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Goodwill and intangible assets - Intangible asset impairment charges (Details) - USD ($)
 3 Months Ended 12 Months Ended
Sep. 30, 2020
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Jun. 30, 2020
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   $ 167,000,000 $ 0 $ 378,000,000  
Cash flow projection forecast duration   5 years      
Cost of net sales [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   $ 106,000,000      
Surgical [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   66,000,000 0 378,000,000  
Recoverable amount   65,000,000      
Surgical [member] | Currently marketed products [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   65,000,000      
Surgical [member] | CyPass [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges       (337,000,000)  
Surgical [member] | Optonol Ltd. [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges       (39,000,000)  
Vision Care [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   101,000,000 $ 0 $ 0  
Vision Care [member] | Cost of net sales [member]          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges   $ 41,000,000      
Recoverable amount         $ 88,000,000
Vision Care and Surgical          
Disclosure of detailed information about intangible assets [line items]          
Impairment charges $ 61,000,000