Laser iridotomy



Definition

Laser iridotomy is a surgical procedure that is performed on the eye to treat angle closure glaucoma, a condition of increased pressure in the front chamber (anterior chamber) that is caused by sudden (acute) or slowly progressive (chronic) blockage of the normal circulation of fluid within the eye. The block occurs at the angle of the anterior chamber that is formed by the junction of the cornea with the iris. All one needs to do to see this angle is to look at a person's eye from the side. Angle closure of the eye occurs when the trabecular meshwork, the drainage site for ocular fluid, is blocked by the iris. Laser iridotomy was first used to treat angle closures in 1956. During this procedure, a hole is made in the iris of the eye, changing its configuration. When this occurs, the iris moves away from the trabecular meshwork, and proper drainage of the intraocular fluid is enabled.

The angle of the eye refers to a channel in which the trabecular meshwork is located. To maintain the integrity of the eye, fluid must always be present in the anterior (front) and posterior (back) chambers of the eye. The fluid, known as aqueous fluid, is made in the ciliary processes, which are located behind the iris. Released continuously into the posterior chamber of the eye, aqueous fluid circulates throughout the eye. Eventually the fluid returns to the general circulation of the body, first passing through a space between the iris and the lens, then flowing into the anterior chamber of the eye and down the angle, where the trabecular meshwork is located. Finally, the fluid leaves the eye. An angle closure occurs when drainage of the aqueous fluid through the trabecular meshwork is blocked and the intraocular pressure builds up as a result.

For most types of angle closure, or narrow angle glaucoma, laser iridotomy is the procedure of choice. Changes in intraocular pressure (IOP) can alter the name of the condition when the IOP in the eye becomes elevated above 22 mm/Hg as a result of an angle closure. Then,

Normally intraocular fluid flows freely between the anterior and posterior sections of the eye (A). As pressure builds in the eye, this circulation is cut off (B). In laser iridotomy, a special lens is placed on the eye (C). A laser is used to create a hole in part of the iris (D), allowing fluid to flow more normally and intraocular pressure to return to normal (E). (Illustration by GGS Inc.)
Normally intraocular fluid flows freely between the anterior and posterior sections of the eye (A). As pressure builds in the eye, this circulation is cut off (B). In laser iridotomy, a special lens is placed on the eye (C). A laser is used to create a hole in part of the iris (D), allowing fluid to flow more normally and intraocular pressure to return to normal (E). (
Illustration by GGS Inc.
)

angle closure becomes angle closure glaucoma. Lowering of the IOP is important because extreme elevations in IOP can damage the retina and the optic nerve permanently. The lasers used to perform this surgery are either the Nd:Yag laser or, if a patient has a bleeding disorder, the argon laser. The majority of patients with glaucoma do not have angle closure glaucoma, but rather have an open angle glaucoma, a type of glaucoma in which the angle of the eye is open.

An angle closure occurs when ocular anomalies (abnormalities) temporarily or permanently block the trabecular meshwork, restricting drainage of the ocular fluid. The anatomical anomalies that make an individual susceptible to an angle closure are, for example, an iris that is bent forward in the anterior chamber (front) of the eye, a small anterior chamber of the eye, and a narrow entrance to the angle of the eye. Some conditions that cause an angle closure are a pupillary block, a plateau iris, phacolytic glaucoma, and malignant glaucoma. The end result of all of these situations is an elevation of the IOP due to a build-up of aqueous fluid in the back part of the eye. The IOP rises quickly when an acute angle attack occurs and within an hour the pressure can be dangerously elevated. The sclera or white of the affected eye becomes red or injected. The patient will usually experience decreased vision and ocular pain with an acute angle closure. In severe cases of acute angle glaucoma, the patient may experience nausea and vomiting. Individuals with neurovascular glaucoma caused by uncontrolled diabetes or hypertension may have similar symptoms, but treatment for this type of glaucoma is very different.

Within a normal eye, the iris is in partial contact with the lens of the eye behind it. Individuals with narrow angles are at greater risk of angle closure by pupillary block because their anterior chamber is shallow; thus, the iris is closer to the lens and more likely to adhere completely to the lens, creating a pupillary block. Patients who experience a pupillary block may have had occasionally temporary blocks prior to a complete angle closure. Pupillary block can be started by prolonged exposure to dim light. Therefore, it not uncommon for an acute angle closure to occur as an individual with a narrow angle emerges from a dark environment such as a theater into bright light. It can also be brought on by neurotransmitter release during emotional stress or by medications taken for other medical conditions. Pupil dilation may be a side effect of one or more of those medications. However, pupillary block is the most common cause of angle closure, and laser iridotomy effectively treats this condition.

The irises of individuals with plateau iris is bunched up in the anterior chamber, and it is malpositioned along the trabecular meshwork. Plateau iris develops into glaucoma when the iris bunches up further; this occurs on dilation of the iris, which temporarily closes off the angle of the eye. Laser iridotomy is often performed as a preventive measure in these patients, but is not a guarantee against future angle closure. This is because changes within the eye, such as narrowing of the angle and increase in lens size can lead to iris plateau syndrome, where the iris closes the angle of the eye even if a laser iridotomy has already been performed. Peripheral laser iridoplasty and other surgical techniques can be performed if the angle still closes after iridotomy.

Other causes of narrow angle glaucoma are not as common. Phacolytic glaucoma results when a cataract becomes hypermature and the proteins of the lens with the cataract leak out to block the angle and the trabecular meshwork. Laser iridotomy is not effective for this type of angle closure. Malignant glaucoma exists secondary to prior ocular surgery, and is the result of the movement of anatomical structures within the eye such that the mesh-work is blocked. Patients who have no intraocular lens (aphakic) are at increased risk for angle closure, as well.

Laser iridotomy is also performed prophylactically (preventively) on asymptomatic individuals with narrow angles and those with pigment dispersion. Individuals with a narrow angle are at higher risk of an acute angle closure, especially upon dilation of the eye. Pigment dispersion is a condition in which the iris pigment is shed and is dispersed throughout the anterior part of the eye. If the dispersion occurs because of bowing of the iris (the case in 60% of patients with pigment dispersion) a laser iridotomy will decrease the bowing or concavity of the iris and subsequent pigment dispersion. This decreases the risk of these individuals to develop pigmentary glaucoma, a condition in which the dispersed pigment may clog the trabecular meshwork. Laser iridotomy is also done on the fellow eye of a patient who has had an angle closure of one eye, as the probability of an angle closure in the second eye is 50%.

There are other indications for laser iridotomy. It is performed on patients with nanophthalmos, or small eyes. Laser iridotomy may be also be indicated for patients with malignant glaucoma to help identify the etiology of elevated IOP. Because laser iridotomy changes the configuration of the iris, it is sometimes used to open the angle of the eye prior to performing a laser argon laser trabeculoplasty, if the angle is narrow. Laser trabeculoplasty is another laser procedure used to treat pigmentary and pseudoexfoliation glaucoma.

Laser iridotomy cannot be performed if the cornea is edematous or opacified, nor if the angle is completely closed. If an inflammation (such as uveitis or neovascular glaucoma) has caused the angle to close, laser iridotomy cannot be performed.


Purpose

The purpose of a laser iridotomy is to allow an equalization of pressure between the anterior (front) and posterior (back) chambers of the eye by making a hole in the superior peripheral iris. Once the laser iridotomy is completed, the intraocular fluid flows freely from the posterior to the anterior part of the eye, where it is drained via the trabecular meshwork. The result of this surgery is a decrease in IOP.

When laser iridotomy is performed on patients with chronic angle closure, or on patients with narrow angles with no history of angle closure, the chances of future pupillary blocks are decreased.


Demographics

Acute angle glaucoma occurs in one in 1,000 individuals. Angle-closure glaucoma generally expresses itself in populations born with a narrow angle. Individuals of Asian and Eskimo ancestry appear to be at greater risk of developing it. Family history, as well as age, are risk factors. Older women are more often affected than are others. Laser iridotomy is performed on the same groups of individuals as those likely to experience angle closures due to pupillary block or plateau iris. They are performed more often on females (whose eyes are smaller than those of males), and more often performed on the smaller eyes of farsighted people than on those of the nearsighted because angle closures occur more frequently in those who are farsighted. Most laser iridotomies are performed on those over age 40 with a family history of plateau iris or narrow angles. However, preventative plateau iris laser iridotomies are performed on patients in their 30s. Individuals who are aphakic (have no intraocular lens) are at greater risk of angle closure and undergo laser iridotomy more frequently than phakic patients. Phakic patients are those who either have an intact lens or who are psuedophakic (have had a lens implant after the removal of a cataract removal).


Description

After the cornea swelling has subsided and the IOP has been lowered, which is usually 48 hours after an acute angle closure, laser iridotomy can be performed. Pilocarpine is applied topically to the eye to constrict the pupil prior to surgery. When the pupil is constricted, the iris is thinner and it is easier for the surgeon to form a penetrating hole. If the eye is still edematous (swollen)—often the situation when the IOP is extremely high—glycerin is applied to the eye to enable the surgeon to visualize the iris. Apraclonidine, an IOP-lowering drop, is applied one hour before surgery. Immediately prior to surgery, an anesthetic is applied to the eye.

Next, an iridotomy contact lens, to which methylcellulose is added for patient comfort, is placed on the upper part of the front of the eye. This lens increases magnification and helps the surgeon to project the laser beam accurately. The patient is asked to look downwards as the surgeon applies laser pulses to the iris, until a hole is formed. Once the hole has penetrated the iris, iris material bursts through the opening, followed by aqueous fluid. At this point, the surgeon can also see the anterior part of the lens capsule through the opening. The hole, or iridotomy, is formed on the upper section of the iris at an 11:00 or 1:00 position, so that the hole is covered by the eyelid. In an aphakic eye, the hole may be made on the inferior iris. After performing the laser iridotomy, the surgeon may place a gonioscopy lens on the eye if the angle has been opened. There is no pain associated with this surgery, although heat may be felt at the site of the lasering.

If a patient has a tendency to bleed, the argon laser will be used to pre-treat the patient prior to completing the procedure with an Nd:Yag laser, or the argon laser alone may be used. The argon laser is capable of photo-coagulation, and, thus, minimizes any bleeding that occurs as the iris is penetrated. Formation of a hole is more difficult with the argon laser because it operates with a decreased power density and the tissue response to the argon laser has greater variability. The argon laser can be used with more patients who have medium-brown irises, however, since the energy of this laser is readily absorbed by irises of this color.


Diagnosis/Preparation

To determine if laser iridotomy is indicated, the surgeon must first determine if and how the angle is occluded. The eye is anesthetized and the aonioscopic lens, which enables the surgeon to see the interior of the eye, is placed on the front of the eye. This is done at the slit lamp biomicroscope in a dark room. In cases of prophylactic surgery, an image of the eye is taken with a ultra-sound biomicroscope in both dim and bright light; this shows the doctor how the patient's iris moves with dilation and constriction, and how this movement can close an angle if the patient has ocular features that predispose the eye to an angle closure.

When an angle is completely occluded (blocked), the elevated IOP usually causes corneal edema (swelling). Because this swelling can obscure the surgeon's view of the iris, prior to performing a laser iridotomy, the IOP must be lowered. One technique to lower the IOP is corneal indentation, in which the gentle pressure is applied several times to the cornea with a lens or hook to open the angle. This pressure on the cornea causes a shift in the internal structures of the eye, enhances aqueous drainage, and lowers the IOP.

