Affiliated Health Insurers :

Glaucoma Awareness Month

March is Glaucoma Awareness month in New Zealand. Watch Dr Perumal explain key concepts in glaucoma here:

Learn more about glaucoma awareness month

Eyelid surgery can be for functional issues or cosmetic improvement. In general, when the lid works well it also looks good, so these goals are usually aligned. Everybody is different and so discussing any possible eyelid intervention with the specialist is essential.

  1. Tailored treatment for eyelids with a detailed discussion of what to expect
  2. Rapid access to our fully-equipped Day-Case Theatre in Auckland
  3. Safe surgery and fast recovery, utilising the latest in minimally invasive techniques to reduce down-time and reduce risk of infection eg Dermabond glue replacing sutures for upper lid surgery 
  4. Lid tightening, lump excision /biopsy, eyelid reconstruction, Botox, watery eyes, droopy lids / blepharoplasty / ptosis repair, eyelash misdireciton. 
  5. A lot of lid procedures are covered by private insurance however some are not and we can assist with pre-approval 
  6. See now, pay later (24 months interest-free)

What is Glaucoma?

Glaucoma is a disease that damages the nerve at the back of your eye, called the optic nerve. The optic nerve sends the signals to the brain that enables you to see. Glaucoma is associated with increased sensitivity to pressure within the eye. The eye’s aqueous fluid is constantly produced and drained at a balanced rate and forms the intraocular pressure within the eye (IOP). When this drainage is reduced, or if there is too much fluid production, IOP increases and leads to damage of the optic nerve.

Image of the optic nerve showing loss of nerve cells in patients with glaucoma.

Glaucoma typically has no symptoms. Most patients do not experience any issues until they visit their eyecare provider. Untreated glaucoma can cause a gradual loss of vision, usually starting in the periphery which may go unnoticed for long periods of time.

Image showing the effect of loss of sight in patients with glaucoma.

Our Process :



Detailed measurements of the eyes are taken for safety and accuracy as part of the eyelid workup so that all the information is available to discuss your options


Meet your surgeon

Usually, at the same visit, you will meet your surgeon who will examine your eyes and eyelids and discuss your specific findings. With your input you will both tailor any intervention to suit you and your eyelids, starting with the least invasive options. Fully informed consent ensures you understand what each option can and sometimes can’t achieve, and also what to expect before, during, and after surgery. Any questions are welcomed as it is very important that expectations are discussed beforehand to reduce the risk of any surprises.



Eyelid surgery is typically performed under local anaesthetic. Oral sedation is provided if desired, there is good evidence there is less bruising when relaxed and comfortable. Both eyes are typically done on the same day. Most lid procedures take 30-45 minutes for both sides.



An eye patch or dressings are not required but typically overnight there will be some bruising and swelling develop which may last 1-2 weeks or longer. This can be asymmetrical but postop swelling settles. Full healing takes about 6 weeks. All sutures (stitches) if used will be absorbable and not need to be removed. Skin glue will peel off on its own in 5-10 days.



A follow-up appointment in a week is there for reassurance but if things are going well can be skipped. A final postop check will be booked about 4-6 weeks postop. If any biopsies have been taken this is when the results will be ready.


Saving money

The hidden costs: what could you save?

What could that money have done?

The $40,000 you'd potentially spend on glasses and contact lenses over the next 30 years could have given you 15 luxurious holidays.

Est- 15 Holidays

Est - 15 Holidays

Average holiday cost: $2600
Calculation: 40,000 / $2600 = 15

Saving time

The hidden cost of wearing glasses or contact lenses.

Did you know?

The time you'd spend handling glasses and contact lenses over the next 30 years is enough to have could have taken you around our planet over 30 times!

Est - 526 hours

Est- 526 hours

Cleaning: 3 minutes/day
Finding misplaced glasses: 2 minutes/day
Repair, shopping: 2 hours/year
Total: 526 hours (over 30 years)

Est- 526 hours

Inserting and Removing: 3 minutes/day
Cleaning: 2 minutes/day
Renewing & Check-ups: 2 hours/year
Total: 1,012 hours (over 30 years)

Saving planet

Reducing our carbon footprint

The environmental perspective

Over 30 years, using glasses and contact lenses contributes to 876lb of CO2 emissions. Opt for vision correction and take a stand for our planet!

Est - 876.6lb C02 emissions

Est- 876.6 CO2 emissions

Combined plastic waste:

0.525 kg (glasses)+65.7 kg (contact lenses)=66.225 kilograms over three decades.

Total: 66.225 kilograms of plastic×6=397.35 kilograms = 876Lb of CO2 emissions(over 30 years)

Why lid surgery


Lift droopy lids to improve vision and or cosmesis.


Remove lumps or bumps on your lid and send to the lab if needed.


Repair eyelid trauma, remove old scars, and address lid malposition.

Simple Surgery

Assess and manage tear duct problems (constant watering).

Personalised Surgical Care

Some patients are not suitable for drops or laser therapy and require either cataract surgery, minimally invasive glaucoma surgery or complex glaucoma surgery.

