SLT Laser or Daily Eye Drops? Your Glaucoma Treatment Options Explained

Most people diagnosed with glaucoma are handed a bottle of eye drops and told to use them every day for life. Fewer are told that drops are not the only option, or what happens when daily drops stop working.

So here is the practical version.

Why glaucoma treatment never really stops

Glaucoma damages the optic nerve, usually because pressure inside the eye stays too high. That damage does not reverse. Treatment therefore has one job: lower the pressure enough to stop further loss.

Because the disease is silent in its early stages, most people feel completely normal while it progresses. As a result, treatment protects vision you have not lost yet rather than restoring vision you have.

How eye drops work, and why people stop using them

Drops lower eye pressure either by reducing the fluid the eye produces or by helping that fluid drain away. They work well when used correctly.

The difficulty is consistency. Studies of glaucoma treatment repeatedly find that many patients stop using their drops within the first year. The reasons are ordinary rather than careless:

• They are easy to forget, especially on a busy morning
• They sting or redden the eyes, so people quietly reduce the dose
• They are difficult to instil for anyone with arthritis or a tremor
• Nothing feels different when a dose is missed, so the consequence is invisible
• The cost adds up month after month, for years

Missed drops mean uncontrolled pressure. Uncontrolled pressure means continued nerve damage.

What SLT laser does differently

Selective Laser Trabeculoplasty, or SLT, uses a low-energy laser to treat the eye’s natural drainage tissue. That tissue then drains fluid more efficiently, and eye pressure falls.

The procedure is done in the clinic rather than a theatre. It takes a few minutes per eye, uses only anaesthetic drops, and does not involve cutting. Most people drive home afterwards.

Mount Lotus introduced Sri Lanka’s first SLT laser, so the procedure has been available here longer than anywhere else in the country.

SLT compared with daily drops

Adherence. SLT works without you having to remember anything. This is its single biggest advantage over drops.

Duration. The effect typically lasts somewhere between one and five years. It can be repeated when the effect fades.

Side effects. Mild inflammation or a brief pressure rise can occur, and both are usually short-lived. Drops, by contrast, cause daily surface irritation for many people.

Cost over time. SLT is a single upfront cost rather than a monthly one, which changes the arithmetic considerably over several years.

It is not a cure. This matters: SLT lowers pressure, but glaucoma still needs monitoring for life. Some patients continue on drops alongside it.

Who is suitable for this glaucoma treatment

SLT suits many people with open-angle glaucoma or ocular hypertension. In fact, it is increasingly offered as a first treatment rather than a last resort.

However, it is not right for everyone. Certain types of glaucoma respond poorly, and advanced disease may need surgery instead. Only an examination that measures your pressure, examines your drainage angle and images your optic nerve can establish which group you fall into.

What the appointment involves

Your eye pressure is measured, your optic nerve is examined and photographed, and a visual field test maps any vision you have already lost. The drainage angle is checked with a special lens.

Together these results decide the treatment. The assessment is painless and takes about an hour, though dilating drops will blur your near vision for a few hours afterwards, so arrange not to drive.

The takeaway

If you are managing glaucoma with drops and finding them difficult, that is worth saying out loud at your next appointment rather than quietly skipping doses.

Glaucoma treatment has more than one route. SLT will not suit everyone, but for many people it removes the daily burden that causes treatment to fail in the first place.

The vision glaucoma takes does not come back. Protecting what remains is the whole point of getting the treatment right.

Mount Lotus Eye & ENT Hospital — Mount Lavinia & Kurunegala. Home of Sri Lanka’s first SLT laser.
📞 Mount Lavinia: 0112 333 444 | Kurunegala: 0372 333 444