The doctor can attempt to lower the IOP medically, as well. One drug that lowers the pressure is acetazolamide, which is given either orally or by intravenous(IV) to decrease aqueous production in the eye. This may be administered up to four times a day, until the adhesion is broken. Another method of lowering the IOP, if acetazolamide is not effective, is with the use of hyperosmotic agents, which through osmosis causes drainage of the aqueous fluid from the eye into the rest of the body. Hyperosmotic agents are given orally; an example of such an agent is glycerine. Given by IV (intravenous administration), mannitol can be used. As the fluid drains from the eye, the vitreous—the jelly-like substance behind the lens in the posterior chamber—shrinks. As it shrinks, the lens in the eye pulls away from the vitreous, creating an opening to the anterior chamber such that aqueous fluid can flow to the anterior chamber. The success of this procedure is increased, due to gravity, if the patient is laying supine.

Once the IOP has begun to decrease, the pressure is further decreased using topical glaucoma medications, such as pilocarpine, or beta blockers. Any inflammation that occurs because of the iridotomy must be controlled with steroid eye drops.

If glaucomatous-like visual field is present prior to surgical intervention, the prognosis for the patient is not as good as if the visual field were completely intact. Thus, a visual field test may be done prior to surgery.


Aftercare

Immediately after the procedure, another drop of aproclonidine is applied to the eye. The IOP is checked every hour for a several hours postsurgery. If the IOP increases dramatically, then the increased IOP is treated until lowered. Because of inflammation is inherent in this procedure, corticosteroids are applied to the eye every five minutes for 30 minutes, then hourly for six hours. This therapy is then continued four times a day for a week. Thereafter, the patient is seen by the surgeon at one week post-surgery and again at two to six weeks post-surgery. If there are complications, the patient is seen more frequently.

After the pressure has been stabilized, a visual field test to determine the extent of damage to the optic nerve may be performed again.


Risks

The greatest risk of laser iridotomy is an increase in intraocular pressure. Usually, the IOP spike is transient and of concern to the surgeon only during the first 24 hours after surgery. However, if there is damage to the trabecular meshwork during laser surgery , the intraocular pressure may not be lowered enough and extended medical intervention or filtration surgery is required. Patients who undergo preventative laser iridotomy do not experience as great an elevation in IOP.

The second greatest risk of this procedure is anterior uvetis, or inflammation within the eye. Usually the inflammation subsides within several days, but can persist for up to 30 days. Thus, the follow-up care for laser iridotomy includes the application of topical corticosteroids. A posterior synechia, in which the iris may again adhere to the lens, may occur if intraocular inflammation is not properly managed.

Other risks of this procedure include the following: swelling of, abrasions to, or opacification of the cornea; and damage to the corneal endothelium (the part of the cornea that pumps oxygen and nutrients into the iris); bleeding of the iris during surgery, which is controlled during surgery by using the iridotomy lens to increase pressure on the eye; and macular edema, which can be avoided by careful aim of the laser during surgery to avoid the macula. The macula is the part of the eye where the highest concentration of photoreceptors is found. Perforations of the retina are rare. Distortion of the pupil and rupture of the lens capsule are other possible complications. Opacification of the anterior part of the lens is common, but this does not increase the risk of cataract formation when compared with the general population.

When the iridotomy hole is large, or if the eyelid does not completely cover the opening, some patients report such side effects as glare and double vision. The argon laser produces larger holes. Patients may also complain of an intermittent horizontal line in their vision. This may occur when the eyelid is raised just enough such that a small section of the inferior part of the hole is exposed, and disappears when the eyelid is lowered. Blurred vision may occur as well, but usually disappears 30 minutes after surgery.


Normal results

In successful laser iridotomy, the IOP differential between the anterior and posterior chambers is relieved and IOP is decreased, and the pupil is able to constrict normally. These are the results of the flatter configuration of the iris after laser iridotomy. If an angle closure is treated promptly, the patient will have minimal or no loss of vision. This procedure is successful in up to 44% of patients treated.


Morbidity and mortality rates

For up to 64% of patients, one to three years after laser iridotomy, the IOP will rise above 21 mmHg, and long-term medical treatment is required. One-third of argon laser iridotomies will close within six to 12 weeks after surgery and will require a repeat laser iridotomy. Approximately 9% of Nd:Yag laser iridotomies must be redone for this reason. Closure of the iridotomy site is more likely if a uveitis presented after surgery. Up to 45% of patients will have anterior lens opacities after laser iridotomy, but these opacifications do not put the patient at an increased risk of cataracts.


Alternatives

An alternative to laser iridotomy is surgical iridectomy , a procedure in which part of the iris is removed surgically. This was the procedure of choice prior to the development of laser iridotomy. The risks for iridectomy are greater than for the laser iridotomy, because it involves an incision through the sclera, the white tunic covering of the eye that surrounds the cornea. The most common complication of an iridectomy is cataract formation, occurring in more than 50% of patients who have had a surgical iridectomy. Since an incision in the eye is required for surgical iridectomy, other procedures, such as filtration surgery—if needed in the future—will be more difficult to perform. Studies comparing the visual outcomes and IOP control of laser iridotomy with surgical iridectomy show equivalent results.

In the case of acute angle closures that occur because of reasons other than, or in addition to pupillary block, argon laser peripheral iridoplasty is performed. During this procedure, several long burns of low power are placed in the periphery of the iris. The iris contracts and pulls away from the angle, opening it up and relieving the IOP.

Resources

books

Albert, Daniel M., M.D. Ophthalmic Surgery Principles and Techniques. Oxford, England: Blackwell Science, 1999.

Albert, Daniel M., M.D. Principles and Practice of Ophthalmology, 2nd ed. Philadelphia, PA: W. B. Saunders Company, 2000.

Azuara-Blanco, Augusto, M.D, Ph.D., et. al. Handbook of Glaucoma. London, England: Martin Dunitz Ltd, 2002.

Kanski, Jack J. M. D., et. al. Glaucoma A Colour Manual of Diagnosis and Treatment. Oxford, England: Butterworth-Heinemann, 1996.

Ritch, Robert, M. D., et. al. The Glaucomas. St. Louis, MO: 1996.


periodicals

Breingan, Peter J. M. D., et. al. "Iridolenticular Contact Decreases Following Laser Iridotomy For Pigment Dispersion Syndrome." Archives of Ophthalmology 117 (March 1999): 325-28.

Brown, Reay H.,M. D., et. al. "Glaucoma Laser Treatment Parameters and Practices of ASCRS Members–1999 Survey." Journal of Cataract and Refractive Surgery 26 (May 2000): 755-65.

Nolan, Winifred P., et. el. "YAG Laser Iridotomy Treatment for Primary Angle Closure in East Asian Eyes." British Journal of Ophthalmology 84 (2000): 1255-59.

Wu, Shiu-Chen, M. D., et. al. "Corneal Endothelial Damage After Neodymium: YAG Laser Iridotomy." Ophthalmic Surgery and Lasers 31 (October 2000): 411-16.

other

"Narrow Angle Glaucoma and Acute Angle Closure Glaucoma." http://www.M.D.eyedocs.com/edacuteglaucoma.htm .

"Laser Iridotomy and Iridoplasty." http://cuth.cataegu.ac.kr/~jwkim/glaucoma/doctor/LI.htm .

"Lasers in the Treatment of Anterior Segment Disorders." http://http:www.tnoa.net/articles/1.HTM .

"Plateau Iris Glaucoma." http://emedicine.com/OPH/topics574.htm .


Martha Reilly, OD

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


A laser iridotomy is performed in an office setting by an ophthalmologist, a doctor or osteopahic doctor with residency training in the treatment of eye diseases. The doctor who performs a laser iridotomy may have advanced fellowship training in the treatment of glaucoma, after completing his or her three-year residency.

QUESTIONS TO ASK THE DOCTOR




User Contributions:

1
Day Karen Cooper
My eyes have been like this for a long time. When I would go to the eye doctor they would always discuss putting drops in my eyes, never knew what the problem was, but I have never had a problem after being dilated. I went to a new doctor today just to get a second opinion about my eyes, since I have had high blood pressure for about 30 years. I feel it is just because I am small. Do you think the risk outways just waiting and praying that it does not happen?
2
lori cohen
Yours is a very good cite for worthwhile information. Thank you for everything I have learned from you. My question surrounds the post-op experience. I have suffered from migraines since I was 9 years old. After my iridotomies, I have had a migraine within that first 24 hour window. I have had a dull migraine in one eye, the damaged eye, since the third day after surgery. My doctor sees no correlation between the migraine and my acute closed angle episode. What are your feelings on this subject?
Thanking you in advance, Lori
3
linda morgan
i was treated with laser irodotomey because i was told i had narow angles. i asked the doctor why he was doing this because i had not had glacoma... he said it was a preventative measure.... i was told my eye pressure in one eye was 15 and the other 16 now i am told i have to come back for a touch up... this makes no sense for me can you explain why this is done since it isn't a q00 percent.
4
Kate
I was treated with laser iridotomy ten months ago in my right eye because of high pressure (25). Afterwards I had severe bleeding, the pressure rose to 29, then to 43 and finally to 55. The doctor put all sorts of drops into my eye to lower the pressure, which however didn't decrease until after 3 days.
Before the iridotomy the visual field test was completely normal. A week after the surgery I did a test again and learned that because of the high pressure for two days my visual field had deteriorated by 40%!
I can hardly see with my right eye (which had 100% vision before the iridotomy), I have severe blurred and double vision which, as I was told, is a very common side effect of iridotomy (Nobody told me before, though). Because of the double vision I frequently have to vomit.
I now wear a patch over my right eye, only then can I prevent vomitting.
I can no longer drive a car, I lost my job and have barely enough money for a living. But I can't find a job with just one eye working. I often think of suicide.
My doctor said the iridotomy was a complete success, as it finally lowered the pression. He is very proud of himself.

Please, think twice before letting a doctor perform an iridotomy to your eyes.

