When Surgery is Necessary for Glaucoma

Glaucoma | Portland | Oregon |

Glaucoma is like a thief in the night. You have no idea you’re being robbed until it’s a done deal. Only in this case, your vision is stolen. With glaucoma, pressure builds inside the eye, usually due to improper drainage of fluids. As this pressure builds it begins to damage the optic nerve. Glaucoma doesn’t present any symptoms early on, so if patients opt to skip their regular eye exams, the disease can be damaging their vision long before they have any idea.


That’s why glaucoma is one of the leading causes of blindness the world over.

The use of eyedrops to lower intraocular eye pressure is the first course of treatment, but this often doesn’t lower the pressure to the degree necessary. At The Eye Clinic both Dr. Donohue and Dr. Samples have specific advanced training in glaucoma. They perform three basic types of glaucoma surgery, all with the goal of improving or reestablishing drainage out of the eye. By improving drainage, pressure inside the eye drops.


The goal of glaucoma treatment is to lower intraocular eye pressure before it does any additional damage to the optic nerve and the patient’s vision. Damage that has been already done by adult glaucoma is not reversible. In congenital glaucoma in children, some damage can be reversed.

Treatment options include both medicines and surgery. When eyedrops prove ineffective, Dr. Donohue and Dr. Samples can perform glaucoma surgery. Here are descriptions of three glaucoma surgeries he performs:

  • Trabeculectomy

This procedure involves the creation of a new fluid outflow pathway within the eye’s natural tissues. An incision removes a piece of tissue to allow drainage. After trabeculectomy surgery, fluid flows from inside the eye to the space underneath the front clear skin tissue of the eye, called the conjunctiva. From there, the fluid gets absorbed into the eye’s tear film and normal blood vessel supply.

  • Tube-shunt surgery

In this surgery, an artificial filtering device is placed onto the sclera, the eye wall. The device is connected to a silicone tube that carries the fluid away. The fluid collects at the site of the implant and is then absorbed by the eye’s natural tissues.

  • Laser trabeculoplasty

This procedure uses a laser to burn tissue to create an opening that allows fluid drainage from the eye. For some patients who have had this surgery their intraocular pressure only decreases for a few years, and then it begins to increase again. This may require another laser procedure to again facilitate drainage.

If you have glaucoma and need surgery to improve drainage and drop intraocular pressure, trust the board-certified expertise of The Eye Clinic team. Call us at (503) 297-4718 to schedule your appointment.

Posted in: Glaucoma

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