Multiple ocular conditions can lead to the development of glaucoma, which is the most common optic neuropathy. All therapeutic interventions are directed towards lowering the condition's greatest risk factor, intraocular pressure.

Typically, therapy is instituted in an ascending fashion, with topical medical therapy being the first and simplest option. Medications include topical beta adrenergic blockers, prostaglandin analogs, carbonic anhydrase inhibitors, alpha adrenergic agonists, and miotics; these agents, used alone or in combination, are often sufficient for control of intraocular pressure. In cases of open angle glaucoma requiring greater management of intraocular pressure, laser trabeculoplasty, an outpatient procedure, is used in conjunction with medications. For angle closure glaucoma, outpatient laser iridotomy is applied to relieve the pupillary block mechanism.

Incisional intraocular surgery is the most frequent choice when medical and outpatient laser procedures fail to diminish intraocular pressure, with trabeculectomy and aqueous tube shunt placement being the most commonly used procedures. Both approaches lower intraocular pressure by allowing aqueous humor to leave the anterior chamber and collect in the subconjunctival space. When other interventions have either failed or are unfeasible, such cyclodestructive procedures as laser ablation or cryoablation of the ciliary processes may be done. Incisional surgery is done in an operating room, usually on an outpatient basis; cyclodestructive operations are performed in a clinic setting; and local anesthesia is standard for both methods.

Usual postoperative course

Expected postoperative hospital stay

Glaucoma surgery usually does not require hospitalization, though monocular patients undergoing incisional surgery may be hospitalized.