An iridotomy is a common eye procedure that involves creating a tiny opening in the iris, the colored part of the eye. This outpatient procedure is often performed to manage or prevent certain eye conditions.
Understanding the Need for Iridotomy
The eye contains a fluid called aqueous humor, which constantly flows in and out to maintain healthy pressure. This fluid drains through a structure known as the drainage angle, located where the iris meets the cornea. In some individuals, this drainage angle can be narrower than typical, a condition referred to as narrow-angle or angle-closure.
If the iris bunches up or is pushed forward, it can block this drainage pathway. This blockage can lead to a rapid increase in eye pressure, known as an acute angle-closure glaucoma attack, which can cause sudden vision loss and is a medical emergency. An iridotomy helps by creating an alternate channel for fluid to flow, relieving the pressure and preventing damage to the optic nerve.
The Iridotomy Procedure Explained
A laser iridotomy is performed in an ophthalmologist’s office or an outpatient setting. Before the procedure, your eye will be numbed with topical anesthetic drops. Your doctor may also administer drops to make your pupil smaller, which stretches and thins the iris, making it easier for the laser to create the opening.
You will sit in front of a laser machine that resembles a standard eye examination microscope. A special contact lens is then placed on your eye to help focus the laser and keep your eye still during the treatment. The laser is used to create a small, pinhead-sized hole in the outer edge of your iris, usually in an area that will be covered by your upper eyelid and not visible.
During the procedure, you might hear clicking noises and see bright flashes of light, similar to a photographer’s flash. While the procedure is not painful, some patients may experience sensations like a mild pinch or stinging. The entire laser treatment takes 5 to 10 minutes per eye.
What to Expect After Iridotomy
After the laser treatment, the contact lens will be removed, and your eye may be rinsed. Your eye pressure will be checked within 30 to 60 minutes to ensure it has not increased significantly. You may be given anti-inflammatory eye drops to use for several days to reduce soreness or inflammation.
Temporary side effects are common immediately following the procedure. These can include mild discomfort, a scratchy sensation, redness of the eye, and temporary blurry vision. Light sensitivity may also occur and last for a few days. Some individuals might also experience a mild headache due to the eye drops used.
Most people can resume their normal daily activities immediately after the treatment. However, it is advisable to have someone drive you home due to temporary blurred vision or light sensitivity. While severe complications are rare, these temporary effects resolve within a few hours to a few days.
Potential Outcomes and Long-Term Considerations
An iridotomy creates a new pathway for fluid flow within the eye, reducing eye pressure and preventing angle-closure attacks. It is effective in preventing acute angle-closure glaucoma and can be used as a preventative measure for individuals with narrow angles. The hole created in the iris allows fluid to bypass any blockage, equalizing pressure within the eye.
The procedure is considered successful if it opens the drainage angle and reduces pressure on the optic nerve, thereby preserving vision. While most iridotomies remain open for many years, the opening can occasionally close due to debris, which may require a repeat procedure. An iridotomy helps manage eye pressure and prevent certain types of glaucoma progression, but it does not improve vision that has already been lost. Ongoing monitoring of eye health and continued use of any prescribed glaucoma medications are necessary after the procedure.