What Can I Do About the Side Effects of an Iridotomy?

April 27, 2010

I had laser surgery 10 months ago. An iridotomy was done to my eyes, because I have narrow angles. During and after the procedure I was in great pain, but the pain stopped 3 days later. Ever since the surgery I see a broad fluorescent white line in the middle of my vision, which drives me crazy. Besides, I have double vision and am extremely sensitive to light. My IOP was 15/16 before surgery and is now around 30. I now need glaucoma drops, which I didn’t need before. My visual acuity dropped from 20/20 in both eyes to 20/80 in my left eye and 20/100 in my right eye.

Is there any chance that the white line, the double vision, and the glare will eventually go away, that my visual acuity will improve and that my IOP will come down? My doctor says sometimes iridotomies have these side effects and I have to put up with it. Why didn’t he tell me before he performed the iridotomies? I am absolutely desperate. I lost my job because of my poor vision after the surgery. Can anyone help me?

 

 



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58 Responses to “What Can I Do About the Side Effects of an Iridotomy?”

  1. ari on April 29th, 2010 3:28 pm

    yeesh! side effects are so rare after iridotomy. i’m shocked it was so painful and your pressure went up.
    the glare may be due to the high pressure in the eye which can make the cornea a little irregular (microcystic edema), or, from the iridotomy itself. if from the iridotomy, there’s not much you can do except go to the operating room and have it closed. but it’s almost unheard of to have a patient so miserable from iridotomy that they would need to do that.
    the pressure can rarely go up chronically after the iridotomy if the iridotomy releases a lot of pigment which clogs up the drain (the trabecular meshwork). that would only happen in a dark-pigmented iris where the iridotomy was difficult and required a lot of laser; blue irides liberate so very little pigment.
    since your experience is so rare, i advise strongly you see a glaucoma specialist for an opinion.

  2. Tina on September 6th, 2010 11:11 am

    Hi,
    I recently had surgical iridectomy and an ICL implant (for myopia). I am experiencing the same symptons as the previous patient. My vision is now very poor in this eye and was told I had corneal edema. I now also have the white lines, terrible ghosting and glare worse in the daytime. I would not feel safe driving at night as every headlight is miltiplied by three!

    The iridotomy holes are large and not near the edge of my iris but close to the pupil. Will this improve with time? I am not having the other eye done until I can see clearly from this eye.

    I wish I had put up with my myopia and stuck with my contact lenses and thick glasses now – whats more I have spent £5200 for this terrible outcome!

  3. ari weitzner on September 7th, 2010 9:20 pm

    corneal edema should resolve- usually not a problem in straightforward cases. if your symptoms are due to the iridotomy, it is possible to close it with surgery. Speak with your doctor.

  4. Terry on August 4th, 2011 9:14 am

    I also had a personal injury. I really only have vision in one eye so we did the bad one first….everything went fine. Not so lucky with the good. After I had discomfort in the eye, dry eye and intermittent ghosting. Very very frustruating. After two years of going to doctors I found that the ghosting can be caused by refraction of light – light getting in the PI hole and creating havoc. I found a doctor who has done corneal tattoos with great success. Although this sounds crazy it also makes sense. It sort of puts a sunglass over the hole. I am not a candidate for this yet as I now have other eye issues. He tried to see if this would be successful with a simple brown eye colored contact. If it works then perhaps this option might help. My cornea doc is pretty conservative as well. My issues are all corneal related now. I am convinced that the laser caused issues but every doc swears it hasn’t. What I am told is undetected underlying conditions actually flared after the PI (like dry eye and fuchs) causing my distress. I am glad I did this to preserve my sight however, I have not had any eye issues that caused me symptoms until I did this. I also have a plateau iris so the PI isn’t as optimal as hoped. Good news is on good days I have not lost vision.

  5. ari on August 4th, 2011 3:34 pm

    corneal tatto not a bad option- agree to first try colored contact lens to confirm.
    the pi has nothing to do with dry eye. theoretically, the shock wave of the laser could aggravate the fuch’s, but that would be highly unusual and i doubt it very much.

