For most people with glaucoma, flying on a regular pressurized passenger plane is safe. The cabin is kept at a pressure that usually causes little change in eye pressure, so flying is not expected to worsen stable glaucoma. The main exceptions are a gas bubble in the eye after certain surgeries and a history or risk of angle-closure glaucoma that may need individual advice.
How does flying affect eye pressure?
Glaucoma damages the optic nerve, which carries visual information from the eye to the brain. Pressure inside the eye, called intraocular pressure (IOP), is an important factor in many forms of glaucoma. Treatment aims to lower eye pressure when needed to help protect the optic nerve and preserve vision.
Although the air pressure outside an aircraft decreases as it gains altitude, commercial airplane cabins are pressurized to limit the effects of these changes. According to the Glaucoma Research Foundation, air travel rarely affects eye pressure because cabin pressure is carefully regulated. For most people whose glaucoma is stable, an ordinary commercial flight is therefore not usually a reason to expect a significant change in eye pressure.
Flying does not have the same effect on every eye condition, however. A person's glaucoma type, recent eye procedures, and individual medical history can affect whether any extra precautions are needed.
When might flying be a concern for someone with glaucoma?
Having a gas bubble inside the eye after surgery
This is an important exception to the general advice that flying is safe. Some operations, especially procedures to repair a detached retina, involve placing a gas bubble inside the eye to help the retina heal. As cabin pressure decreases during flight, the bubble can expand and cause eye pressure to rise sharply. This may damage the eye and threaten vision.
If a surgeon has placed a gas bubble in your eye, do not fly until your ophthalmologist confirms that it is safe. The restriction may remain in place until the bubble has completely disappeared. The American Academy of Ophthalmology explains that pressure changes during air travel can make flying dangerous while an intraocular gas bubble remains. This restriction is different from the usual advice for people who have glaucoma without a gas bubble.
Flying soon after glaucoma surgery
Common glaucoma procedures, including laser treatment and operations designed to improve fluid drainage, do not typically involve leaving a gas bubble inside the eye. The Glaucoma Research Foundation notes that people with glaucoma generally do not have routine air-travel restrictions after glaucoma surgery.
However, the type of procedure, healing progress, and any complications can affect when it is appropriate to travel. Contact your eye surgeon before booking or taking a flight after a recent eye operation, and follow the specific instructions provided for your recovery.
Having narrow drainage angles or a history of angle-closure glaucoma
Angle-closure glaucoma occurs when the drainage angle inside the eye becomes blocked or closes, preventing fluid from draining normally. This can cause eye pressure to rise suddenly and requires urgent treatment. It differs from the more common open-angle glaucoma, which usually progresses slowly.
A report published in JAMA Ophthalmology described three cases of angle-closure glaucoma occurring during long-haul flights. These reports do not establish how often this happens or show that flying commonly triggers an attack. However, if an eye specialist has told you that you have narrow drainage angles, or you have previously experienced angle-closure glaucoma, ask whether your travel plans require any special precautions.
How can you prepare for a flight with glaucoma?
Most people with stable glaucoma can focus on maintaining their usual care routine while travelling. A few practical steps can help prevent missed treatment and make the journey more comfortable.
- Keep glaucoma medication in your carry-on bag. Bring enough prescribed eye drops or other medication for the entire trip, with extra supplies in case your return is delayed.
- Continue your prescribed treatment. Do not stop or change your medication because you are flying. If your trip crosses several time zones, ask your eye doctor or pharmacist how to maintain an appropriate dosing schedule.
- Protect your medication. Follow the storage instructions on the packaging and avoid leaving eye drops in excessive heat or cold. Keep containers securely closed to reduce the chance of leakage.
- Plan for dry cabin air. Airplane cabins can be dry, which may cause eye discomfort or worsen dryness, particularly for contact lens wearers. Lubricating eye drops, also called artificial tears, may help when appropriate for your eyes.
- Check before travelling after eye surgery. Confirm that your surgeon has cleared you to fly, especially if you have been told that a gas bubble remains inside your eye.
The Glaucoma Research Foundation's guidance on travelling with glaucoma medication recommends keeping medication accessible, carrying enough for the journey, and planning ahead for changes in time zones. If you are unsure how to adjust your routine, get advice before departure rather than changing doses on your own.
Which symptoms during or after a flight need urgent attention?
Routine air travel is not generally expected to worsen stable glaucoma, but sudden eye symptoms should not be dismissed as ordinary travel discomfort. Acute angle-closure glaucoma is an emergency, and warning signs may include:
- Sudden, severe eye pain
- A red eye with blurred vision
- Seeing coloured rings or halos around lights
- A severe headache accompanied by eye symptoms
- Nausea or vomiting with eye pain or visual changes
The Mayo Clinic's guidance on glaucoma symptoms identifies sudden severe eye pain, redness, blurred vision, halos, headache, and nausea or vomiting as possible symptoms of acute angle-closure glaucoma. These symptoms can have other causes, but they require urgent medical assessment. If they begin during a flight, alert the cabin crew and request medical assistance; do not wait until the end of your journey to seek help.
What is the bottom line for flying with glaucoma?
For most people with glaucoma, a routine commercial flight is safe, and cabin pressure changes usually have little effect on eye pressure. The most important exceptions involve a gas bubble remaining inside the eye after certain operations and individual risks related to angle-closure glaucoma. Keep your prescribed medication with you, follow your usual treatment plan, and obtain advice from your ophthalmologist when travelling after surgery or when you have been told that you have narrow drainage angles.