Minimally invasive Glaucoma surgery (MIGS) marks a milestone in the advancement of glaucoma patient care. MIGS are a form of glaucoma surgery which is associated with minimal incisions, and are generally associated with lower risks in restoring normal eye pressure.

Prior to MIGS, treatment options were limited to medications, laser and major glaucoma tube and filtration surgery. Now, with MIGS, our team at Re:Vision have more treatment options which benefits a patient with faster recovery , less surgical risks and less dependence on medications following surgery.

Our surgeon is a leader in MIGS surgery in NZ, with a wealth of experience with iStent -W, Kahook Dual Blade, Hydrus, XEN, Preserflo, micropulse and cyclodiode laser.

MIGS management include:
1) Various treatment options and benefits which are patient centric and individualised
2) Evidence based therapy and
3) Promising outcomes for glaucoma patients.

MIGS can be performed as a standalone procedure or in conjunction with cataract surgery. There are different surgical approaches under the MIGS umbrella, but they generally are designed to allow more fluid to drain out of the eye and hence, reduce intraocular pressure.

a) iStent

The iStent is the smallest medical device ever implanted into humans. The iStent decreases eye pressure by creating a pathway into the eye’s drainage system. The iStent was the first trabecular micro-bypass device approved by the FDA and is the most thoroughly-studied glaucoma device on the market.

Click here to watch video on iStent

b) Kahook Dual Blade

The Kahook Dual Blade goniotomy procedure involves removing a section of the trabecular meshwork (the part which is associated with the greatest resistance in fluid outlflow) and hence increasing drainage out of the eye.

Click here for information on KDB

c) Micropulse Laser Treatment

This procedure decreases the amount of fluid produced by the eye and increases fluid outflow. A probe is placed on the surface of the eye and the surgeon applies laser energy to part of the eye which controls the production of fluid in the eye.

d) Preserflo Stent
The Preserflo drainage shunt is type of microshunt implant used to reduced intraocular pressure by creating a controlled pathway for the drainage of fluid out of the eye. It is made from a specialised biocompatible material called SIBS, which is known for its stability, flexibility and compatibility with the human body, hence minimising tissue inflammation.

Click here for information on Preserflo

Trabeculectomy surgery has been done for more than 50 years, and involves making a separate channel for fluid to filter out of the eye.

A drainage tube is a device inserted into the eye, which acts as straw where fluid can access to drain out of the eye onto the outer coat of the eye. There are several drainage tubes available in NZ which include Molteno drainage tube, Paul drainage tube and Baerveldt drainage tube.

Generally, these surgeries are done once all others have been exhausted and have failed to stop the progression of glaucoma.

Glaucoma is optic nerve damage due to increased pressure sensitivity within the eye while a cataract is a clouding of your natural lens within your eye.

In some patients, the hardening and change in the shape of the lens with the development of cataract, can potentiate the effects of glaucoma, such as angle closure glaucoma. In this situation, we may suggest having cataract surgery as a way to treat your glaucoma.

Some patients can combine glaucoma and cataract surgery (includes patients with open angle glaucoma). MIGS procedures in particular can be performed through the same incision as cataract surgery, providing an efficient way to address two problems at once.

Our Technology:

Custom Built Surgical Facility

Re:Vision Laser & Cataract was specifically designed and created by our surgeons to provide maximum safety for patients in need of eye surgery. We are fully accredited by the Designated Auditing Agency (DAA) with an excellent scoring.

Custom Built Facility

Tissue Glue Copy

At re:vision where possible we don’t use skin sutures “stitches” instead we use the medical glue “Dermabond Advanced” which is waterproof and avoids the microtrauma of multiple sutures in your lids, reducing bruising and swelling, and reducing the risk of infection while speeding surgical time and healing. The glue falls off when it has done its job so no need to have it removed in clinic. Patients can shower and wash their face the same day of surgery, and no additional pads / dressings are required.

Tissue Glue

woman and man having a glass of wine over a cheese board

Glaucoma Research at Re:Vision

Dr Perumal values the importance of research initiatives and technology in glaucoma. We may invite you to participate in the Save Sight Registry run by the Save Sight Institute, in collaboration with the University of Sydney and Sydney Eye Hospital to fight glaucoma blindness.

The Save Sight Registries is one of the most advanced ophthalmic registries in the world, and is a unique platform for tracking eye disease, interventions and patient outcomes. Its sophisticated design delivers real-world evidence on the risks and benefits of current and new treatments for ocular conditions. This information helps clinicians provide safe, cost-effective and evidence-based solutions for vision impairment and avoidable blindness.

The Save Sight Registries also promotes international scientific research aimed at developing strategies for reducing the incidence of blindness throughout the world.

How much does lid surgery cost?

Lid surgery costs are usually covered by most insurance companies if they cause functional issues. Exact costs depend on the type of lid surgery best suited for you.

By the time I turn 45, I will have spent on contact lenses/glasses :

At Re:Vision, all types of laser vision correction
(LASIK or PRK) cost : $3,494/eye

References :