  6. Rita on September 1st, 2011 11:38 pm

    I was scheduled for implantable contact lens (ICL) surgery and had a laser iridotomy done last week. Since then my right eye was in pain and I postponed my surgery till next week. I am on steroid medications for inflammation and now my eyes are so sensitive to light and I do feel like they are burning, probably a side effect from medications. I’ve tried putting my contacts back today and the pain and pressure made it impossible to wear after half a day. I am going to my eye doctor tomorrow and definitely canceling my ICL surgery. I’ve never had such a discomfort in with my eyes before. Will my eyes be the same again? Will I be able to wear my contacts again with those laser holes left in my eyes? I am so devastated…

  7. ari on September 2nd, 2011 8:46 am

    very very strange and unusual inflammatory reaction to a laser iridotomy. dont make any decision until the doctor has evaluated you. perhaps a second opinion would be helpful here if things dont resolve soon.

  8. Tony Carr on October 17th, 2011 2:26 am

    Seems as though the more I look into this the more horror stories I find. I to had the iridotomy performed in both eyes my left eye first. That same day I was (and I am still ) seeing 2 white lines across my eye. After going to my Opthamologist for an emergency checkup he assured me this was a floater from the procedure and it would go away as the gel inside the eye settled so feeling a bit comforted I had the second eye done. Its been 2 months and I still have the lines and i get constant headaches which I rarely used to get headaches before and now i am very sensitive to light. Come to find out my opthamologist actually works for the eye group he sent me to for surgery which he stated i needed asap because my pressure was so high he couldnt even dialate it to finish my checkup which at the time was at 19 and up to 22 is considered normal (which i didnt know at the time
    ). At the time of surgery my pressure was at 14 after the surgery it was at 20. Come to find out all i really needed was eye drops and a yearly check up to keep it in check this I found out from a glaucoma specialist after the fact who I went to after finding out my opthamologist may have had different priorities. The specialist also told me that usually they make a pin hole in the retina, in my right eye it was a pinhole but in the 1 with the lines he said it was more like a tear and that the light was seeping in from it being so large. So all in all if your doctor tells you you need this procedure go to get another opinion if you can afford to. Dont make the same mistake as me. What i really found comical about this, is a site i found where they posted a video on this procedure which people were posting so much negative feedback (all these posters being former iridotomy treatment patients) that the moderator closed the boards because of negatve feedback from all of the former patients. Well maybe if we were a little more informed before hand about possible risks and or side effects and other tereatment options less of us would have this dangerous procedure done.

  9. ari on October 18th, 2011 9:27 am

    we do not do iridotomies for high pressure. so of course your pressure was normal prior to the laser. we do it for narrow angles, which (esp. if you are dilated) can lead to angle closure glaucoma, a serious, painful, blinding condition.
    light rays entering the eye after iridotomy is rare. the risk is far outweighed by the benefit of avoiding angle closure.
    lately, there has been good data to suggest that if we perform the iridotomy at the 3/9:00 position, this rare complication can be avoided (we usually put it at 12:00, where we figured the upper eyelid will cover it and avoid this issue. turns out that the tear film meniscus (where the lid meets the eye) acts like a prism, bending light up towards the iridotomy. i know a colleague who performed literally thousands of iridotomies at 3/9:00 and never had a problem, even though we were taught in residency never to put it there, lest light enter the eye and cause glare. classic counter-intuitive. so i now place it at 3/9:00, too.

