Secondary Glaucoma Treatment
Secondary glaucomas share the same overall treatment toolkit as primary glaucoma, but each type also has its own specific underlying cause that must be addressed directly.
Treat the Underlying Cause, Then the Pressure
Unlike primary open-angle or angle-closure glaucoma, secondary glaucomas are caused by an identifiable underlying condition. Effective treatment requires addressing that specific cause, in addition to the same general toolkit of drops, laser, and surgery used across all glaucomas.
Examples of Cause-Specific Treatment
- ✓Neovascular glaucoma — anti-VEGF injection and panretinal laser photocoagulation to treat the underlying retinal ischemia are essential first steps, alongside pressure-lowering treatment and, if surgery is needed, a tube shunt is generally favored over trabeculectomy
- ✓Pigment dispersion & pigmentary glaucoma — SLT can be very effective given the heavily pigmented angle, but we use deliberately lower laser energy given the risk of a post-laser pressure spike
- ✓Pseudoexfoliation glaucoma — often more aggressive and medication-resistant, so we monitor more closely and consider laser or surgery sooner; cataract surgery requires extra precautions for zonular weakness
- ✓Uveitic glaucoma — controlling the underlying inflammation is the priority, steroid use is monitored closely for its own pressure-raising effect, and tube shunt surgery is generally favored over trabeculectomy given scarring risk
- ✓Steroid-induced glaucoma — stopping or switching the causative steroid, when medically possible, can fully resolve the problem
- ✓Traumatic/angle recession glaucoma — standard medical therapy first-line, with a lower threshold for surgery since laser is less predictably effective on structurally damaged drainage tissue
The Same Overall Toolkit
Once the underlying cause is addressed (or in parallel with it), the same options used across all glaucoma types — eye drops, SLT laser, MIGS surgery, trabeculectomy, tube shunt surgery, and cyclophotocoagulation — are available, with the specific choice and sequencing tailored to each condition. See each modality's dedicated page for full detail.
Each secondary glaucoma type has its own dedicated condition page with cause-specific detail — visit our Conditions page to find yours.
Frequently Asked Questions
What makes secondary glaucoma different to treat?
Secondary glaucomas are caused by an identifiable underlying condition — inflammation, abnormal blood vessels, pigment, medication, trauma, or a genetic syndrome — so effective treatment addresses that specific cause in addition to standard eye pressure-lowering treatment.
Do you use the same drops, laser, and surgery as other glaucomas?
Yes, the same overall toolkit (drops, SLT, MIGS, trabeculectomy, tube shunt, CPC) applies, but the specific choices, cautions, and sequencing are tailored to each secondary glaucoma type.
Which secondary glaucoma types need the most different approach?
Neovascular glaucoma (needs anti-VEGF and retinal laser treatment of the underlying ischemia), pigment dispersion glaucoma (needs cautious, low-energy SLT), and uveitic glaucoma (needs inflammation control and often favors tube shunt over trabeculectomy) are among the more distinctive examples.
Where can I read about my specific type?
Each secondary glaucoma has its own dedicated condition page under our Conditions section, with a full explanation of its cause, diagnosis, and treatment nuances.
See a glaucoma specialist. Dr. Robert Gunzenhauser is Harvard-educated and UCLA fellowship-trained in glaucoma, providing expert diagnosis and treatment for Secondary Glaucoma Treatment at Inland Glaucoma Center in Upland, CA.