Kate
5
Anne
I had an iridotomy on my left eye 3 months ago. I had a rise in pressure for two days (up to 42), then it dropped to 23. But after a week it rose again (34) and is now higher than it was before the surgery (24).
So I have to take more drops than before it was done.
Now the doctor wants to do my right eye, but for what purpose?
Anne
6
Adele
I am Scheduled to have the laser iriditomy done on March 6th, 2008. Went for a check up and Dr. told me I had narrow angles, and to prevent a 10% chance of blindness in the future I had to have the laser iriditomy. After reading your comments I am very worried, if I should have this done or not. I am a single mom with three daughters, I can't afford not to work.
Nobody had ever told me that I had this problem this problem before. I am a women and 45 years old, my blood plessure is alittle high, I am on pills for it. Does anyone know how common of a procedure this is. Thanks for any information Adele.
7
Maud
Hi, Adele,
how was your surgery? I hope it was successful and you had no side-effects.
I had iridotomies 1 year ago and I am still suffering from glare, double vision and other visual aberrations. The inflammation hasn't subsided. I will certainly not have the other eye done!
8
Penny
I had iridotomies done to my eyes 2 years ago and I have suffered ever since. Both eyes are still red and sore. My vision was 20/20 in both eyes, it is now 20/100 in my right eye and 20/70 in my left eye. I have glare, double vision and cataract progression. I can only advise everybody to think twice before having this surgery done.
9
Ifijenya
I have myope -8.75 (right eye), -9.25 (left eye) and 1.5 astigmat. I'm using contact lenses in such ease for 21 years. I had no problem with them and my eyesight was so satisfactory. I wanted to see if I can have lasic and the doctor told me that I should have Fhakic IOL with ICL Toric. Before this surgery I had treated with YAG laser iridotomy in my both eyes last week. The reason for this surgery was to prevent a possible eye pressure due to the execution of Fhakic IOL. The doctor told me that there will be two microscobic holes on my irises with no risks, but he shot more than 10 times to each eye and after the surgery I had some glare (just like someone is reflecting light by a mirror) in my both eyes. (more on the left eye) I feel the hole is bigger than it should be especially on my left eye. (My eyelids also don't completely cover the openings but if this was the only reason then my left eye should be better as it covers better than the right eye) I'm so uncomfortable especially when I'm outdoors (sunlight) Is there a cure for this side effect? Is there a possibility that the problem will be removed after implementing Fhakic IOL? I'd be appreciated for your assistance, thanks in advance.
10
Sunny
Hi, Ifiienva,

unfortunately there is no cure for this side effect. The problem will not be removed after implementing the Phakic IOL.
The only possibility might be to suture the iris holes. But there are few doctors who can do that.
Go to
http://198.170.234.66/cgi-local/discus/discus.cgi
Then click on 'Glaucoma' and then on 'Iridotomy'. There are others with your problem The doctor who moderates the forum can give you names of doctors who can perform such surgery if you tell him where you live.
Glare and other visual aberrations after an iridotomy cannot otherwise be cured.
11
Anne (2)
Hi. Yesterday I was told by a new doctor (my previous doctor has retired) that I need laser iridotomy in both eyes. I don't know whether to be grateful that he found this condition, or to be concerned he may be suggesting unnecessary and potentially harmful surgery. How often do we hear of someone suffering an acute angle closure attack? Would it be wiser to put this off, but stay aware of the potential problem and avoid drastic changes in lighting and dilation drops? How many survivors of iridotomy are grateful they had it done and have no visual or side affect problems?
12
Mimi
Hi, Anne,
nobody can answer your questions, not even an ophthalmologist. There are many different sorts of narrow angles. The iris may bulge forward and close the trabecular meshwork, it may obstruct
schlemm's canal, it may be too close to the lens, so that posterior synechiae develop, there may be a plateau iris syndrom, etc. For some narrow angles an iridotomy is necessary, for others it should not be done.
All in all, iridotomies have quite a lot of side effects and are not harmless. Go to at least two glaucoma specialists and if you decide for that surgery have it performed by someone who has great experience in doing it. It is a tricky surgery and not all eye doctors know how to do it.
13
beverly mccoy
I'm scheduled to have an iridotomy this Thurs.(5-22-08). I don't have glacoma, but I was told I had to have this procedure done before I have the lens implant surgery in June to correct my vision. I couldn't have Lasik surgery because of large pupils, vision not good--20/200, and dry eye. My eye surgeon is the head of the Dept. of Opthamology at Univ. of Souch Carolina School of Medicine. Is this a standard procedure or is this a great risk?
Thank you for your reply (in advance).
14
Sandy
Beverly,

you have had your iridotomy by now. I hope everything went well! It is a standard procedure but carries risks, as all surgery does. Most patients have glare, double vision, see strange flashes of light after this surgery. Some cope, others don't. About 20% have severe side effects like a rise in IOP, inflammation, uveitis, cataract development etc.
I do hope you are among those who have only mild symptoms and aberrations. If not, don't have the other eye done. So you can still see normal with one eye.
15
vgconcerns
I have no vision in one of my eye due to retinal detachment and cataract in that eye as well. My IOP in this eye is normal and has been normal all the time. But my eye doctor who has monitored me for several years says that I am at a great risk of normal angle closure because of lens pushing angle closure; thereby leading to acute-angle closure glaucoma. Dr. is recommending that YAG laser iridatomy be performed to prevent angle closure glaucoma attack. After reading about possible side effects, I am concerned, given condition of my eye, if this procedure would benefit?
16
Sharon
I had laser iridotomy to both eyes a year ago as a preventive measure for possible future glaucoma. I have always had normal eye pressure. I now see the horizontal white line of light at certain times in both eyes, but this does not trouble me. My left eye seems okay. However, I have an odd "feeling" to the right eye and it sometimes aches.
My optometrist could not think of a reason other than the opthamologist must have hit a nerve. Have you heard of similar outcomes and can anything be done to determine if this is the cause, and how to rectify it? Could the laser have harmed any other area?
17
Desiree
I was told I have Narrow Angle and I am being sent to a surgeon,but I have not seen any possitive Comment's so it makes me wonder I am not having any problems with my sight but was told I could later on with fluids not being released because of closure I was wondering why it wasen't detected with previous eye exams. Well I will see what the surgeons says first Thank You Desiree
18
Linda
My diagnosis of narrow angles and the risk of having an acute angle closure glaucoma attack has resulted in my having the first of two iridotomies. The doctor wants me to proceed with the second surgery but I have some worries. I don't have the side effects that some people have mentioned here, but I feel that the eye that had the procedure done, does not see colors as bright and vividly as the eye that hasn't been done. In other words, the colors are more muted/darker. I'd appreciate some feedback on this issue. Thanks.
19
Sirri
Hi, I heard about laser iridotomy today. I am 32 years old and I have glaucoma as a result of pigment dispersion on both eyes for the past three years. The specialist I saw today advised me to have laser iridotomy on left eye because the drops I use didn't decrease the high pressure (18-20) well enough.
Reading your comments, I thought I should really think carefully about going through the operation. The specialist said there are risks, but really didn't give as much detail as I have found here. Thanks to all of you for sharing your experiences.
I have two question:
1- Is there a higher/lower risk associated with the operation depending on the type of the glaucoma you have? (most of you had mentioned narrow angle, and a few said preventative)
2- Is there a higher/lower risk associated with the operation depending on the type of laser used? (such as YAG vs. Argon vs. any other type)
Thanks
20
Penny
Sirri,

1. An iridotomy only makes sens if you have narrow angle glaucoma or if you are in danger of having it.
Opinions are dicides about doing this surgery for patients with pigment dispersion glaucoma. As the iris debris cut out by the laser remains in the eye (doctors have found that debris even 12 years after iridotomy on enucleated eyes)it might obstruct the trabecular meshwork and increase pressure so that you have to have filtering surgery.
2. Argon laser makes larger holes and consequently risks like glare, white line and double vision are very high.
Yag laser has more energy and consequently risks like retinal detachment due to the shock waves and bleeding are very high.
But with either laser you will have serious side effects.

In any case iridotomy has many, many very severe side effects and can ruin your vision forever.
Test your doctor. Ask him what the side effects are. If he says there are none or if he says the risks are low, then go and get a second opinion, because a doctor who says risks of this surgery are low is a liar.
21
TEW
I just had the laser iridotomy on the right eye yesterday. I was very frightened by what I read here. Fortunately I found that I have a friend who's father had had this surgery about six months ago. He gave me a call and has had no ill effects from his surgery. I decided that I must come back here and let you know how mine goes (hoping I can post some good news). So far so good. I will go back in a couple of weeks to do the left eye. Plan to follow up here then. I was told that I have narrow angles, but had not had closure, and had not yet suffered any damage to the eyes. I am guessing that most people who have a good out come never come back here to post. Good Luck to anyone else looking for news about this. There are people who have not had problems after a laser iridotomy.
22
TEW
It has been two days since the laser iridotomy on my left eye. I am back at work and things seem to be fine. Had a headache after the left eye (but it was relieved by Advil). The right eye has been fine. Go back to have things checked in about a month. This was not fun, but has not been very bad. I was lucky that narrow angles were found before any closure or damage. Still wish Best of Luck to anyone who has to have this done.
23
john starr
today i went to the eye doctor for a glasses / eye test . after the sergin came in as something was narrow in the conner of my eye . i was told a lesor operation was neaded . further , had to be done right away as if it wasnt id soon have a eye atack and would through up and fall down in paine . worst , the hospitle wouldnt treat me and ill permitly go blind , i read this article in full / and has this doctor scared me because im 70 and insured ?
24
callie
Hi all,
I've just been told I need laser iridotomy for narrow angles. Reading all these comments about side effects is pretty scary. Has anyone had a good experience with this surgery?
25
Jane Waller
I had laser irdotomy four years ago for narrow angle. It was to be a preventive measure to keep from having a closed angle attack. I have developed open angle in the eye i had the irodotomy laser treatment.What caused that to happen. I am very worried about going blind.
26
Dan L.
I was recommended to go a laser prophilactic iridotomy by a glaucoma doctor specialist .I'm at risk of developing open angle glaucoma. She said that the risks are low and it can prevent an acute attack in the future which can lead to loss of sight.
After readding that success rate of this procedure are 44% and what I've read here, I'm not so sure of wanting to do it. The procedure looks quite riskey and to my opinion not worth the risk. Besides, in some cases the procedure must be repeated after a few years.
I want to thank the people who shared their information here and helped me to come and make my decision.
27
Nancy
I have a friend who's dr. told her she needed the surgery. He told her she could lose her vision today , 3 months from now or never. And that the surgery is common and that her vision would improve after this. She went to 1 dr she did not like his response he told her you dont believe me here's a 2nd dr. to go to. Problem is she only has vision in 1 eye the other eye was removed because of retnia detatchments. Is this surgery worth the risk ? Thanks for any informed comments you can give. I had her cancel the surgery until she gets 4 or 5 opionons.
28
ewa
here is the article on the operation that they are planning for your iris later this year
29
Mike p ventresca
My wife has had migrane headaches for years after we were married i used to watch to see it all happen, it was very sad to see her nasiatng or sc ream for pain,she suffered a whole lot, she must went through hell with the pains . BUT things have changed thank God,she doesn't get them any more.Why did all those headaches occur and how can they be prevented on humans.I hope that the problem that certain individuals had to indure at certain times of their lives could not go on anymore
I have had a laser iridotomy done on both eyes. The right eye done two weeks ago, and the left eye one week ago (March 2010). I had narrow angle closure in both eyes which the doctor said was quite severe. I had previous occular miagranes and pains in the back of my eyes for the past several years. I often worried about this, but the optometrists would ignore it when I had my routine contact lens eye exams. One doctor did mention that "my eyeballs had changed shape" and one said "my internal eye exam wasn't so good". Neither would explain further when I pressed for more information. It was finally diagnosed when I developed eye infections and went to an eye specialist. After the iridotomies I did have an eye ache in my right eye for around 10 days and still feel a small amount of pressure off and on in that eye. The doctor explained that there were no nerves in the iris where he did the procedure, but perhaps it was caused by the eye drops being absorbed into the retina after surgery and would be termporary. He said this happens to around 2% of patients after this surgery. The left eye had no problems. My vision is as good as before in both eyes. I do not have distorted vision. It is certainly better than going blind, and I am frustrated that my other eye doctors did not care enough to address the problem before that could have have happened. I phoned my doctor before having either eye done with a list of questions. I asked how many of these procedures he had done. I told him the negative I had read online. He said if it is not done at the appropriate spot in the iris, it could cause multiple vision problems..a very serious reason to only have an experienced eye surgeon do it.
I certainly thank you for all the information about this procedure. I am scheduled to have it tomorrow on my left eye and six days later on my right eye. I feel a little more relaxed knowing this is a procedure that has been used for a good while.
I am scheduled to have iridotomy on both of my eyes by a well known and much liked eye surgeon this coming thursday. I am 41, female and have suffered lightining type headaches for the past 2 years. After en expensive brain Scan, with nothing found, my doctor suggested a vist to an ophtamologist. We had initially scheduled two surgeries two weeks apart but due to missing work and the cost of two surgeries, I have requested that both eyes be done at the same time. I am hoping it will reduce the headacehs, however, i know that it will not restore my lost vision. I will post again after I have healed to let you know how it went. (Cross your fingers)
Sandy and others who have posted: I would like to hear updated reports on the aftermath of your iridotomy surgeries. I have narrow angle glaucoma in both eyes and have been advised to have surgery because I could have an acute attack and lose vision. After reading the posts, I am wondering if I should take my chances on doing nothing rather than risking the side effects of the surgery. Granted those who post and generally those with bad experiences but it is scary stuff. There does not seem to be a valid body of research on successes and complications following surgery.
34
SUSAN
I am scheduled for iridotomy surgery in both eyes, one week apart. After reading theses outcomes I am really afraid to do it - I have angle closure glaucoma. My Dr. said it was "in-and-out," easy surgery, with usually no after effects. Anyone have positive outcomes/descriptions of the surgery? I really don't know what to do now.
I woke one night with severe eye pain and loss of vision. A&E tried to send me home but I begged to see an Eye Specialist. Within 10 minutes he was going laser surgery to save my eye and did the other because it was affected, but I was unaware. I am nearly three weeks post surgery now and apart of a little blurring of vision in one eye, and an ache in the eye which was severely inflammed, my vision is fine and my pressures are well down. My migraines - suffered for the past 10 years, are vastly improved. Go for the surgery - what is your option: blindness ! Of course there are risks, but there are in everything. These guys do about 10 ops a day and I do not hear millions of people complaining about the outcome. I am so grateful to my surgeon. Have faith.
iwas told to have laser iridotomy i am afraid to have it because of the many side effects from tony any commets
37
julie
HAD IRIDOTMY 7 DAYS AGO. WAS NOT TOLD ANY OF THE RISKS INVOLVED. HAD LASER ON BOTH EYES AT SAME TIME. APART FROM ACHING IN THE EYES, I HAVE NOT HAD ANY ADVERSE EFFECTS AND DO NOT SEEM TO HAVE ANY BLURRED VISON ETC (APART FROM STRAIGHT AFTER PUTTING EYE DROPS IN) HAVE GOT FOLLOW UP APPOINTMENT IN 3 WKS SO HOPEFULLY ALL WILL BE WELL. DID TAKE WEEK OFF WORK TO RECOVER AS EYES FELT TIRED AND ACHING BUT APART FROM THAT HAVE HAD NO BLEEDING ETC
38
Anne
I had laser iridotomy performed on both eyes last month. The right eye was done the first week, and the left was done the following week. The size of the openings in the right eye were increased during the same surgery as the left. I have not had any problems. I do have one recommendation I would like to share with those who will be having this surgery. The burning discomfort that lasts approx. 12 hours after surgery was lessened by leaving my contacts in for the full 24 hours after surgery. After the second surgery, my surgeon agreed to give me a very tiny bottle of the numbing drops that also helped with the burning discomfort. I wore my contacts and also put one tiny drop of this solution in the corner of my eye the few times the burning started. My vision is very important.