  10. Brill on October 19th, 2011 7:02 pm

    I had an adverse reaction to a medication on two separate occasions, the second worse than the first, that caused my left eye to experience blur and halos. Both episodes self-resolved within 24 hours. I reported to my optometrist who felt I had narrowed angles. A visual field exam was normal as was the optic nerve. I was referred to an ophthalmologist who confirmed narrow angles but otherwise healthy eyes. He scheduled me for bilateral prophylactic iridotomies. I started doing some research and found all the horror stories and canceled my appointments. My optometrist scolded me. I did more research and found a glaucoma specialist for a second opinion. She confirmed the emergent need for iridotomies. I shared my concerns and asked her for her track record. We even discussed the most current research that Ari mentioned in the October 18th, 2011 9:27 am post. We agreed to the 3:00 and 9:00 temporal positioning. Since she began doing iridotomies in 2001, she has had only one patient that has visual disturbances severe enough that she feels her quality of life is affected. With much fear and trepidation, I had my first procedure on 10/3 and the second on 10/10. At this point in my recovery, I have NO visual aberrations, only some sensitivity to bright light. I am told this is normal for about 2 – 3 months. My friend who is a cataract surgeon and instrumental in my decision to go forward with the procedures, said that I was very lucky that my two episodes of probable angle closure self-resolved (very unusual) and that I had definitely dodged a bullet and disarmed a bomb that was sure to go off in the future resulting in visual loss. I wish more people with positive experiences would post them, so that those of us who are researching wouldn’t be so scared to death! I am so sorry for those whose experiences did not result in good outcomes. But my friend the surgeon mentioned that for those who have experienced severe visual disturbances, one should look into corneal tattooing. Also, I believe in questions, questions, questions, second opinions, experts in the field, and looking into a physician’s statistics and outcomes. I did not connect with the first ophthalmologist; he did not invite conversation even when I expressed my concerns and anxiety. I think it is important for patients to feel they can talk to their caregiver; not do as they are told. I am so happy to have this experience past me. I pray that the iridotomies do not close as I would not care to repeat the experience. But to anyone who is looking for information, please do not be put off by the negativity; be responsible for your own health; do your homework and choose someone with a positive track record. Even ask to speak to someone who has had a positive experience.

  11. Zuli on December 12th, 2011 9:33 pm

    Hi,
    I was scheduled for bilateral prophylactic iridotomies, because I have narrow angles.
    My doctor told me about lines in my vision after this kind of surgery.
    I started doing some research and found even more horrible side effects and canceled my appointments.
    Now I found this website and information about the most current medical research about 3:00 and 9:00 positioning. Ari told about it in the October 18th, 2011 9:27 am post and Brill on October 19th, 2011 7:02 pm.

    Could you, please, give me answers to my few questions, if possible.
    – When you say “iridotomies at 3/9:00” do you mean two wholes (in 3:00 AND in 9:00) or just one whole (just in 3:00 or just in 9:00)?
    – Is this method known among medical doctors? I am living in Canada and thinking if our doctors know and use it. Are there the publications about this research?

    If Brill still visit this website could you please give us a reply about your situation now? Hope everything is good.
    Thank you.

  12. ari weitzner on December 13th, 2011 4:28 pm

    one iridotomy per eye at 3 or 9 oclock. no change in technique needed- just to aim at 3/9 instead of 12. this idea has been discussed in a few articles in the less rigorous “throwaways”. im sure your surgeon can look into it if not familiar.

  13. Peter on February 11th, 2012 6:23 pm

    I had an iridotomy on my left eye Dec.15 2011 and the right eye a week later at the age of 73.
    The operation was only a minor discomfort and was over in a few minutes.
    I was able to drive home with no vision impairment and to this day I would never
    know anything was done to my eyes .The follow up inspection showed all is
    a success. I regret that I almost cancelled the procedure after reading all the
    horror stories on the web but glad Idid’nt…All I can say is make sure your surgeon is reputable and has had a lot of experience with this procedure

  14. Marylee Taylor on March 20th, 2012 3:48 pm

    June 2010, I had an iridotomy on both eyes. My pressure was 32 & 36 and my doctor told me I had narrow angles.The night before the procedure I researched and found positives and negatives which made me very leary. The morning of the procedure I was very nervous, but one of the nurses told me she had it done and had no side effects so I felt a little bit better about it.

    After each procedure, I had such blurred vision, I could not see to drive. I was told the vision would clear up. It never did. Both eyes are blurred now. My vision in both eyes has been damaged and I would never do this again. I have had multiple prescriptions for glasses from 4 different doctors in order to be able to see without a blurr and I still have problems seeing well.

    Before the iridotomy’s I had excellent vision. Only needed readers because I’m in my 50’s.

    I wish I had tried drops first to lower the pressure. I use drops 3 times a day and my pressure is stable at 17 & 18. I am sooooooooo sorry I had the procedure and hope there is something that can be done to reverse the damage.

