Laser peripheral iridotomy treatment

What is laser peripheral iridotomy?

An iridotomy is a small hole that is created with a laser beam in the outer part of the iris (coloured part of the eye).

Why is laser peripheral iridotomy performed?

It is performed to treat or prevent a sudden rise in pressure inside the eye (acute glaucoma). A sustained rise in pressure can cause permanent loss of side and central vision. The iridotomy allows fluid to circulate freely within the eye, minimising the risk of a sight-threatening pressure rise.

There are three reasons for this procedure:

• to prevent a sudden attack of acute glaucoma
• to treat an attack of acute glaucoma
• to reduce the risk or progression of chronic glaucoma caused by a very narrow drainage channel

This laser procedure is performed to preserve sight. It will not restore or improve the sight.

Risks

Complications are uncommon.

Occasionally after the treatment there may be a rise in eye pressure and some inflammation.t. The pressure will be checked before you go home and if very high, you will need to have extra treatment (drops, tablets or sometimes an injection). You will also need to remain in the Eye Clinic until the pressure has dropped to a safe level.

Other risks include:

• bleeding in front of the iris causing some hazy vision that usually clears within an hour clouding of the cornea (window) of the eye
• Cataract

Repeat laser required

The day of your treatment

The treatment takes approximately 15 minutes, but please allow between one to two hours at the hospital. Your treatment will be carried out in the Eye Clinic. On arrival the nurse will prepare your eye with eye drops to shrink your pupil and reduce your eye pressure. Some patients experience an intense headache after 15 minutes of the drops being administered. Then your clinician will explain the procedure, ask you to sign the consent form and numb your eye with drops. The procedure is then performed with you seated and resting your chin on a microscope similar to that used to examine your eye. A contact lens is placed on the eye to steady it, keep your eyelids open and focus the laser beam. You will see some bright flashes of light, hear a clicking noise and may feel slight discomfort - often described as a flicking sensation.

After your treatment

We will check the eye pressure 30 minutes - one hour after the treatment. If the pressure is at a safe level, you may return home. Your eye may become pink; sore and the vision can be blurred for several hours afterwards. For this reason, you will need someone to take you home. You will be unable to drive for several hours.

We will prescribe additional medication for a few days to prevent inflammation and a rise in pressure. If you experience any discomfort, please take your usual pain relief treatment.

You should continue to use all your anti-glaucoma medication unless specifically instructed otherwise.

We will arrange an appointment with the nurse in 1-2 weeks for an eye pressure check. You will then return to the glaucoma clinic 4-6 weeks later. A small number of patients will require more than one laser procedure.

If you are worried after the laser treatment

In the unlikely event of pain not relieved by simple painkillers, a drop in vision or a very red eye, please contact glaucoma nurses Mon to Friday 08:30 to 17:00 on 01223 274889. If it’s an emergency or outside of these times, please call the Eye Emergency Clinic 01223 217770.