Laser Iridotomy for Glaucoma: What to Expect

Glaucoma is a severe eye condition that can lead to vision loss if not properly managed. One of the treatment options for certain types of glaucoma, particularly angle-closure glaucoma, is laser iridotomy. This procedure prevents pressure buildup in the eye by creating a small hole in the iris, allowing fluid to flow more freely. If you or a loved one has been advised to undergo laser iridotomy, you may have questions about what to expect. This blog post will walk you through the procedure, from preparation to recovery, so that you can feel informed and at ease.

1. Understanding Laser Iridotomy

Laser iridotomy is a minimally invasive procedure used primarily to treat or prevent angle-closure glaucoma. Angle-closure glaucoma occurs when the eye's drainage angle, where the iris meets the cornea, becomes blocked. This blockage prevents the fluid inside the eye (aqueous humor) from draining properly, rapidly increasing intraocular pressure. If left untreated, this pressure can damage the optic nerve and lead to permanent vision loss.

Laser iridotomy creates a small hole in the peripheral part of the iris, the colored part of the eye. This hole allows the trapped fluid to bypass the blockage, reducing intraocular pressure and preventing further damage to the optic nerve.

Who Needs Laser Iridotomy?

Your eye doctor may recommend laser iridotomy if:

• You have been diagnosed with angle-closure glaucoma.

• You have narrow angles, which puts you at risk for angle-closure glaucoma.

• You have had an episode of acute angle-closure glaucoma, and the procedure is needed to prevent future attacks.

• You have other eye conditions that make you susceptible to high intraocular pressure.

Laser iridotomy is generally considered a preventive measure and may be recommended even if you haven't experienced symptoms yet, but your eye anatomy suggests you're at risk.

Preparing for the Procedure

Before your laser iridotomy, your eye doctor will conduct a thorough eye examination to assess your condition and determine the best course of treatment. If laser iridotomy is recommended, here’s what you can expect in terms of preparation:

a. Initial Consultation 

During your consultation, your doctor will explain the procedure in detail, including its benefits and potential risks. This is an excellent time to ask any questions you may have. You’ll also be asked about your medical history and any medications you’re taking.

b. Pre-Procedure Instructions:

Your doctor may provide specific instructions on how to follow before the procedure. This could include:

• Avoiding certain medications that can affect blood clotting.

• Using prescribed eye drops to prepare the eye for surgery.

• Arrange transportation, as you may be unable to drive immediately after the procedure.

The Laser Iridotomy Procedure

Laser iridotomy is typically performed in an outpatient setting, meaning you can go home the same day. The procedure is quick, usually taking 10 to 20 minutes per eye.

Here’s a step-by-step guide to what happens during the procedure:

a. Eye Preparation

• Your doctor will start by applying numbing eye drops to ensure you don’t feel discomfort during the procedure.

• A unique contact lens will be placed on your eye to help focus the laser and keep your eyelids open.

b. The Laser Procedure

• Once the eye is prepared, the doctor will use a laser to create a small hole in the iris. This hole is typically made in the upper part of the iris, under the eyelid, so it’s not visible.

• You may see a bright light or feel a slight sensation, but the procedure is usually painless.

c. Post-Procedure Examination

• After the laser iridotomy, your doctor will examine your eye to ensure the hole was created successfully and that your intraocular pressure is stable.

• You’ll be given eye drops to help reduce inflammation and prevent infection.

After the Procedure: Recovery and Care

The recovery from laser iridotomy is generally quick, but following your doctor’s instructions is essential to ensure a smooth recovery and optimal results.

a. Immediate Aftercare

• You may experience mild discomfort, light sensitivity, or blurred vision immediately after the procedure. These symptoms are usually temporary and should resolve within a few hours to a few days.

• Avoid rubbing your eyes, as this can interfere with the healing process.

b. Follow-Up Appointments

• Your doctor will schedule follow-up appointments to monitor your eye pressure and ensure the iridotomy functions as intended.

• These appointments are crucial to assess the procedure's effectiveness and make any necessary adjustments to your treatment plan.

c. Resuming Normal Activities

• Most patients can return to their normal activities within a day or two. However, avoiding strenuous activities or anything that could put pressure on your eyes is advisable until your doctor gives you the all-clear.

d. Long-Term Care

• Continue using any prescribed eye drops as directed by your doctor.

• Regular eye exams are essential to monitor your eye health and ensure your glaucoma is managed effectively.

6. Potential Risks and Side Effects

While laser iridotomy is generally safe and effective, it’s essential to be aware of potential risks and side effects:

a. Common Side Effects

• Mild eye discomfort or redness.

• Temporary blurred vision.

• Light sensitivity.

• Halos or glare around lights, particularly at night.

b. Rare Complications

• Increased intraocular pressure immediately after the procedure.

• Inflammation inside the eye (uveitis).

• Bleeding in the eye (hyphema).

• Corneal damage.

• Incomplete or ineffective iridotomy, requiring further treatment.

Your doctor will discuss these risks with you before the procedure and take steps to minimize any potential complications.

Benefits of Laser Iridotomy

Despite the potential risks, laser iridotomy offers several important benefits:

• Prevention of Glaucoma Progression: By reducing intraocular pressure, laser iridotomy can prevent further damage to the optic nerve and reduce the risk of vision loss.

• Minimally Invasive: The procedure is quick, involves no incisions, and has a relatively short recovery time.

• Effective for Angle-Closure Glaucoma: Laser iridotomy is one of the most effective treatments for managing and preventing angle-closure glaucoma.

Laser iridotomy is a crucial procedure for those at risk of angle-closure glaucoma, offering a preventive measure that can safeguard your vision. You can approach it with confidence and peace of mind by understanding what to expect before, during, and after the procedure.

If you’ve been diagnosed with glaucoma or have concerns about your eye health, don’t wait. Contact us today to schedule a consultation and learn more about how laser iridotomy can help protect your vision.