  15. ari on March 21st, 2012 3:49 pm

    i cannot possibly explain blurred or damaged vision after iridotomy. it makes no medical sense to me- sorry.
    if you have narrow angles at risk for closure, drops may lower your pressure but will not protect you against an angle closure attack. to decline iridotomy in the face of narrow angles at risk for closure would be an enormous gamble and an enormous mistake, for once you get an attack, you are at great risk of blindness. i would demand the laser if i were the patient.

  16. Diana Maberry on May 15th, 2012 1:47 am

    I had laser iridotomy on my right eye 5 days ago. Prior to surgery, I have had open angle glaucoma for many years and well controlled at 13 in each eye. On last appt., dr said he saw signs that indicated that I might develop closed angle glaucoma and recommended that I have the procedure on both eyes. Ever since the surgery, I have a white, transparent line in the lower part of my eye and a lot of sensitivity to light. My former great vision is now very blurred. I doubt I will be able to read past the first line on an eye chart. 3 days after surgery, I felt extreme swelling. So the dr met me in his office on the weekend and said my issues were from inflammation and dry eyes. He prescribed 10 days of Neomycin and Polymyxin B and Dexamethasone. 3 days of these drops and I only feel more irritated and my vision is not any better. I am supposed to have a check up next week and have the other eye done. There is no way I want to go through that with my vision the way it is now. I am very worried that this is permanent.

  17. ari on May 16th, 2012 4:44 pm

    rarely, the cornea can get scratched from the laser. perhaps thats what caused your symptoms. i have no idea what the “transparent line” is you refer to. it would have zero to do with the laser. your symptoms cannot possibly be permanent.

    not doing the laser in the other eye would be very risky. at the very least, get a second opinion and have it done elsewhere.

  18. Mrs. Cleveland on August 15th, 2012 4:42 pm

    I was told that I have narrow angles and was sent to another doctor who performs eye surgeries. He confirmed that I have narrow angles and scheduled me for an iriodotomy in my left eye and then 3 weeks later in the right eye. I called and canceled. I can’t find peace about doing it. I read that of 1000 patients only 50 have narrow angles and of that 50 only 10% develop closed angle glaucoma. That’s a 10% chance. That being the case and reading the negatives on this site and other sites I’ve been researching on of patients who had bad results, only makes the decision easier. I had rather risk 10% (although I know that if you are one of the 10% it is a 100% for you) than to have the surgeries and be left with problems that I didn’t have before. I pray that my decision works out to be the best for me. Neither of the two physicians could answer the question I posed, “Is this medically necessary”?

  19. ari on August 16th, 2012 11:23 am

    if you have narrow angles, you’d be crazy not to get the laser. its not surgery. its a quick procedure, and rarely gives patients problems. the benefits far outweigh the risk. driving a car is much riskier than the laser, yet you dont think twice about doing it every day. i feel you are making a grave error. get a second opinion about whether your angles are narrow and at risk for closure, and if confirmed, get it done. angle closure glaucoma is a disaster, and you dont want it- trust me.

  20. Mary on September 17th, 2012 2:11 am

    I had a closed angle attack in July of 2011. My highest IOP was 60! We got the pressure down by using drops. A week later I had the iridotomy on the affected (left) eye. An iridotomy was done on the right eye a week later. I can see a light come in through the opening in my left (affected eye). It looks like a prism with rainbow colors. But, the problem is I have double vision. I have a terrible time reading. My vision is blurred as well.

    My right eye has “lazy eye” which didn’t get surgically corrected (cosmetic) until I was 12. My right eye is my weak eye. The muscle may have stretched out and now my right eye wanders more again. I am wearing glasses with prisms, but I am doubtful that it is helping. The double vision goes away when I close one eye. It seems that I only notice the double vision in my left eye, but it is my dominant eye, so it’s hard to tell. My visual acuity decreased after the iridotomies. I don’t care if the experts are saying it is rare for the iridotomy to cause problems with blurred vision and diplopia. The problems need to be addressed. How do we improve my vision?