My mother lost sight in one eye many years ago due to an acute attack of low-angle glaucoma that she never told anyone about. By God's grace, my youngest sister was in the hospital to have corrective surgery. The eye surgeon noticed my mom's eye and immediately had her admitted for emergency surgery that saved that eye.
39
Linda Wolynetz
My 93 yr old aunt saw her optometrist who recommended an appt with an Ophthalmologist regarding her cataracts. She was diagnosed with pseudoexoliation syndrome and laser iridotomy was recommended. No information was provided and when I called to make the appt they briefly gave me some info over the phone about the procedure (not in detail). Needless to say I was not satisfied and during my research found this site and am even more apprehensive about recommending this surgery to my aunt. Any comments would be appreciated.
40
Magda
Hello,
I have high hypermetropia (+8.25, +8.5 glasses which do not allow me to see as basic people do)
Following a UBM exam, I was told I might have a closed angle glocauma, and as prevention, I should make the irodotomy operation to my eyes.
Right eye done without problems. Left eye done 2 weeks later (3 weeks ago)
One hour before the operation, I put three kind of drops in my eyes : (1. to lower the pressure of my eye, 2. to shrink the iris 3. anti-inflammatory)
And then for 2 weeks, I put two anti-inflammatory drops 3 times a day. (I stopped putting the drops last week.)
The problem is that, since the operation of my left eye :
• When I wake up, I have to wait something like 6 seconds to see clearly with my left eye. During the 6 seconds, it usually starts by complete dark. Or only a round is clear and the rest is black, then this clear round becomes bigger to see "normally". During the day, the alteration is mainly by dark or light splotches everytime I move.
• And when I close my left eye during the day or before sleeping, I keep seeing some light. As if I looked to a high source of light before.
• I feel also that my lateral vision has been significantly altered. (I did not have an increase in the pressure of my eye during the operation, nor a week after)
Although my doctor asked me to "wait", I don't feel my eye will come back to normal. Did anybody have a similar problem before ?
Besides, I was surprised that my doctor did not make the exams corresponding to my description : turn off the light, then turn it on to see the reaction of my eye, check my lateral vision ...etc
Are there well known exams to check such deficiencies ?
Is there anything I can do to get my eye come back to normal or to avoid worsen this situation ? Example avoid light changes shocks and start wearing sun glasses ?
Thanks in advance.
I am 62 and had a macular pucker for five years in my left eye and I went through surgery four weeks ago, ( 12/16/2010)I have been seeing my doctor once a week. The problem after this surgery and after the gas bubble dissolved in 12 days, is a dark shadow in my left side, so I lost left peripheral vision in my left eye that I didn’t have before the surgery. Before the surgery I had blurry and distorted vision, but no shadow or dark spots Now after several tests the doctor says there is no retinal detachment, the retina is OK and no hemorrhage, and this loss of peripheral vision could be a "stressed nerve" something temporarily in the eye after the surgery and this happens sometimes and this could be gone in weeks or months either partially or nothing at all. There is an MRI pending in order for the doctor to have more information about this loss of peripheral vision
I do not know what a "stressed nerve" means and now I am stressed worst than before my surgery I would appreciate to hear you opinion. Thanks
i have had 3 iridotomies on my left eye with an still existing on /off pain,
should i be concerned if my doctor wanting to perform a 4th time iridotomy?
i am however not plannig to go ahead for the fourth surgery!!
thank you in advance for your reply
hi Im from mexico, iridotomy was a great solution, my mother is very happy, she was applied the laser in the hospital Conde de Valencia In mexico city, the pressure of her eyes dropped . She has 1 year without drops for the pressure. We listen many disadvantages about the iridotomy, because of others persons , that didnt have good look, they said, the saw double, and things like that, but this is because , the little hole in the eyes was applied belower than it have to do. But today I give thnks god.
44
Patricia
I had an Laser Iridotomy done on my right eye just 3 days ago and have to get it done on my left eye in four days. I have had some small side effects but nothing as scary as some of the stories I read on the internet . This made me feel that I needed to let anyone know that it isn't all bad. I have had a little bit of burning, eye seems tired and some minor aching. Blurry vision is getting much better and almost back to normal. The actual procedure was uuncomfortable and a little unsettling. (like fingernails on a chalkboard), I didn't care much for the sound either but nothing too be totally freaked out about.
45
Jeannine
I had an iridotomy about a month ago in both eyes as the doctor suggested my angles were narrow and this was being strongly suggested as a preventative measure for more serious things that could happen. Since having had this surgery, I was told to put two sets of drops in my eyes, 1. 4 x per day and 2. 2 x per day. I did as told and finished my first set 4 days later and then 4 days after that I had a reaction to drops called Azarga(the 2x/day). My eyes/eye area starter to swell as well as I developed a rash all over my face as well as neck. My eyes were burning and the rash very itchy. I quit taking the drops and went back to the doctor to find out that it was just a reaction to the drops. As far as the iridotomy, I find that my vision is not as good and I see a white line in my left eye if there is bright light. I am dissapointed with the surgery but again what were my choices...taking a chance of going blind! The surgery itself is slightly uncomfortable and I did experieence what they call "brain freeze". It happened when they put drops in my eyes to contrict the pupil...I had a massive headache but was rectified with 3 Tylenol 3s. I just hope that the surgery does what it was intended to do and I wish I could totally recommend this procedure but I cannot. Good luck to anyone who has it done.
46
Patricia
I had commented earlier and felt like updating, funny how Jeannine mentioned the "brainfreeze". I had that exact feeling however, I had it for a few days after, it would come and go. Now it has been over a week since having my second eye done (glad I only have 2 eyes) I am doing pretty good but do get an ache here and there . Sometimes when I am laying down and have my eyes closed they seem to be aching through my whole eye, it is mild. I work on a computer all day at my job and my eyes get tired anyway but seems to be more now than before the surgery. My left eye did start bleeding during the procedure and the doctor had to apply pressure, it was uncomfortable,and since the blood clotted in the hole, he had to move over a little and do the lasering again, numerous zaps, very unsettling . Bottom line is though it is unsettling and there is discomfort the alternative is much worse. My sight is too important to me to not take any preventative measures to preserve my vision. Have a follow-up appt next week , will let you all know of the outcome. Hope this helps!!
47
Paula
I have had Laser Iridotomies done on both eyes today as a preventative measure for narrow angle closure.

The procedure itself was no more than a bit uncomfortable with a slight headache which quickly subsided.

My eyes are now a little achy with some on and off blurriness when administering drops every hour. I have to go back to the consultant in 10 days time for a check up.
I've been told I need laser iridotomy, I have acute angle closure but don't have glaucoma, and have been referred to a research project, which means I will me monitored closely over the next 6 months. My surgery is due to take place mid April. I am rather worried having read the comments above. I get some aches in my eye and my sight is underpar without my glasses and I need to be careful when in underlit rooms and driving at night but mainly my eye aches when I'm at work which is very computer based, the rest of the time I'm OK. I haven't read any comments that are completley positive and I'm starting to question the benfits versus the risks associated with this proceedure! I don't understand why 'Drs' aren't completely transparent about this proceedure, why do we have to find this information out for ourselves. I really don't know what to do now, leave well alone and risk an attack or go ahead a risk the after affects, catch22.
49
Ketan
I was diagnosed with Narrow Angle Glaucoma and already had suffered two bouts of severe eye pain due to it a month back. I went to the best doctor in my city who had done some thousands of iridotomies in the past and is a renowned Glaucoma expert. He is proficient in performing YAG Iridotomies.I had Iridotomies done in both my eyes at a time. I had seven shots of YAG laser in my right and four shots in my left eye. Must admit that at the time of every shot I definitely felt something hitting my eye, but it was not unbearable as such.On my way home my vision started returning back to normal. I put the eye drops suggested by my Doctor and then went to sleep.

The following day when I woke up in the morning, my vision was absolutely fine. Just great. No Pain at all. I went to my office and did my daily chores. In between only for 2/3 times, I experienced a very mild pain that lasted for some few seconds only which was not an issue at all following the laser surgery that I had undergone. Today is the second day and I am just like before. Nothing abnormal. I am very happy with my condition.I was told before hand by my doctor that 90% of Iridotomies are always successful and the ones that fail may require a filtering or incisional surgery.But your specialist doctor is the best judge to look whether Iridotomy is necessary in your case or not.

