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At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
Glaucoma is an eye disease that causes a slow and painless loss of vision. It often has no symptoms and can lead to total blindness if not diagnosed and treated.
Glaucoma causes the pressure inside the eye to be too high, leading to a slow destruction of the optic nerve and loss of peripheral vision, which is the area you can see to the sides while looking straight ahead.
If your child is suspected of having glaucoma, the doctor will want to examine his or her eyes under anesthesia before any surgical steps are taken. Depending on what is found during that examination, your child’s doctor might prescribe eye drops, surgery or both to control your child’s eye pressure.
Increased pressure in the eye can be caused by a blockage in the eye’s drainage system. Trabeculotomy (tra-BECK-yoo-LOTT-o-mee) is a surgical procedure that helps reduce pressure in the eye by opening the eye’s drainage system to allow the eye to drain better. The eye is filled with a fluid called aqueous (AKE-wee-us) humor (HUE-mer). The fluid may not drain properly, causing glaucoma or increased pressure in the eye. Conversely, the eye may produce too much fluid, causing glaucoma or increased pressure in the eye. A trabeculotomy helps improve drainage of aqueous humor and decreases the pressure in the eye.
In the trabeculotomy, the surgeon will create a flap in the conjunctiva (kun-JUNK-tiv-uh), the clear covering over the white of the eye and lining the eyelids, and the sclera (SKLARE-uh), the white of the eye. The surgeon will then identify the drainage system canal and insert an instrument to open the canal wall to help the fluid inside the eye drain better. The scleral and conjunctival flaps then will be closed with stitches. These stitches will dissolve on their own and do not need to be removed. An eye patch and shield is placed on the eye. The patch will be removed by the surgeon in the office the following day.
In the 2 weeks before the surgery, do not give your child any aspirin or ibuprofen. That includes Motrin®, Advil®, Bayer®, Pediaprofen®, Aspergum®, Pepto Bismol® and Alka Seltzer®. Your child may take Tylenol®.
The day before the surgery, do not allow your child to get any kind of vaccination.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the surgery. One business day before your child’s surgery, you will receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) Please have paper and a pen ready to write down these important instructions.
For children older than 12 months:
For infants under 12 months:
For all children:
The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm.
A pediatric anesthesiologist—a doctor who specializes in anesthesia for children—will give the medications that will make your child sleep during the test.
Before the procedure, a member of the anesthesia staff will meet with you to take your child’s vital signs, weight and medical history. As the parent or legal guardian, you will be asked to sign a consent form before the anesthesia is given.
This surgery is done through the Same Day Surgery Center at Children’s Hospital in Lawrenceville.
When you check in at the registration desk, you will be asked for the clearance form from your child’s primary care physician (PCP). This PCP form was given to you at the appointment with the ophthalmologist when you scheduled your child’s surgery.
Once your child is registered, you and your child will be called to the examining room.
While your child is asleep, his or her heart rate, blood pressure, temperature and blood oxygen level will be checked continuously.
When your child is moved to the recovery room, you will be called so that you can be there as he or she wakes up. While your child is in recovery, your surgeon will talk to you about the surgery. This is a good time to ask questions about pain medications, diet and activity.
When your child is discharged from the hospital, he or she still might be groggy and should take it easy for the rest of the day.
You will need to bring your child to see the doctor 1 day after the surgery.
The following symptoms may be cause for concern:
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Division of Ophthalmology at Children’s before the surgery and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
With myCHP, you can request appointments, review test results, and more.
For questions about a hospital bill call:
To pay your bill online, please visit UPMC's online bill payment system.
Interested in giving to Children's Hospital? Support the hospital by making a donation online, joining our Heroes in Healing monthly donor program, or visiting our site to learn about the other ways you can give back.