  21. olga on November 4th, 2012 4:32 pm

    Mrs. Cleveland,

    Did you have your iridotomies? I was also diagnosed with narrow angles in August, 2012 and I need iridotomies. After reading the comments, I cannot sleep and am terribly nervous because I am scheduled to have the first iridotomy in the middle of November, 2012. I would like to cancel it because now my vision is good with glasses, but my understanding is it will be really terrible afterwards.

    I would like to know what you have decided. I am torn apart by doubts and would like to cancel my appointment for the seconf time.

  22. olga on November 5th, 2012 9:27 pm

    I am wondering if somebody had a positive experience with iridotomies?
    What I can understand- iridotomies cause a life-long disability. They cause an endless chain of problems- seeing lines, gosts, double-vision, cataract-growth, they provoke open-angle glaucoma and bullous keratopathy.
    It lookes like this procedure causes such a terrible damage. Why do the doctors insist on it?
    It is usually done when a vision is still good and maybe can stay good for a while, but becomes terrible after the iridotomy.
    God help me to decide what to do. The doctors say I need iridotomies, but I still have 9 years before retirement. How will I be able to survive if the iridotomies deprived me of my vision?

    Could somebody share about his good experience?

    Thank you and God bless you.

  23. olga on November 5th, 2012 9:30 pm

    I am wondering if somebody had a positive experience with iridotomies?
    What I can understand- iridotomies cause a life-long disability. They cause an endless chain of problems- seeing lines, gosts, double-vision, cataract-growth, they provoke open-angle glaucoma and bullous keratopathy.
    It lookes like this procedure causes such a terrible damage. Why do the doctors insist on it?
    It is usually done when a vision is still good and maybe can stay good for a while, but becomes terrible after the iridotomy.
    God help me to decide what to do. The doctors say I need iridotomies, but I still have 9 years before retirement. How will I be able to survive if the iridotomies deprive me of my vision?

    Could somebody share about his positive experience?

    Thank you and God bless you.

  24. ari on November 7th, 2012 10:14 am

    iridotomies only rarely cause problems. the benefit is great, as it prevents angle closure glaucoma. driving a car is riskier than iridotomies, yet you dont think twice about driving in a car. get a second opinion, and have them done.

  25. joyce ireland on November 20th, 2012 11:20 am

    I have narrow angles and 1 week ago I had an iridotomy. There was no pain at all during the treatment and no pain after. During the procedure I saw a red light and heard a clicking sound. The remainder of the day I felt like I had water in my eye but the next day all was clear. I will be having the other eye done one week from today. I just wanted to share my positive experience.

  26. Matt on November 29th, 2012 2:39 pm

    I just had laser iridotomy in both eyes (2 weeks apart) due to narrow angles. My pressure went down immediately, and light sensitivity went away. I didn’t feel a thing in my right eye during the procedure, but had a couple sharp pinches in the left (may not have been numbed as much). I do have a very slight hairline glare (more in the right eye) depending on how the light hits the eye. I only notice it when watching TV if I sit a certain way, or sometimes in bright sunlight (sunglasses takes care of it). I have had no change in vision other than that. I was diagnosed by my eye doctor, referred to an opthamologist, and got a second opinion. I found a guy who specializes in this procedure and works out of an eye center within a hospital. The hole is SUPPOSED to be pin sized and covered by the eyelid. If anyone is looking to have this treatment done, I would HIGHLY recommend doing your research and finding someone who specializes in this procedure. If done correctly, the benefits definitely outweigh the risk of blindness, which can occur over time with narrow angles if left untreated.

  27. ari on December 6th, 2012 10:16 am

    one does not need a specialist for this procedure. a first year resident could do it.

    there is evidence to suggest that having it done superiorly under the lid carries a higher risk of side effects. i no longer do it superiorly. a recent article in the journals suggest it makes no difference.

    one could get a second opinion if one has doubts about the need for the laser.

  28. joyce on December 9th, 2012 1:11 pm

    I had my second iridotomy done for my right eye. This time it took a little longer for the procedure and I felt a slight pinching but nothing that hurt. I will be having a pressure check in 3 weeks. I had no after effects from either procedure. Good luck to everyone.