Friends,I also had done my research on the net before undergoing Iridotomy and ran in to many horrific comments made by some people whose iridotomies went haywire, but believe me mine was absolutely perfect. No trouble at all. No white line, no glare,no double images,nothing at all.I can not see the holes in my eyes.That’s the result of the YAG laser,absolutely perfect.

What I would suggest to people who are suggested Iridotomies by some doctor is:-

1)Go to a top notch surgeon who is a Master of Surgery with years of experience in the laser department. It would be more better if he is a Glaucoma specialist too(Mine was a M.S who is proficient in doing laser surgeries as well as a renowned Glaucoma Specialist)

2)Check how many laser surgeries he has performed in the past and his success ratio.Discuss everything with him that you want to know about the procedure etc.

3)Ask that specialist if your eye condition can be treated without the iridotomy (whether another alternative is possible)

4)If the specialist tells you to undergo the Iridotomy and if he possesses all the above required criteria then don't hesitate to get this procedure done as the specialist is the best one to judge your condition.

5) If at all you are not satisfied by the response you get to your queries, take a second opinion of another renowned surgeon. (I did take a second opinion and that doctor also told me to get the Iridotomy done)

6)Friends,never defer your Iridotomy just by reading the negative comments on the Internet on some forums or blogs etc.I don't mean to say that the ones who had the side effects are fake or wrong, but there are many factors that may have resulted in the Iridotomy going haywire for them.The reasons may be the ones that I have already explained above.

The main reason of my posting the comments here is that not much people who have had the iridotomies done to their eyes care to report their success stories,but the ones who were unsuccessful do voice their concern, but some of them scare people to death and in this way they are doing huge dis-service to mankind and causing wrong fear in the minds of people who are suggested this procedure. If someone's Iridotomy failed due to some reason, it doesn't mean that everyone will suffer. By causing wrong fear such people are pushing others into an abyss of blindness.Iridotomies have never caused serious side effects unless not done properly and in cases where it was not required at all,that's it.
50
Margie
Is this condition a possible occurrence after a rear end collision ? I started having eye pressure a week or two after my accident and I have an appointment for an evaluation for this procedure. Thank you for any information that could help me.
Margie,If you had an eye injury due to the collision then there is a full chance of the increase in eye pressure due to the injury caused by the jolt that you might have received in the eyes and if that's not the case then the pressure rise is due to some other reasons and factors that can be best evaluated by your eye surgeon.Do visit a very well experienced and renowned eye surgeon only and never hesitate to take a second opinion if a surgery is advised by the doctor in your case.All the best from my side.Cheers and God bless all.
I am a 75 year senior. My mother had glaucoma cataract in her 80's. I have now been advised to have YAG iridotomy as a preventive measure for glaucoma. I have
- history of dental and ceasarean hemmorage and both times I was given vitamin K injections. Blood work showed high risk of hemmorage. Currently on daily dose of 81 mg ASA.
- had severe allergic reaction to naprosyn for a frozen shoulder treatment.

Is it advisable for me to go through the YAG iridotomy treatment as a preventive measure for glaucoma.
Hello all, Very sad to hear of all the bad experiences on this forum. Two days ago I had an iridotomy and iridoplasty. Am now feeling great, eyes feel good. Guys you must make sure your surgeon gives you the appropriate drops before hand and aftercare drops as well. I suppose I am very lucky as they were performed on the NHS in England. I wish everyone all the healing and wishes I can.
Hi, I had an iridotomy on my left eye last November (due to narrow angle closure) as a preventative measure.
Before the op the pressure was 25 and after it came down to 17. It was uncomfortable and I definitely felt the six hits but nothing too bad. After a couple of days of mild discomfort my eye felt normal and has done ever since, I also had perfect vision in that eye (which I didn't have before) for a day!
I went back to the hospital last week as I am scheduled to have my right eye done on Thursday, and they told me that the pressure in both eyes was 38!!! They're still recommending I go ahead with the procedure this week on my right eye, but have now given me drops for both eyes to administer twice a day (I assume for the rest of my life) to try to reduce the pressure. They still say that I should go ahead and have the other eye done as the pressure is very high. I would rather do that than go blind though. I too had mine done on the NHS in the UK.
Just thought that this site needs some positive feedback.
Good luck and wishes to you all
55
kuldipbadhan
hi,
the success rate of lasergrodotomy is only 40% and in face of so many adverse comments of patients why the
eye sergons are still insisting upon lasergrodotomy is beyound understanding.
Hi I have just had iridotomy laser surgery on both eyes due to an emergency attack of acute angle closure glaucoma on 14/10/11. I spent two nights in hospital because on admission the pressure of my left eye was 70mm and my right 20mm.I was advised to have both eyes treated and after seeing the doctor last Friday was told that i have no permanant damage to my optic nerve. I have finished my course of drops and returned to work after 3 days. I am now waiting to have cataracts removed that i didnt know i had. My vision in my left eye has deteriorated slightly and is still feeling irritated but i think i have been very lucky not to have any permenant damage. These attacks dont come with warning signs,I would like to thank the doctors at Wirral Trust Hospital for their prompt action. I have regular eye checks last one being June 2010. I am 60 yrs old
I just had my second iridotomy today on my left eye, two weeks after the first one. I am experiencing a bit more discomfort with blurred vision, and a foreign body sensation in the left eye. In the right eye I have better vision accuity and sometimes I see what resembles a hair in the bottom of my visual field. So far the actual procedure wasn't as bad as I thought it would be. Not really pleasant but also not unbearable. The only thing that I found to be diturbing was the sensation of looking thru a smokey tinted glass immediately after the today's procedure. Maybe the difference was I had to get zapped 20 times in the left eye as opposed to only 6 times in the right eye. I had no blurring in the right eye two weeks ago. I guess the experience is different, even with two eyes from the same patient. Hopefully there won't be any complications. I will write again later If I experience any adverse effects.
Jan 2009 I had an iridotomy for acute angle glaucoma (low pressure, no vision problems). I had flashing in the upper quadrant of my eye for over a year if I raised my eyebrows in surprise. I had a glare as soon as my eyes were returning to normal. 6 months later I had a vitreous bleed which left me with a floater. It has dissipated by 2/3 in visbility, but I think the dispersed blood has left me with intermittent blurriness which makes me nuts when reading or working on the computer. My eye doctor never responds to my side-effects. I am due for the second eye on Thursday. My anxiety was so great that I went to see a glaucoma specialist for a second opinion who insists that of the 1000 or so iridotomies he has done, no one has complained of glare. He was very dismissive of my complaints. However, while waiting to be seen, I met a man in the waiting room who had had an iridotomy by one of that group of doctors and he said he had a glare after the procedure! Are people not reporting these symptoms or is the doctor in denial or lying? I feel like I'm living in an alternative universe.

I know that the risk of an acute attack is getting greater as my angle constricts further, but my fear of ruining my good eye is intense.
Just reporting in that my second iridotomy went as well as could be expected --WHEW!!! It was yesterday. No side effects, no flashes, no white line. I see as well as I did before and still better than my right eye. My dcotor said that she used both kinds of lasers on each eye. The first one with more zaps to reduce the thickness of the iris and fewer snaps to penetrate. On the second, it was the reverse. Perhaps the lesser pounding caused less trauma to the second eye.

Since I reported the bad news, I wanted to report the good news. I'm so grateful to have the second eye spared the distortion of the first that I am "over the moon." I'm also glad that I don't have three eyes!
Margaret,
How long did you have to stay at the Dr's office after you had the surgery?
61
Cassandra
I had an iridotomy in my left eye due to a diagnosis of narrow angles. I was supposed to have one in the right eye as well, but have put it off because I have what I was told is an extremely rare side effect. A streak of light that periodically appears and floats up and down in my vision. After reading all the stories above. I wonder just how "RARE" this side effect is and if I should go through with the iridotomy to my right eye, "the good one". My doctor told me that me even having this problem based on my statistics was so rare he could not tell me if it was likely to occur in the other eye as well. No one in my family has ever been diagnosed with narrow angles so I'm wondering if I even really have this condition! Please Help.
62
Ray
I am a 42 year old male, who is set to have a preventative Iridotomy procedure in my left eye tomorrow. It's too bad that not more people who have had successes with this procedure would speak out. Anyone who just relied on this message board to make an informed decision would run far far away from having it performed. I will be sure to post up good, bad, or indifferent experiences following tomorrows procedure.
63
Ray
Hello everyone,

As promised... this morning I had a Laser Iridotomy procedure done in my left eye. I would like to say, that so far everything has gone smoothly. I see my Ophthalmologist again tomorrow morning for a follow-up. During the procedure I experienced no real pain, some discomfort as I don't like anyone near my eyes to begin with. However, I coped with that because I had built up a relationship with the doctor before hand. This doctor also performed cataract surgery on my father last year and I went to all of his appointments. I was well prepared (research wise) having made my decision to have this preventative procedure performed on my left eye.

I will follow-up with another posting in a day or two to let you know my progress. I do feel sorry for those who have had a bad experience with their surgeries/procedures. I am not dismissing your claims. I just think there needs to be some non biased posting on the internet. At the end of the day, no one should enter into a medical procedure of any kind without some of their own personal research. If you don't know how to research your procedure visit your local public library. The library staff will be glad to help.

Good health to all!

Ray
64
Anne
Thank you Ray for the positive comments. After reading all the negative posts I had cancelled my iridotomies but know I will likely have to go forward eventually and it is good to hear some positive outcomes.
65
Ray
Hello again everyone,

Here I am again with a ten day post procedure update. As I am posting this I have had absolutely no discomfort or pain in the eye, nor have I had any white line distortion that others have reported. I know each case will differ, but I am just sharing my experiences.

I did see the Ophthalmologist the following day and he was very pleased with how everything was looking. With this appointment we discussed having the same procedure performed on my right eye. I will probably be getting that done later in the spring - for the same reason a preventative procedure.

Anne, if your experience is anything like mine, you will probably end up kicking yourself in the butt for putting it off. I wish you all the best health when you do eventually have the procedure.

Warmest regards,

Ray
66
josephine
I have just been advised to have the LPI done in both eyes to prevent acute angle closure glaucoma. My physician, a specialist at a renowned research hospital, apparently knows what he's doing, yet I am looking for more information and reassurance before I commit.

Thanks to everyone who posts their successes. It is true that these posts lean toward those who have had negative experiences, as we humans are more vocal about our unhappiness than our happiness!

I wish there were more definitive research completed on the position of the iridotomy holes and vision problems. Comments, anyone?
67
Tanya Whitaker
Hi all from the uk,

On 16th of January this year I went through iridotomy. I was told that I have narrow drainage angles. However, I have not been told about any side effects that might follow this procedure. I am seeing a horizontal white line across my left eye. It looks like a glare from light and I see it when I look from darker space into lighter (like in a day light, looking at the window, computer screen). I have been examined twice after the procedure by NHS doctors and have described to them what I see. They both seem do not really pay any attention to it and said that what I see it is floaters and nothing to worry about. It is not floaters as I know what floaters are look like. I did not have any problems with my vision before in my life. This white line is quite disturbing, especially when I am driving or working at the computer. It makes me wanting to rub my eye and take the distraction away. I went on-line and have read about such an effect as the opening in my iris was done too high and is not covered by my eye lid. Apparently it is impossible to see during examination. I could not find the answer if this effect will go away and if so then when?
I would appreciate very much if you could answer to my question.

