Laser Iridotomy:
A Vital Glaucoma Procedure

Imagine trying to clear a clogged drain in your sink. If water cannot escape through the usual route, you might create a second exit point to relieve the pressure. Laser Iridotomy works on a similar concept: it creates a small opening in the iris to re-establish the flow of aqueous humor, bypassing the blockage that disrupts fluid drainage.

The process involves focusing a laser beam on a specific spot in the iris to precisely remove a minute section, forming a new passageway. This new opening helps balance the pressure inside your eye, preventing the iris from being pressed against the drainage angle—a scenario that could lead to acute findings and damage over time.

Preparation is an essential part of ensuring that the procedure goes smoothly. Your appointment often begins with the administration of medications to create optimal conditions for the surgery:

• Pilocarpine Drops: These drops constrict your pupil, making the iris thinner and easier to penetrate with the laser. You might experience temporary blurred vision or slight headaches as a side effect.
• Pressure-Lowering Medication: In some cases, medications are given to help manage intraocular pressure ahead of the procedure.
• Numbing Drops: Anesthetic eye drops are applied to ensure that you do not feel any pain during the treatment.

This careful preparation is key to achieving the best possible outcome, as it allows our glaucoma specialist to work precisely and safely, ensuring your comfort every step of the way.

During the procedure, you will be seated at a slit lamp—a special microscope used during eye exams—to provide a clear view of your eye. A specialized contact lens is placed on your eye to help the glaucoma specialist focus the laser beam accurately. Here’s what happens during this brief yet effective treatment:

• Positioning and Focus: The contact lens stabilizes your eye while the glaucoma specialist carefully directs the laser to the predetermined spot, typically the upper part of the iris to minimize visibility of the opening.
• The Laser Pulse: The laser emits precise energy bursts to create a small, pin-sized hole in the iris. Depending on your eye’s characteristics, the glaucoma specialist may use different types of lasers such as the Argon or Nd:YAG.
• Duration: The entire process generally lasts about 5-10 minutes per eye, making it a quick outpatient procedure.

Despite the idea of a laser treatment in your eye sounding intimidating, most patients find the process to be well-tolerated, with only a mild sensation during the laser firing.

Following Laser Iridotomy, you can expect a period of recovery where follow-up care is essential. Immediately after the procedure, your eye pressure will be reviewed about 30 minutes to 2 hours later to ensure no unexpected spikes occur. Your eye might feel a bit scratchy or sensitive, and your vision may be slightly blurry for a short period.

• Anti-Inflammatory Drops: To alleviate irritation and prevent inflammation, you may be prescribed anti-inflammatory eye drops, which are typically used for a few days.
• Monitoring: Regular follow-up visits allow our glaucoma specialist to ensure that the iridotomy opening remains open and continues to function as intended. Imaging tests such as gonioscopy or anterior segment OCT may be used during these visits.
• Activity and Comfort: Although you might experience some mild discomfort and light sensitivity, you should be able to resume routine activities within a day or two. However, it is best to avoid strenuous physical activity for a short period after the treatment.

The follow-up appointments are a critical component of the healing process. They not only help monitor the health of the treated eye but also offer a chance for you to ask any questions or address concerns with our glaucoma specialist.