Trabeculectomy is a type of glaucoma surgery used to lower pressure inside the eye. During the procedure, your surgeon creates a new pathway that allows fluid to drain from the eye. This forms a small area under the upper eyelid called a bleb.

Lowering eye pressure can help protect your optic nerve and preserve the vision you still have. However, trabeculectomy cannot restore vision that has already been lost from glaucoma.

Recovery takes time, and your eye may need several adjustments as it heals. Based on updated guidance from MyHealth Alberta and other current glaucoma surgery resources, here is what you can generally expect after surgery.*

What to Expect During Recovery

It is normal for your eye to feel different after trabeculectomy. You may notice redness, irritation, watering, mild swelling, or a gritty feeling, as though something is in your eye. Your vision may also be blurry.

These symptoms usually improve as the eye heals. Blurry vision may last several weeks, and it can sometimes take about six weeks or longer for your vision to settle. Your vision will usually return to around the level it was before surgery, although you may eventually need an updated glasses or contact lens prescription.

Try not to rub, press, or touch your healing eye. Your surgeon may have you wear an eye shield while sleeping for the first week or for several weeks after surgery. Follow the specific instructions you receive from your surgical team.

Many people can return to work within one to two weeks, but your timing will depend on the type of work you do and how your eye is healing. Jobs that require heavy lifting, bending, physical activity, or demanding visual tasks may require more time away.

Follow-up visits are an important part of treatment

Trabeculectomy recovery involves more than simply waiting for the eye to heal. Your surgeon will need to monitor how well fluid is draining and whether your eye pressure is reaching a safe level.

You may have several follow-up visits during the first few weeks after surgery. During these appointments, your surgeon may adjust or remove stitches or use medications to help control inflammation and prevent excessive scarring around the bleb.

These adjustments can be a normal part of recovery and do not necessarily mean something has gone wrong with the surgery.

You will also likely use prescription eye drops after surgery. These may help prevent infection, reduce inflammation, and control healing. Your doctor will tell you exactly which drops to use and how often.

Do not stop, restart, or change your glaucoma medications on your own. Your surgeon will let you know whether you should continue any of your previous glaucoma medicines as your eye heals.

Taking Care of Your Eye at Home

Giving your eye time to heal can help lower the chance of complications.

During the first few weeks, avoid strenuous activities such as running, heavy lifting, intense exercise, and activities that involve frequent bending. Walking is usually fine if you feel comfortable, but ask your doctor before returning to more demanding exercise.

You should also ask your surgeon when it is safe to drive. Your vision needs to be clear enough for you to drive safely.

Other helpful precautions may include:

• Avoid rubbing or putting pressure on your eye.
• Wash your hands before using eye drops.
• Keep soap, shampoo, dirt, and dust out of your healing eye.
• Avoid swimming and hot tubs until your surgeon says your eye has healed enough.
• Avoid gardening or dusty activities during the early recovery period.
• Wear sunglasses if your eye is sensitive to light.
• Avoid contact lenses in the operated eye until your doctor says they are safe to use.
• Ask your doctor when it is safe to return to makeup, exercise, and other normal activities.

Your surgeon’s instructions should always come first. Recovery recommendations can vary depending on your eye, the type of surgery performed, and how quickly you heal.

If you take aspirin, blood thinners, or other medications that were stopped before surgery, ask your doctor when you should begin taking them again. Do not restart them without medical guidance.

When Should You Contact Your Doctor?

Some discomfort, redness, and blurry vision can be expected after trabeculectomy. However, certain symptoms need prompt medical attention.

Contact your eye doctor or surgical team right away if you experience:

• New or worsening eye pain
• Increasing redness or swelling
• Pus or thick discharge from the eye
• A sudden decrease or loss of vision
• Symptoms that are getting worse instead of improving
• Any other change your doctor told you to watch for

Seek emergency medical care for severe symptoms such as sudden vision loss, chest pain, difficulty breathing, or loss of consciousness.

Remember your bleb even after you recover

The bleb created during trabeculectomy remains part of your eye after the initial recovery period is over. Although serious bleb infections are uncommon, they can sometimes occur months or even years after surgery.

For that reason, do not ignore unexpected redness, pain, discharge, or sudden changes in vision in an eye that has had a trabeculectomy. Contact your eye doctor promptly if these symptoms develop.

Continuing your regular glaucoma appointments is also important. Your doctor will monitor your eye pressure, optic nerve, vision, and the health of your bleb over time.

The Takeaway

Trabeculectomy can be an effective way to lower eye pressure and help protect your remaining vision when glaucoma is not adequately controlled with other treatments. Recovery usually takes several weeks, and follow-up appointments are an important part of helping the new drainage pathway work properly.

Take your medications exactly as prescribed, protect your healing eye, avoid strenuous activities until your doctor clears you, and keep every scheduled follow-up appointment. Most importantly, contact your eye care team whenever something does not seem right.

Everyone heals differently, so use general recovery guidelines as a starting point—not a replacement for the instructions provided by your glaucoma surgeon.

Medically reviewed by Alan Robin, MD. Dr. Robin is a leading glaucoma specialist and researcher. He serves as an Associate Professor of Ophthalmology at Johns Hopkins University and has contributed extensively to the development of modern glaucoma treatments. Dr. Robin has authored more than 260 peer-reviewed publications and is widely recognized for his impact on patient care and global eye health.

*Myhealth.Alberta.Ca. (July 31, 2024) “Trabeculectomy: What to Expect at Home”. myhealth.alberta.ca

This content from The Glaucoma Community is intended for educational purposes and should not be considered a substitute for professional medical guidance. Please consult with your personal healthcare team prior to adjusting your clinical care. The Glaucoma Community does not recommend or endorse any particular medications, specialists, or commercial products.