Tanya W.
Tanya,

I had an iridotomy done in my left eye 2 years ago, the hole was made in the 3 o'clock position, and my eyelid does not cover it, I have extreme cloudiness, glare, and double vision in that eye, I had the other eye done in the 12 o'clock position and have had no problems at all. I complained and complained about this to my doctors and they kept telling me that my brain would get used to it and I wouldn't notice after awhile, I had one doctor tell me that I should ignore it, and that it was always going to be with me and that I should name it, he asked me if I liked the name Oscar for it? Very professional, right? I have tried colored contact lenses, and they did not work for me, one doctor recommended a tatoo over it, but fda doesn't approve that procedure any longer. They talked about suturing it, but that is a risky procedure and most doctors will not do it. They are now talking about cataract surgery, and I don't have a cataract, so I don't know how that will help. I hope you are doing better, but in my experience, this is something that has to be lived with and it is very dibilitating and more then that very frustrating that no help can be given.
69
Shelley
Today was my second iridotomy. The first, one month ago, went very well and the recovery was quick and without issue. The second today went equally well and I am glad that I decided to have my eyes done. The doctor, a glaucoma specialist, checked the first one today and it is open. I think that it is important to get a doctor with good training and lots of experience to perform this. I have no double vision, no lines in my vision, and it was done quickly and without pain. I could feel it, but it was not painful. The doctor was kind and patient, the staff was also attentive, and it was a positive experience.
My 2 children are complaining of eye problems. Since my Mom has a good opthalmologist, I brought my children to that doctor for check-up. When we got there, my mom convinced me to have an eye check-up evev i insisted that i didn't feel anything wrong at all. Results? my children have dry, iritated eyes and for me- i was told to have a Yag laser treatment for my both eyes. The doctor asked some question that might be symptoms of my condition, and I answer him NO for all his questions, he still insist to do the procedure on that the same day. I did let the procedure done and tell to be back on another day, and he told me I should have it done to prevent glaucoma. I consulted another eye doctor and told he saw the same descriptions of my eye as the first doctor, but this time, he did recommend an eye surgery and needs some eye drops for treatment. I'm now so confused especially i'm starting to feel strange feeling that haven't before. My eyes get fatigue so easily and sometimes get blurred. Though I know this is some signs of aging (i'm 43). Now that I have these new feelings, I prepared my self for surgery ( as my mom always telling me to accept the procedure since the doctor is truly known to be good). After reading all the comments above, i am having a second thought to push it through.
71
Milly
I had an iridotomy on both eyes yesterday. I have glaucoma and was told I needed the laser treatment because there was a risk of acute angle closure. The procedure was a little uncomfortable but not really painful. My vision cleared after about 15 minutes and apart from feeling tired today (the result perhaps of being a little worried) I have absolutely no side effects whatsoever. I need to put drops in both eyes 3 times per day for 15 days but don't see the opthalmist again until 22nd June.
72
Rosa
Is there a difference between the YAG Laser test, procedure or surgery?
73
laurienne
My friend had an iridotomy yesterday. Now indoors it seems to him like he is wearing sunglasses. Everything seems dim - is this normal?
74
Fran Gour
A clip hit me in the eye back in Feb.2012. Experienced pain and went to eye Dr. ASAP. He said I was fine, then first part of July had severe pain in right eye. Dr. said I had closed angles. Saw a specialest w/Mayo and he said I should have Laser surgery. My eye Dr. would not discuss this with me and I was quite anxious because this was a new dr. which I did not know. Went to another Dr. my friend recommeded and he did yag laser in both eyes. I now have pain in right eye, temple, and bones in right side of face. I'm so worried and don't know where or whom to turn too. What would cause this pain? Pressure in eyes is 12 and was never over 19. No problem with left eye or face. Can you help me please.
75
reg nicholls
I had iridotomy procedure to both eyes on this wednesday no pain today is frday no pain or any
problems whatsoever
best wishes any one about to have it.
76
Nicky
I just had the iridotomy procedure done on both of my eyes on Tuesday, as a preventive measure from having an attack of acute narrow angle glaucoma. I did my research and read many posts of those who had negative experiences, so on the day I told my ophthalmologist that I was freaking out. He reassured me and explained the procedure in good details step by step, even told me the first laser "shot" normally catches people by surprise.
End results: left eye done, I did feel the last two "shots" a bit but no real pain. Right eye, have to come back in 4 weeks' time to get it redone, as my iris is dark and thicker than normal, max number of shots done for the session.
My eyes were a little bit irritated but after I put the prescribed cortisone drops, they were fine.
So far my vision is still fine, no stray light, no floaters, no blurry, no pain.
I do however experienced light constant headaches around the temples, forehead & back of the head. I took Tylenol and it did the trick. The headaches seemed to have subsided after 2 days. Maybe it was from me stressing out.
I recommend wearing a good pair of sunglasses when you go outside into natural sunlight after the surgery, it minimizes the discomfort to your eyes.
Good luck to those about to have the procedure done.
77
sue
I'm due to have laser treatment on both eyes soon but the doctor just told me i needed it. she gace me no information about the treatment or even what kind of laser will be used or the after care. having read whats been posted here i now have doubts about the treatment. also the hospital that want to treat me messed up my dads left eye and he had to go back three times before the mess on his left eye was fixed. in the end his left eye was left disfigured and it affected how he looked. as the hospital want to do both my eyes i'm terrified of ending up looking like a monster.
78
Golfer Happy
Two weeks ago I developed the shingles on my face, which involved my right eye. I developed iridocyclitis and increased IOP in my right eye. My eye doc discovered a narrow drainage system in the affected eye and the well fellow eye. After 10 days of treatment of the shingles, my IOP in the right eye (left was normal), he recommended a peripheral iridotomy. I am a retired physician and when I discovered this website with all these horror stories, I was concerned. Fortunately, I have the privilege of knowing many qualified eye docs over the US and their universal recommendation was that the PI is sight preserving, low risk and should be performed. I had the procedure yesterday. Minimal discomfort, no change in vision. I have to agree with several other posts with a favorable outcome of a very important, sight preserving procedure. It took a total of 5 minutes. Follow up next week. In contrast to those with less than favorable outcomes, my experience has been positive and I am grateful for a good operative outcome. As an aside, if you're over age 60 and had the chicken pox as a child, I would take the shingles vaccine. Speaking from personal experience, you don't want that affliction!!
79
Cynthia
I had iridotomy done a few months ago and I was very pleased. Prior to having it done I woke up every day with a fantastic headache, usually between 4 and 6 in the morning. I could not feel better and I look forward to my next eye appointment (hoping for a decrease in pressure).
80
Jennifer
I am 33yrs old and had a Laser Iridotomy yesterday on my Right Eye. I have to say I was very nervous after reading all the comments on this message board. I almost cancelled my appointment. I am glad that I did go through w/it as it wasn't nothing like most ppl have stated on here. The procedure in itself was very easy and took a total of 5 minutes for the Dr to prep and do the actual procedure. I have experienced a headache and pressure in my eye with blurred vision. All of these symptoms are normal for 24-48 hours after treatment per my Dr. I go in 2 weeks for my left eye. All I can say is make sure you get an experienced Dr whom is known and trusted. Good luck :)
I have a 7 year old daughter. I took her to an optometrist because she had a stubborn stye on her upper lid and I thought it might need some otintment. Well her stye was no big deal, but after a thorough examination he told me that she has narrow angles and is at a high risk of developing glaucoma and that an iridtomoy should be performed in each eye as a preventative measure to an attack in which her vision is at risk. He then suggested that we make an appointment with the eye surgeon for his evaluation in the same center. We made the appointment (she has not had it yet - it's coming up). In the meantime I have left no stone unturned looking for every bit of information out there on the subject. Turns out in children iridotomies are very rare and there is not much written about it. But with regard to this issue in adults here's what I found that you should consider: only 10% of people with narrow angles - WILL EVER have an acute angle attack and/or glaucoma. Listen up people - that means that 90% WILL NOT. You do not have to run out and get an iridotomy just because you have narrow angles. YOU DO neeed to consider everything. If you have Glaucoma in your family, if you have high pressure or other symptoms of it - then that's another matter. But with no other symptoms I would not consider it.I would become famliar with symptoms of an attack and I would get established with a good eye surgeon to call in the event of an emergencey. I found the best of the best in pediatric eye surgeons in Los Angeles and scheduled an appointment for my daugheter. He saw her this past Saturday. He confirmed that my research was valid. He also confirmed that getting an iridotomy as a preventative measure does not always mean you will never suffer from angle closure. Sometimes they close up - and other problems can occur. To me the numbers do not support getting an iridotomy in an otherwise healthy eye that has narrow angles. Before considering an iridotomy, you can also elect to have your pupils dialated in a controlled environment. If the angles dont close after dialation - they most likely will never close and you most likely will never have an attck and don't need the iridotomy. If they do close- you are in the surgery center and you immediately have the iridotomy. This makes much more sense to me if you are considering this procedure as prevention - at least you have a 50% chance of a positive outcome that confirms you do not need the procedure. During my daughter's appointment he performed a number of tests including a three mirror gonioscope exam. He told me that even though her pupils where very dialated, her angles where still open - a very positive sign. He told me that he thinks she will be fine - and recommended that we bring her back in 6 months for another pressure read. Her pressure was fine by the way 11 in one, 12 in the other. It's all very scarey. Eye sight is so precious. I would just encourage everyone to please do your homework. Get more than one evaluation. Find the best eye specialist you can. Talk to people who have had the procedure and consider all of the information. Then make your decision. Once you do the procedure there is not going back - you're in for life. Trust me - i am worried about my daughter's eye health. I have to make the smartest and most informed decision for her. She will go see the other surgeon for his opinion this Friday. And I will most likely get yet a third opinion - though I don't expect the outcome to change. I suspect for her, monitoring her pressure every 6 months will be the way to go. If something developes or if there is a significant pressure change that we will have to consider alternatives. The good news is that should you need the laser procedure it is available!!! I'm praying for you all! GOD Bless you!!!
82
ann
I had laser surgery for narrow angle glaucoma in April 2012. The hole was placed at the 1:30 position. I started seeing a bright white line across my vision about a week after surgery. My Dr. does not have an answer and says he has never had a patient, in his 40 yrs of practice to have this? It happens if I go outside, drive, stand at a window even the lights from the dash while driving at night causes this line to come up. I really feel it is the light getting into the hole in my iris. When I raise my eyelid or just move it slightly this line moves with it. I read Mary Ann's comments and am interested to know if the cataract surgery helped. If anyone has had this problem and found a solution, please let me know. My other eye needs surgery but I am very afraid to do it.
83
Susana
I am schedule for this narrow angle glaucoma laser procedure this coming Friday, but after reading so many negative comments and really bad results, I am freaking out and terrible afraid. Anyone with good results and experiences after the iridotomy that lives in NYC could please give me the name of your doctor? I have bad feelings about mine. Please answer ASAP. God bless you!
Susana
10/17/12
I had iridotomy yesterday because my IOP had suddenly reached a really dangerous high (47) - I went to see the ophthalmologist the evening before and he got me in yesterday morning. It wasn't the most pleasant of procedures, having the laser shot through both irises, but I have to say that I've woken up today and I'm really, really pleased with the result. My vision hasn't improved (I was warned that the small are of lost vision 'next to my nose' would not be restored), but I can DEFINITELY feel the pressure has reduced. After I used Maxidex at home the evening before the surgery, my IOP had dropped right back down to 18 yesterday morning, and went up slightly immediately post-surgery (26, then 24, but this was expected).

