Question 1

What are the benefits of having a laser iridotomy?

Accepted Answer

It is important to remember that this procedure is performed to preserve the sight you still have. It will not restore any sight you may have already lost, neither will it improve your sight. The laser treatment is to prevent a sudden (acute) rise in pressure within your eye. Without having this treatment, you are at risk of developing sudden glaucoma and irreversible blindness. The three reasons for YAG laser peripheral iridotomy are: to prevent an attack of acute angle closure, to treat an attack of acute angle closure, and to treat chronic glaucoma where the drainage channel is very narrow.

Question 2

Are there any alternatives?

Accepted Answer

An alternative to laser treatment is a surgical lens extraction cataract operation, which is technically identical to cataract surgery. Although the risk is still low (less than 1 in 1000), lens extraction is usually only recommended for patients who are already developing visual problems from cataract, or for patients who are unlikely to benefit from laser treatment. Patients who choose not to have laser peripheral iridotomy or lens extraction treatment risk developing angle-closure or deterioration of established angle-closure, which can result in high intraocular pressure and loss of vision from glaucoma. Observation only is a reasonable option for patients who do not have high intraocular pressure or other signs of damage from angle-closure, and we would recommend having regular reviews by a local optometrist. There are no other alternatives to open up the drainage channels in your eye. Some patients with this condition also develop a long-term (chronic) rise in their eye pressure and may need drops or other treatments in the long-term to keep the eye pressure within safe limits.

Question 3

Are there any risks associated with a laser iridotomy?

Accepted Answer

Complications after this treatment are uncommon. Occasionally your eye pressure will rise immediately after laser treatment; if this happens, you may need extra treatment before you can go home, usually in the form of eye drops or tablets. A small number of patients find that extra light enters through the new opening, which can be a little distracting at first and cause glare, but most patients soon learn to ignore this. Other complications include haemorrhage in the eye, which can blur your vision for a few days, or slight bruising and inflammation afterwards, which is usually small and can be treated with more frequent steroid drops. You may wish to take a mild painkiller such as Paracetamol for any discomfort. Certain symptoms require urgent attention: excessive pain, loss of vision, flashing lights, or the eye becoming increasingly red. If you experience any of these, telephone us for advice immediately or visit your nearest accident and emergency department.

Question 4

How successful is laser iridotomy?

Accepted Answer

Laser iridotomy is very good at protecting against acute angle closure glaucoma. Occasionally the small hole can partly or completely heal up in the first few days after the laser treatment, and further laser treatment may be necessary following your review in clinic. This is usually very successful.

Question 5

What do I need to do to prepare for laser treatment?

Accepted Answer

As this is an outpatient treatment, you can eat and drink as normal. You must take your regular eye medication and diet as normal on the morning of the laser treatment, unless instructed not to. The treatment itself should take about 15 minutes, but you are likely to remain in clinic for 1-2 hours.

Question 6

What happens on the day of treatment?

Accepted Answer

Upon arrival, we will explain the procedure and ask you to sign a consent form. Remember to bring a list of your current medications with you to the appointment. We will then check your vision and put some drops into your eye to make your pupil smaller and prevent the pressure rising within your eye. The drops take up to one hour to work. A few minutes before the treatment, you will have anaesthetic eye drops put into your eye to gently numb the surface of the eye.

Question 7

An important reminder

Accepted Answer

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

How successful is laser iridotomy?

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