Glaucoma is a group of eye conditions that can damage the optic nerve and gradually affect vision. In many cases, the damage is associated with increased pressure inside the eye, known as intraocular pressure.
Managing that pressure is an important part of glaucoma treatment. For some patients, selective laser trabeculoplasty (SLT) offers a way to lower eye pressure without starting, or increasing, daily eye drops.
At Farnham Eye Care in Surrey, Professor Dan Lindfield provides specialist glaucoma assessment and personalised treatment advice, including SLT laser treatment where clinically appropriate.
Selective laser trabeculoplasty is a treatment designed to improve the drainage of fluid from inside the eye.
The eye continually produces fluid, which normally drains through a specialised structure called the trabecular meshwork. When fluid does not drain efficiently, pressure inside the eye can rise.
SLT uses carefully controlled laser pulses directed at this drainage structure to help improve fluid outflow and reduce eye pressure.
Unlike procedures that create a new drainage pathway, SLT works with the eye's existing drainage system. The laser does not burn or “drill” any holes, instead it gently stimulates cellular responses to “clean up” the natural drainage pores.
SLT may be considered for patients with certain forms of open-angle glaucoma or ocular hypertension, where eye pressure is raised but glaucoma damage may not yet have developed.
It can be particularly useful for people who:
SLT is not suitable for everyone. The decision depends on the type and severity of glaucoma, current eye pressure, previous treatment and the health of the eye's drainage system.
National clinical guidance recommends SLT as an initial treatment option for many patients with non-advanced chronic open-angle glaucoma, reflecting its established role in modern glaucoma care.
SLT is generally performed as an outpatient laser procedure.
Before treatment, eye drops are used to prepare and numb the eye. The patient sits at a microscope similar to the equipment used during a routine eye examination.
A specialised contact lens is placed gently on the eye to help the ophthalmologist direct the laser accurately towards the drainage angle.
The laser treatment itself usually takes only a few minutes. Patients may notice flashes of light or hear clicking sounds, but significant pain is uncommon.
Some patients experience temporary blurred vision, redness or mild discomfort after treatment. These symptoms usually settle.
It is important to follow the ophthalmologist's advice about driving, medications and aftercare. Patients already using glaucoma drops should not stop them unless advised to do so.
SLT does not necessarily lower pressure immediately. The full response may take several weeks to assess, and follow-up measurements are important.
Although SLT is generally considered a low-risk procedure, possible complications include temporary inflammation, visual blurring, sensitivity to bright lights and a short-term increase in eye pressure. Rarely, more significant complications can occur.
No. SLT is a treatment for controlling eye pressure, not a cure for glaucoma.
Existing optic nerve damage cannot normally be reversed. The aim of treatment is to reduce the risk of further damage and preserve remaining vision.
SLT is effective for many patients, but the degree and duration of pressure reduction vary. Some people continue to need eye drops or other treatments, and the effect can diminish over time.
The average duration of SLT is 2.5-3.0 years however, this is an average and hence some patients may achieve shorter or significantly longer duration of effect.
SLT is eminently repeatable. If / when it wears off it can be topped up with a statistically similar response rate.
Regular glaucoma monitoring remains essential, even when eye pressure responds well.
Modern glaucoma care includes several different options, from prescription eye drops and laser procedures to minimally invasive and conventional glaucoma surgery.
At Farnham Eye Care, patients can also learn about treatment developments including ELIOS™, OMNI® and FLigHT using ViaLase.
These procedures work in different ways and are not interchangeable. The best option depends on the individual patient's diagnosis, treatment history and required pressure reduction.
A specialist assessment helps establish which approach is most appropriate.
Professor Dan Lindfield has extensive experience in glaucoma assessment, laser treatment and surgery. At Farnham Eye Care, treatment recommendations are tailored to each patient's eye health, circumstances and long-term vision needs.
If you have been diagnosed with glaucoma or raised eye pressure and would like to understand whether SLT could be suitable, contact Farnham Eye Care to arrange a specialist consultation.
The aim is straightforward: informed treatment decisions and the best possible protection for your remaining vision with the most minimal impact on your quality of life.