I'll be seeing my guy again next week, but I have absolute confidence that iridotomy was the right op and that the surgeon who did it was competent. Unfortunately, I don't live in NYC, but all I can say is don't be nervous. The alternative is too awful to contemplate really (blindness). I live in the UK, but I'm sure your practitioners have the same kinds of certification and medico-legal obligations as anywhere else in the world, don't they?
85
Deena
I had iridotomy done a week ago. all seemed well until yesterday when my eyes starting burning and the pain in my right eye gave me such a headache. I am suppose to go and do the left eye in a copy weeks but I am having doubts about doing it. My problem is narrow angles, 21 in right and left eye, and when I went back to the doctor 4 days after having the right eye was done my pressure was the same. the doctor told me that can be from the drops and told me to stop using them. I stopped and the next day is when this problem occured with my eye feeling very soar and a headache on top of head on the side I had done. I really dont think I will be doing the other eye. I felt fine before all this and now I regret having done it to my right eye.
86
Sarah
Hi all I have had laswer irdotomies on both eyes on the past 2 months and had to use drops for a fortnight after. After having the left eye done i have had nothing but headaches. I also have the symptom whereby I have a horizontal line in both eyes intermitantly, it is very annoying and wondered if anyone else had suffered from this?
87
Nicole
Kate post 4 from November 18, 2007
I thank you, Kate, for posting your story and your experience following LPI. Kate, your story has touched me.
I truly hope that you are well. My prayers are with you.

Each person who has posted
Thank you for sharing with me and others of your experiences. You are in my prayers for God's healing hand upon your life.
You have all helped me by sharing your stories, some terrible, some hopeful, all revealing and heartfelt.
May God keep us all in the palm of His Hand.

In Love,
N
88
Borderline
Age 63 with Diabetes II.
Doctor says I need YAG lesser hole drilling to prevent possible severe problems (blindness) with overpressure due to drainage.
Sounds like a plumber job ?
I have only one "good" eye, the other is what they call "lazy eye" syndrome (out of focus).
Surgery set for March 2013.
I like the Doctor but he has no experience with Laser, since his office does not have the apart us, he shares it with other Doctors, so gets it every few months or so.
ShouldI look for a more experienced Doctor or laser surgery center where they do this on more routine basis.
I coud let him practice on my lazy eye first !
89
Mary Ann
Ann,

I saw your post and just wanted to say that I did not have the cataract surgery, because my insurance wouldn't pay for it, my eye did not warrant cataract surgery, so I ended up having the iridotomy hole sutured in Sept. I will say that do not have the glare in that part of my eye any longer, but while doing the surgery the doctor put a tear in my iris accidentally and I have since developed a cataract in that eye, so i am basically back to square one, having a difficult time seeing out of that eye. I see the eye doctor again in February and we are going to discuss cataract surgery again and when he does that he will repair the tear in the iris. This has been a nightmare, and I have lived with it for over 2 1/2 years since I had the iridotomy done. Good luck to all.
90
Linda
I am 60 years old. I was told I needed the Laser Iridotomy when I went for my annual eye examination. The doctor told me the pressure in my eyes had risen each year for the last 3 years. She wouldn't dilate my eyes at the examination for fear I might have a sudden glaucoma attack. She sent me to a specialist for another examination. I had Laser Iridotomy a week ago on my right eye because of narrow angle closure. My eye was extremely blurry for about 30 minutes after the procedure. The vision was completely normal in about 24 hours. The eye was red and light sensitive with a sudden sharp pain when I looked out the window from a darkened area or when I went outside. I wore sunglasses when I went out and sometimes around the house. Tylenol helped with the pain. However, the pain was not bad. More annoying than extreme. The sharp pain, redness and light sensitivity continued for five days. Then it all went away completely. I am scheduled to have my left eye done in two weeks.
91
Jackie
Hey I'm 24 and had an acute angel closure attack early Monday morning (march 25th 2013) awful pain bulging blurry ness to the point I couldn't see & vomiting I was so scared A&E didn't know what it was but luckily an eye specialist from another hospital had a clinic on that day at the one I'd gone too - after being in A&E for hours with tests etc he diagnosed me within 10mins my pressure was at 55! He put loads of drops in my eye to bring it down & the pain went away & I could see almost perfectly again :) & an injection to keep it down till the next day when he had scheduled me in for the laser surgery LPI -I had it both eyes as the other is at risk too - it was quick & almost painless my eyes where really red after it which gave me & everyone around me walking past a fright lol but he said it was successful & all going well after my follow up I shouldn't need to go back again :) 3 days later my sight is almost as good as new - my eyes still feel a little tired and red but I can see fine - at times it is still a tiny bit blurry but I'm confident that will go soon :) don't be scared I'd rather get this done than live in fear of going completely blind! Make sure you ask your doc all the questions you want too - don't rely on sites like this - although some drs are eejits most are very good I've been through many in my 24years seen good & bad but we all forget how smart these people are we just have to hope they remember our health Is in their hands - but remember you don't have to do anything you don't want to - its your decision NOT his gee can only advise :) hope this helps x
92
Norma
I was diagnosed with narrow angle glaucoma in about 2000 ans was petrified to have the Laser Iridotomy. I must have waited about 5 years before working my courage uo to have it done. I had absolutely no discomfort no blurre vision afterwards. A few weeks later I had my other eye done and again no negative sise effects. I am realized how foolish I was in putting my eyesight in jeopardy. My only fears now are that you have to be smart and aware of certain over the counter medications as well as prescriptions that can increase the pressure in your eyes.
93
Emily
I had laser iridotomy on my both eyes today for narrow angle (my is at 13 degrees). I was terrified to have it done after reading lots of negative comments. I also did not have any discomfort afterwards. So far no blurred vision nor horizontal white line. I only hope it will stay that way. Just to wanted to share as some people will jeopardize their vision after reading negative comments. My laser iridotomy was done at 3 and 9 o'clock.
94
Niky
Hi,
I am 32 years old and last month it turned out that my IOP is too high. It was expected as my father and his father have glaucoma. So i was recommended to perform iridotomy. It was done 6 days ago. There were no discomfort on the next day. Intervention itself just was not so pleasant, but it was quick. Yesterday doctors checked my IOP and it seems at it was before the intervention. They said that this is normal as the intervention was so soon. They expect IOP values to drop next few weeks.
I wanted to ask people done the same procedure how long after the intervention there were noticeable drop in IOP values?
Thanks in advance!
Best regards.
95
I.H.OBERAI
i had taken my wife for a retina checkup for my wife. the dr. had not checked it saying that i take her to another dr for consultation since there is little pressure.The second dr had advised peripheral iridotomy(laser treatment). kindly advise by return.(My wife is taking diabetic medicine glucophage and 5 mg pressure medicine).
96
Mary
I have a family history of narrow angle glaucoma. My brother was diagnosed last year and my mother was almost blind at the time of her death. After exhibiting high eye pressure for years, when it finally hit 26IOP in each eye my eye doctor decided to do iridotomies in each eye. Before the laser iridotomies I used drops for two months to lower the pressure. Although anxious I went ahead with the procedures. After a few hours of mild discomfort (it felt like I had sand in my eye)everything was fine. By the next day I had no discomfort at all. My eye pressure is now 19IOP in each eye. I have also been instructed to use drops to further decrease the possibility of damage to my optic nerve by an acute attack of narrow angle glaucoma. At this time my optic nerves are healthy and I feel like I have dodged a bullet by having this procedure.
Glaucoma is a serious eye disease that steals sight. Listen to your doctor.
97
Jo
I had laser iridotomy in both eyes to open up narrow drainage channels and hopefully stop my daily headaches. I had it done last Thursday and have no apparent side effects. I suffer from headaches early every morning and I'm hoping they will stop, the doctor said i should know in 2 weeks. Cynthia, I see you had headaches and they stopped after the iridotomy, was that immediate or did it take a couple of weeks or longer?
98
Kitty
I"m going to have this surgery on both eyes (at the same time) in a few weeks. I have Fuch's Dystrophy also and have had no surgery for it yet (not till after THIS surgery). After reading the first comments up there from several years ago I was becoming very concerned. The latest comments have me feeling better about the surgery now although I"m still not completely sure about it.
99
Lin
Had laser iridotomy done five days ago, they put drops in to numb the eyes and I did not feel any pain. It was done very quickly. After it was blurry but not for that long. I am seeing white lines at times but they are not very intrusive, I had eye pain occasionally for the last year not sure if its gone yet now that I have done this, lets see. For me the risk I worried about was if the lens of my eye got scratched when using the laser as you would probably need surgery but it didn't happen
100
Kate
Hi all I had an ICL implantable contact lens done a month ago and needed iridontimy in my left eye, I now have a white line in my vision that is really driving me totally crazy.
I was not told of any risks my right eye suffered a retina detachment many years ago which I lost alot of sight out of, now my good eye (the left one) has now got a white horizontal line in it.
Is there nothing that can be done about this? Surely they can cover it and reposition it?

Any help truly appreciated, I am lost with what to do next, as I live in New Zealand, we are limited to options, but I need to do something as I can't handle it the way it is!!

Help please!
101
Diane
Hi everyone, I first have to say I am so thankful to read so many success stories here because after reading so many irirdotomy horror stories I'm debating putting of my own recommend iridotomy off out of extreme FEAR! I'm sick to the stomach with anxiety, can't sleep well because I have to make this decision. I mean it's my EYES!!! I really don't want to go through life with a white line accross my vision, glare, cloudy or double vision or possibility left blind. I'm TERRIFIED! Whine whine! 62 year old baby on board!

What I would like to know is what type of laser surguries you folks have had. I was told I need Argon laser because I have brown eyes, thicker iris are harder to penetrate. I've read that Argon laser makes a bigger hole with an increased chance of having glare, ghosting or double vision. Then I'm told it will be done at 3 and 9 o'clock. When I explained that I read 12 o'clock was the preferred placement my doctor said not anymore. it used to be thought that was the best placment but new studies show otherwise, with less undesired side effects at 3 and 9.

I had 4 opinions and 3 out of 4 say I need this done and she comes highly recommended, yet I am having a very difficult time making a decison. I've read that only about 1/4 percent of people diagnoised with this go on to have an accute attack... what to do?

