevard
#16-01/02 Camden Medical
Singapore 248649
Tel : (65) 6565 6888
Blog
Dr. Steve Seah’s Eye Clinic in Singapore
View On Google Map

*Map are for illustration purposes