Glaucoma at Spire Hull and East Riding Hospital

Glaucoma is caused when there is damage to the optic nerve, caused either by raised eye pressure or weakness in the nerve. In most cases, both of these factors are involved. The eye needs ‘pressure’ to keep the eyeball in shape to make it work properly.

However, if the optic nerve comes under too much pressure, it can become damaged. The amount of damage there is depends on how high the pressure is and how long it lasts, and whether there is a poor blood supply or other weakness of the optic nerve.

There are four main types of glaucoma:

• Primary open angle glaucoma (POAG) also known as chronic glaucoma
• Acute angle closure glaucoma
• Secondary glaucoma
• Developmental glaucoma

If you have glaucoma, you will be looked after by a consultant ophthalmologist.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

Selective Laser Trabeculoplasty for Glaucoma (SLT)  is performed by Consultant Ophthalmologists Mr Craig Burnett

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

If you are diagnosed with glaucoma, an ophthalmologist will assess your condition and you will require regular appointments, at least at the outset, to make sure you are responding to treatment and that your eye pressure is in the right range for you and it is stable.

With time, and if your eye pressure stays stable, you may only require an appointment once every six or 12 months. It is very important that appointments are kept to check your eye pressure continues to be stable.

On each visit, you will have the pressure measured in the eye, the visual field tested and the back of your eye examined using drops to dilate your pupil.

SLT stands for ‘Selective Laser Trabeculoplasty’. This is a laser procedure used to reduce the pressure in the eye.
SLT can be an effective addition to eyedrop treatment  or it can be used as a primary treatment to reduce or eliminate the need for glaucoma eyedrops, along with their common side effects. 
It may be used as a ‘lifestyle choice’ – rather than using eyedrops.
Furthermore, SLT may be an alternative for those who have been treated unsuccessfully with other glaucoma treatments or in order to avoid risky glaucoma surgery.

What are the advantages of SLT?

There are a few key reasons why SLT may be deemed beneficial for you:
Safe: SLT is not associated with systemic side effects or the compliance issues of medications.
Selective: SLT selectively targets only specific cells, leaving the surrounding tissue intact.
Smart: SLT stimulates the body’s natural mechanisms to enhance outflow of the fluid in your eye.
Sensible: SLT therapy is covered by insurance providers, but it is also available for those who self-pay. 

SLT does not rely on medicines. Instead, it uses an advanced laser system to target only specific cells of the eye – those containing melanin, a natural pigment. This allows for only these cells to be affected, leaving surrounding tissue intact. As a result, your body’s own healing response helps lower the pressure in your eye.

The eye pressure rises when there is a blockage of fluid leaving the eye through the fine, sieve-like structure called the 'trabecular meshwork', which is located in the 'drainage angle' of the eye, at the boundary of the iris. This elevated pressure results in damage to the optic nerve and vision loss occurs.





A goal in glaucoma therapy is to improve the flow of fluid out of the eye through the trabecular meshwork

SLT selectively targets the pigment-containing cells of the trabecular meshwork, while preserving the surrounding tissue. Each laser application is only three nanoseconds (an incredibly short period of time) and uses very low energy levels (1000 times less energy than older treatments). This makes the laser gentle and safe with no damage to other cells. Therefore, the tissue is protected and there is no scarring.

This selective targeting is believed to stimulate the body's own repair mechanisms in the trabecular meshwork, which increases the fluid drainage out of the eye and reduces the eye pressure. SLT is an established treatment that can safely and effectively reduce eye pressure. Typically, the eye pressure is lowered by 25-30% (approximately 6-8mmHg) in about 80-90% of patients. However, it is important to understand that individual results can vary (the drop in eye pressure can be more or less than this).

How is SLT performed?
SLT is an outpatient procedure. Many aspects of the treatment are similar to a slit lamp examination at a clinic visit and, therefore, it will be very familiar to you.  You will sit in a conventional exam chair, where the doctor will use a slit lamp to examine your eye. The same slit lamp contains the SLT laser. During the procedure, the doctor will put anaesthetic drops in your eye to numb it, and then place a contact lens (‘gonioscopy lens’) on your eye for better viewing (most patients will have had this same examination previously in the clinic). The laser is shone into one of the mirrors of the gonioscopy contact lens and then reflected into the drainage angle of the eye. SLT is a procedure that usually causes no discomfort, and it only takes a few minutes to perform.

Will I feel anything with the laser treatment?
Generally, the laser treatment does not cause pain. However, studies show some patients experience a slight sensation during treatment. You may see a green flash of light. The lens used on your eye may cause some redness or irritation.

What are the side effects of SLT?
Unlike glaucoma medications, there are no incidences of allergy or systemic side-effects with SLT.
Unlike risky glaucoma surgery, SLT is extremely safe – for instance, there is no risk of infection inside the eye with SLT.

Complications from SLT are minimal but may include: inflammation (it is normal to have a little light sensitivity & a slightly red eye for a day or so); temporary increase in eye pressure (however, eye drops are used prior to the laser treatment in order to minimise this risk); blurred vision, headache, and eye pain have also been reported.

SLT cannot guarantee elimination/reduction of eye drops.
In the long-term, the effect of the laser can wear off, but SLT can be effectively repeated.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.