Laser iridotomy

Patient Information Leaflet

Introduction

You have been given this leaflet because your eye doctor has recommended that you have a procedure called laser iridotomy. This leaflet explains what this procedure is, its benefits and risks, and what will happen when you have the procedure.

What is a laser iridotomy?

Everyone has a watery fluid circulating in the front part of the eye, called aqueous humour. If you have healthy eyes, the fluid in your eye flows through your pupil into the front of your eye, and drains away through drainage channels (in the angle of the eye).

The balance between the fluid being produced and draining away maintains a steady pressure within the eye. By nature, some peoples’ eyes are shaped so that the drainage passageways may close as they get older. As a result, there is reduced fluid drainage and the pressure within the eye increases (narrowing of the angle).

Laser iridotomy creates small holes in the coloured part of the eye, called the iris. This allows the aqueous humour to drain out of the eye to balance eye pressure.

What are the benefits?

This treatment ensures that the aqueous humour can pass through the opening in the iris at the front of the eye. Therefore, the risk of sudden closure of the drainage passageways, known as acute narrow angle glaucoma, is prevented.

What are the risks?

All procedures carry some risks. The risks of laser iridotomy are:

• A temporary increase in eye pressure.
• Inflammation in the eye after the procedure. This is usually only temporary.
• Temporary bleeding from the iris.
• Increased sensitivity to light.
• Rarely, lens damage and cataract formation.
• Small risk of reduced vision and need for further treatment.

What are the alternative treatment options?

The alternative to having laser treatment is to have an opening in the iris made surgically (an operation on the eye). This carries a greater risk of complications than when the procedure is carried out using a laser. There is also the option to remove the clear lens from the eye (even before a cataract develops).

What happens if I do not have this treatment?

It is your decision as to whether you have this procedure. However, if you do not have treatment, there is some risk of sudden acute glaucoma, with high eye pressure, a very uncomfortable eye and painful eye with reduced vision.

What do I need to do before the procedure?

It is important that you use your regular eye medication drops as normal on the morning of your laser treatment (unless your doctor has told you otherwise).

As your eyes will be blurry after the treatment, you may want to arrange for someone to come with you. Also, please note that you will not be able to drive after the treatment.

What happens during the procedure?

You will need to visit the eye clinic for about half a day. The treatment is usually carried out in both of your eyes together at the same visit (if they need treatment). A nurse or doctor will put some drops into your eyes and an anaesthetic eye drop to numb the surface of the eyes. They will also check your eye pressure and constrict your pupil with an anaesthetic drop to prepare the eye for the laser treatment. This drop may give you a slight headache.

You will then sit at a machine – similar to the one used to examine your eyes when you routinely visit the eye clinic – which has a special laser attached.

The eye doctor will put a special mirrored lens, similar to a contact lens, on your eyes before using the laser beam. The lens allows the doctor to view the iris clearly. The doctor will then make small holes in the iris using the laser.

You may feel this, there may be some discomfort but usually no pain. The procedure will be over in a few minutes. After that your doctor will put another eye drop in your eye and ask you to wait outside.

What happens after the procedure?

After the procedure, you will return to the waiting area. Your eyesight will be misty for a while.

The doctor will check your eyes, including the eye pressure, 30-60 minutes later to make sure that it is not too high. The doctor will then examine your eyes to check the newly formed openings are working well.

After laser treatment, we will give you a prescription for steroid eye drops. You may also need to take tablets. These medications are aimed at reducing eye pressure spikes and inflammation after the treatment.

You should not drive on the day of the laser treatment.

 What happens when I go home?

It is normal to have gritty, sticky eyelids and mild discomfort for a couple of hours after laser treatment. You may also find that your vision is a little blurred. This is normal, your vision should return to how it was before the laser treatment by the end of the day.

If you have any of the following symptoms, it may mean that you need urgent treatment:

• Excessive pain.
• Loss of vision.
• Flashing lights.
• Increasing redness of the eye.

Telephone for advice immediately by contacting:

The Urgent Referral Clinic team at Russells Hall Hospital Eye Clinic on 01384 456111 ext. 3633 (9am to 4.30pm, Monday to Friday).

Can I find out more?

You can find out more from the following weblinks:

Royal National Institute for the Blind

http://www.rnib.org.uk/eye-health-eye-conditions-z-eye-conditions/glaucoma

The Royal College of Ophthalmologists

https://www.rcophth.ac.uk/patients/glaucoma/

What if I have any problems or questions after reading this leaflet?

If there is anything you do not understand, or you are concerned or worried about any part of the treatment, contact:

The Urgent Referral Clinic team at Russells Hall Hospital Eye Clinic on 01384 456111 ext. 3633 (9am to 4.30pm, Monday to Friday).

Eye emergency, out of hours

In case of an eye emergency after the closing hours of the Eye Clinic at Russells Hall Hospital (including weekends and bank holidays), please contact:

Birmingham and Midland Eye Centre on 0121 507 4440

The doctor on call is usually based at the Eye Centre, City Hospital, Dudley Road, Birmingham. They may need to call you back, and if necessary, they will arrange for you to visit them.

Note: the information in this booklet is provided for information only. The information found is not a substitute for professional medical advice or care by a qualified doctor or other health care professional. Always check with your doctor if you have any concerns about your condition or treatment. This is only indicative and general information for the procedure. Individual experiences may vary and all the points may not apply to all patients at all times. Please discuss your individual circumstances with your eye doctor.

Author: Mr Akash Raj, MD, MRCS, DRCOphth, FRCS, FRCOphth consultant ophthalmologist (glaucoma lead)

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

  Laser Iridotomy/AR/SS/SJ/ST/09 2024/v4 – review 06.2027 DGH/PIL/01136