Laser iridotomy is an outpatient eye procedure performed on patients with narrow angles to reduce their risk of acute angle-closure glaucoma.
Angle-closure is a rare form of glaucoma where the fluid drainage system in the eye is blocked. In some patients, angle-closure happens intermittently (chronic), without symptoms, and leads to optic nerve damage from glaucoma and a gradual permanent loss of the peripheral field of vision. In other patients, angle-closure happens suddenly (acute). A severe pressure rise in the eye then can cause a headache above the eyebrow, nausea, red eye, and blurry vision, with halos around lights. Acute angle-closure glaucoma is an ocular emergency because of the risk of rapid permanent vision loss and blindness.
Most patients with narrow angles will have no signs of glaucoma but have a risk of this severe condition. Laser iridotomy is a safe procedure recommended in patients with narrow angles to reduce the risk of developing angle-closure glaucoma. Laser iridotomy reduces the crowding of the angle by the iris.
What is the laser iridotomy procedure?
Laser iridotomy is performed by an ophthalmologist in an office or outpatient setting without any sedation. You will be given drops to constrict the pupil that may cause a temporary headache above the brow. Anesthetic drops are used to make the eye comfortable and a specialized contact lens is placed on the eye to focus the laser. Your ophthalmologist will use the laser to create a tiny hole in the outer corner of the iris as a new pathway for the fluid in the eye. It is normal for you to feel pain in the brief moment the laser energy is applied. Your eye pressure will be checked after the procedure to ensure it remains in a safe range.
Risks of laser iridotomy
Laser iridotomy is a commonly performed procedure and complications are uncommon but may include:
- Headache above the brow
- Sudden increase in eye pressure
- Inflammation in the eye
- Bleeding in the eye
- Halos or glare with lights
- Need for repeat laser iridotomy
What should I expect after the procedure?
Your vision may be blurry for a few hours after the laser and you may have mild light sensitivity. Your eye surgeon will likely give you prescription drops to take for a few days. You should plan to have someone drive you home after the laser procedure. You can resume normal activities immediately after the laser procedure.