You have a disease called glaucoma. This occurs when the pressure inside the eye becomes high. It causes the small blood vessels in the back of the eye to become closed so the blood cannot get to the optic nerve, which is the wire connecting your eyes to your brain. The damage that has occurred to your eyes cannot be reversed and it will worsen until you go blind unless we can lower your eye-pressure. We tried to treat you with eye drops but they do not lower your eye pressure sufficiently. There is an operation that can be done in an effort to reduce the pressure in one of your eyes. This is the best possibility for stopping or slowing down the loss of your eyesight. Without the surgery you are going to go completely blind soon. THE SURGERY WILL NOT MAKE YOU SEE ANY BETTER; IT WILL JUST PREVENT YOU FROM GOING BLIND. During surgery we create a small hole from inside the eye to underneath the white part of the eye called conjunctiva. The fluid will drain out of your eye through the hole. There is no pain during surgery, and you might have some discomfort afterwards for a few days but you will not have severe pain. The surgery is successful only 4 out of 5 cases but if we do not do the surgery, you will go blind for sure. Sometimes the surgery may make your vision worse at the beginning, but it is better than doing nothing in your case. The surgery can have complications once in a while and these might need to be treated by a second surgery. You will need to use drops after surgery for 2 months. If it is successful, very likely after this you will not need eye drops, but there is a small chance you still will. Please, do not go to a traditional healer, he will spoil your eye.
Please, think about the glaucoma surgery and let us know if you wish us to do it. Also please let us know if you have any questions.
I understand the above and I am consenting to the glaucoma surgery
in my RIGHT LEFT eye.
Name:……………………………………………….. Date: ………………