Peripheral Iridotomy

Background

The eye produces fluid which circulates throughout the eye, exiting through a structure called the angle. Blockage of the angle prevents fluid from exiting the eye, causing the eye pressure to rise.


Some individuals have narrow angles. If the angle is critically narrow, it may close spontaneously. When the angle closes, the eye pressure rises dramatically and patients develop Angle Closure Glaucoma, a condition which is painful and causes severe and sometimes permanent vision loss.

image2

Evidence

If your eye doctor identifies angles that are critically narrow, Angle Closure Glaucoma can be prevented by a laser treatment. The laser produces a small hole, called an iridotomy, in the iris. This allows fluid to drain more effectively, preventing further angle narrowing. 

image3
image4

Procedure

 Laser peripheral iridotomy (LPI) is a brief and painless office procedure. Topical anesthesia is applied and a contact lens placed against the eye to focus the laser. A brief pinching sensation is often experienced when the laser is applied to the iris. The procedure usually takes a few minutes. Temporary irritation and blurring after the procedure are common. 

Risks

LPI is very safe. Occasionally, the eye may become inflamed, bleeding may occur, and the eye pressure may rise. There is also a slight chance of increased glare, or double vision. In rare cases, angle closure may still occur despite LPI. 

Alternatives

If laser cannot be applied, incisional surgery may be performed to create an opening in the iris. Medication to constrict the iris may be given, which may temporarily prevent angle closure.

Comment

LPI for the treatment of narrow angles and prevention of glaucoma is a safe and effective in-office procedure. Your eye care provider will advise you if you have narrow angles.