Only I can make this decision but I sure would appreciate a pep talk.
102
blida
Hi.my mother is 55 years old and have narow angle .she has done the laser irioditomy before 1 week ago but the angle dont opeb to much.im very desperate .if somebody has some situation what they do please please help me to do. The right thing ..blida.
103
Kathleen
I had the Laser Iridotomy last week and have no ill effects from it at all. I went for a second opinion because I wanted to be sure it was something I really needed to do. I actually had the procedure done by the 2nd opinion doctor. I have every confidence that he performed the Laser Iridotomy because I needed to have it done. This is a preventative measure but I didn't want to worry the rest of my life that I would have an attack and have to have the procedure done in an emergency ward and I certainly wouldn't want to end up blind when there is a procedure that is available to me to prevent that from happening. My pressure was at 16 after the surgery and has not gone back up and the fluid flowed freely after the procedure, it was a success. I go for my follow-up appointment at the end of the week and back to have the other eye done next month. Anytime you have surgery, you should always have a 2nd opinion.
104
Eileen
Hi. I had laser treatment this morning in my left eye. No matter what side effects this may have, I would still do it as it is the only way to prevent angle closure attack. I have narrow angle in both eyes. Have had glaucoma diagnosed in 2008 but never been told the type. After seeing a privat health care doctor I was diagnosed with significant narrow angle with plateau iris configuration. The ultrasound examination showed that the narrowing of the anterior chamber angle is particularly in the dark and worse in the left. Fundoscopy showing large optic disc cupping with cup disc rate 0.7 both eyes. The iridotomy treatment is necessary to reduce the risk of an angle closure attack. I will be seen by the doctor next week to check if the treatment was successful and if not, to enlarge the hole and also to repeat treatment in the right eye. I have had severe symptoms in the left eye from years ago and was advised it is migraine. I always new it was not migraine as I wake up in the mornings with discomfort in both eyes and blurred vision at times. My vision is 6/6 in both eye. I only wear reading glasses since I'm 40 years old. I asked my doctor if I could have angle closure glaucoma over the years and was told it's impossible to have symptoms other than in an acute attack. So much to the norms and standards of symptoms. After this mornings treatment, I'm feeling discomfort in both eyes and head. I am feeling like after a severe whiplash. Drowsy, restless, tired, feeling sick, discomfort a slight head ache but no double vision, no bleeding and no blurred vision. Rather a strange greyish vertical line when I look straight. The pressure was after the treatment 20 mmHg.it was only checked once and was sent home after, with 0.1% dexamethasone.
105
ree
Does anyone know if iridotomy causes white flashes of light on my side vision?
106
Cindy
I was very nervous after having read some comments prior to having my iridotomy but apart from a bit of mild discomfort (gravely-feeling eye, slight pressure & mild headache) on the day of the surgery I've had zero problems. After some Tylenol and a good night's rest it's as if I never had the surgery. I just continue to put the drops in as I'm supposed to (for 5 days) thankfully all is good. No side effects, no vision problems, no white lines or light sensitivity, nothing. I encourage others to have it done. It is a small price to pay considering the risk of the alternative.
107
Sharon
I had iridextomys cut fifteen years ago before lens implants, they were both cut too big and for years suffered glare and light streaks , got the surgeon in uk to stitch them but they burst open, I then lived with it for years, I got cataract surgery done last year and the surgeon(I'm now in Canada) did a flap cover over the irdextomys and its a lot better ! Not perfect but better , so it can be corrected ,
108
Kim
I had laser surgery one and two weeks ago. In addition to having narrow angles I have also been having issues with Blepharitis (swelling of eyes, tearing, itching, dry eye, etc.) My left eye measured at 9 and my right eye measured at 11. Prior to the surgery, I suffered from a lot of headaches/migraines but never felt they were eyesight related. 45 yo, vision was fine. Surgery didn't take long at all. It was a little uncomfortable but bearable. After both procedures my vision was temporarily blurry and the day of the surgery my eyes felt like I had something in it. This went away within 4 hrs after surgery. With my left eye it felt she was trying to laser at the 11 o'clock position but ended up in the 4 or 5 o'clock position. Following the surgery I was using 2 different eye drops (1 drop & 4 drops/day) for a week. In my left eye (worst one) I was experiencing some pressure behind my eye, headaches following surgery. The day after my 2nd surgery I went to see my doctor due to swelling in my eyes/face. I was put on oral antibiotics for 2 weeks, tobradex (for Blepharitis issue), Zaditor, drops 4/day for dry eyes in addition to the surgery med's for my right eye. At the 10 day mark I noticed that my pupil in my left eye was very large, pressure still there, migraine. Also having a lot more tearing in that eye than the right and seeing what appears to be a little whiteness in my lower right corner of my eye (where ultimately I believe the laser was done.) Next two days I have noticed that my pupil is fine in the AM but increased in size as the day goes on. I'm now at the 7 day mark for surgery in my right eye, 14 days since my left eye. Today will be my first day without putting surgery drops in my right eye. It appears fine at the moment. No vision issues, pressure, etc. I go back to my doctor tomorrow for followup to swelling, etc. Swelling has gone down. Not sure if the other drops/medicines that I have been using is causing the issues with my left eye or if it's due to the positioning of the laser. If it wasn't for the pressure I'm feeling behind that left eye I think I could get over the whiteness I'm seeing at times in that eye. (It's almost like double vision but it's hard since I am also experiencing the constant tearing in that eye.) So far I have not read anyone else having the pupil issue following this surgery but will continue to research.
109
Steve
I just wanted to toss in my 2 cents. I am 55 and just had my right eye done last week. No pain. No side effects. I just used the drops as directed and everything seems to be fine so far. I am going back for the left eye on Friday and hope to have a similar experience.

I definitely understand how everyone feels. I was a big chicken when they told me I needed the iridotomies, but went through with the first one then so that I did not have time to get all nervous and I am glad I did.

Hopefully these procedures will help me to avoid IOP issues for the long run.

Good luck to all!
110
Goutam Hazra
I have cataract on my left eye and I had laser iridotomy for 29 pressure, when I can go for cataract surgery to doctor?
111
Rose
Can anyone recommend a top notch surgeon who is a Master of Surgery with years of experience in the laser department and a Glaucoma specialist too, who is proficient in doing laser surgeries (laser iridotomy) as well as a renowned Glaucoma Specialist in Houston, Texas. I need a second opinion from an expert Thanks.
112
Lori
I had this procedure on both my eyes because my doctor told me I had severe narrowing of the angles. Which I had no clue what she was talking about, but I made an appointment with the ophthalmologist who told me that I could choose not to have it done. But if I didn't, that I would have a headache so bad, that I would wish I could die and I would wind going blind and having surgery anyway. That this would be a preventative procedure. Had it done on the first eye and they told me if I had pain in my eye to let them know. Well, I didn't have pain in my eye, but my head hurt so bad and the bone which goes around your eye was killing me, but not my eye. I waited a couple of days and called because I couldn't take the pain anymore and they asked me why I didn't call sooner...had to go back and there was an infection in my eye. So she told me to remind her when I came back for the second eye of those symptoms and she would make sure that this eye was affected as the first...wrong, this one was worse!! Never again!! That was done in May 2016 and I am still having problems.
113
Katy
I had narrow angle glaucoma but my pressure was not too alarming. However, listening to the Dr. he scared me into having the surgery done. I too cannot stand the light and glare and to make matters worse before this surgery at 73 yrs old had 20/25 vision and readers only. I also had to have one eye opened again as there was a piece of cataract floating around in it (although Dr said my cataracts were so little I would outlive them.) At any rate I now have had to get prescription eyeglasses and need then close or far away. I am very upset about the whole thing and wonder if I wasn't taken advantage of?? Anyone had to go thru this?
114
George Barber
I had the iridotomy done 20 Years ago and have no problems since or during or after the procedure. My doctors kept track of the angle and like cateracts, said it was time..I think yearly exams are important and the doctor should let you know the state of your eyes especially upcoming problems if any. I have a friend who put off the surgery and nearly went blind.
115
jackie
I had the iridotomy in both eyes 1 year ago for narrow angles found by my optometrist. I did have severe pain after stopping the steroid drops but it subsided when I weaned off them rather than stopping suddenly. Now I was told that the skin has grown over, no light is coming through and the angles are dangerously narrow again and I should return for another laser surgery. they had to do it twice the first time also. Said my iris was tough or something like that. What is going on? anyone have to do it over?
116
Bruno Madsen
I’ve had an iridotomy done on both eyes twice... first a couple of years ago and again a few months ago. No problems or after-effects other than a bit of minor discomfort above the left eye (the only eye that felt anything during the procedure) for about 4-5 days. I have fairly narrow angles (and had a minor acute narrow-angle glaucoma attack three years ago) so this procedure is important in order to prevent IOP. I’m not saying an iridotomy is always without any issues, but personally, I’d rather have it than a root canal any day.
117
Milena
I am supposed to have this surgery tomorrow morning as a prevención, but after reading all the comments I'll canceling.
My husband had 20 surgeries for retinal detachment, lost the vision on his left eye.
After all this comments I will wait for a second and third opinion before I get it done.
Freaking out now!
Thanks.
118
Antonia
Can someone recommend a good doctor and clinic in Michigan for a second opinion on narrow angles. I was diagnosed with narrow angles in both eyes and the doctor recommend me laser iridotomy. Reading all this is kind of hard for me to me a decision... Anyways...one of the doctors I saw dilated my eyes and no attack happened... I do not really know if I really need the laser done...
119
Carole B
I am a female 70 years old and was active. Back in March of 2017 I had a laser iridotomy done by a highly respected opthamologist in my right eye and then in early April I had the left eye surgery done. I don't have glaucoma, but I was told I had to have this procedure done on both eyes before cataract surgery to avoid a glaucoma event. In mid June I saw a retinal specialist because even with a very expensive lens placed in my right eye, my vision was quite poor. I was then diagnosed with wet macular degeneration in my right eye and now must go every 4-6 weeks for an eye injection. Is it possible that the laser iridectomy cased this problem?
120
John C
The article is fine, except the statement saying that the success rate is 44%. Most procedures have multiple goals and outcomes. The article should state (1) the success rate of the initial hole, (2) whether it is still open (patent) at future times (e.g., 1, 3, 5 and 10 years), and (3) the success rate that the iridotomies have in preventing angle closure glaucoma. The procedure is usually done to prevent a future catastrophic angle closure attack and subsequent glaucoma. A second, but separate goal, might be to relieve current elevated pressure or to keep pressure lower when it is suspected that the patient is having periodic pressure spikes, including at night, that might be due to narrowing or partial closure. In any medical surgery evaluation, it is always important to separate out two issues. Was the procedure physically successful, for example was the hole made or the pathological tissue moved (strabismus surgery) or removed (tumor) versus what were the functional or health outcomes - was blindness prevented, was vision improved (better binocularity or stereo for strabismus surgery), was the patient more mobile (knee surgery), or did patients on the average live much longer.
121
teri
Can someone refer a great glaucoma surgeon/specialist in the Boca Raton, Florida area? Thanks
122
Letisia
I had the laser iridotomy done about a week ago. I have had nothing but problems since. The procedure did not go very well as they had to put three holes in my iris due to a thick iris. My right eye has been inflamed and irritated since. Went back to the doctor the third day with inflammation and pain and finally gave me drops. Eye was getting better so stopped the drops and the next morning woke up with sever pain in the eye. Will I need to take these drops all the time. I have to get my left eye done and very scared. I'm 49 years old and diagnosed with narrow angles in both eyes.
123
Tate
I had laser iridotomy than five months ago, because I had narrow angles. Now I am suffering from side effects: glare, halos, ghost images, white lines, starburst... Did anyone have the same experience. How long these side effects can last? Thank you.
124
Lynne Durham
Per this page's information, 64% of patients will STILL NEED TREATMENT for glaucoma after laser iridotomy. Complications appear to be underreported as well. Within weeks of my iridotomy, I had double vision and blurry vision. I could see fine before the iridotomy. DO NOT TRUST YOUR PHYSICIAN WITHOUT DOING YOUR RESEARCH. They will say complications are rare. They are not. Remember: they are trying to make money for a business. If 64% of people still need treatment after the procedure, then it's clearly NOT worth the risk of losing your vision after the procedure.

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