  29. gwen on December 22nd, 2012 11:07 am

    I had iridotomies done half a year ago and am still suffering from glare, ghost images and bright white lines across my nose. Now I have to avoid looking at windows, cross the road at night, or even going into the kitchen because the ghost images from the shiny stainless steel utensils hurt my eyes. I get headaches more often. After two follow up consultations, my doctor still insisted that she’s done thousands of iridotomies but had not come across such symptoms. I’m already wearing glasses with polarised and tinted lenses but the disturbances only alleviated slightly. Only when I put on my Ray Ban sunglasses will the ghost images, glare and white lines reduce to the minimum. I found that the symptoms increased in intensity after I was given medication to dilate my pupils for the doctor to examine my eyes. I also found that if I close my right eye, the ghost images cut down or disappear.

  30. Elsa on December 28th, 2012 7:24 pm

    My mother had an acute narrow angle attack when she was in her 70’s, my sister was diagnosed with narrow angles and has had preventative iridotomies with no permanent side effects. I have received numerous opinions on whether or not I have narrow angles; about half the doctors say yes the other half say no. My pressure is 14 in both eyes. I recently moved and am now going to a new Ophthalmologist who is pressuring me to get iridotomies, because of the family history.

    Can anyone tell me what the percentage is of people who end up with mild to serious side effects? It is a very hard decision to make, since my vision is good and my eyes are healthy and it doesn’t seem that the doctors can agree on how narrow my angles are. I want to make sure the research shows that the side effects are as low as the doctor is claiming.

  31. ari on December 31st, 2012 6:25 pm

    side effects are rare. if you dont get the laser, and you end up in angle closure, you will be very, very sorry. driving a car is much more dangerous than laser. go to a glaucoma specialist and ask how narrow your angles are, if you want reassurance.

  32. Sandy on January 3rd, 2013 4:36 pm

    I had a very positive experience with laser iridotomies. I went to a very specialized eye surgeon to see if I had Fuch’s Dystophy as my older sister has it. During the exam he found I had narrow angles. He monitered the narrow angles for several months and because they were getting more narrow, he wanted me to have the laser procedure. To me, it was a choice of maybe losing my eyes or the laser iridotomies. He did one eye over a year ago. For four months he checked it to see how it was going and to make sure the hole stayed open. Also, he used the smallest hole necessary. At first the hole closed up, and he has to open it again. But then it stayed open, and four months later he did the other eye. I have to admit that I was nervous, but it was only a little painful during the procedure. I am extremely glad I had it as now I don’t have to worry constantly that I could not only lose my vision from narrow angles, but maybe an eye. My advice is to make sure you find a doctor who is more than an ophthalmologist. They should be an eye surgeon who has had lots of experience doing this procedure. And do have a second opinion if you have doubts.

  33. marilyn on February 11th, 2013 9:39 am

    I’m 71, developed “narrow angle glaucoma”…the specialist followed me for several yrs,re the pressure, and i also developed a left cataract.he needed to do the laser in order to dilate to view the cataract.
    I’m happy and relieved to share that i had none of the side effects mentioned so far, except occasional “eyeball” brief aching,now and then.
    no changes in colors, no lines, no headaches,thankfully.
    However,i’m very sorry i had them done,and will always wonder if they were necessary, because this is irreversible…
    The Dr did wait years,patiently,until I was ready..I had both eyes done, 6 months apart..
    best of luck to everyone..its so hard to trust a Doctor where your permanent vision is concerned, and can be altered forever…
    I now have to have cataract surgery on my left eye…blurring way before the iridotomy,so not related …

  34. Joe on February 15th, 2013 3:14 pm

    I am 66. At a routine eye examination I was found to have high intraocular pressure and was refered to a specialist via my GP. I saw him two weeks ago (1 Feb) and my IOP results were L36 and R19. Following examination he told me that I had narrow angles and recommeneded that I have a laser iridotomy in my left eye ASAP because of narrow angle glaucoma and in my right eye as a preventative measure. He explained that without treatment there was a 50% chance my right eye would also develop narrow angle glaucoma. He immediately prescribed pressure lowering eye drops and an appointment was made for me to have the procedure today (15 Feb). The surgeon suggested that if after the left eye was done I was comfortable and there were no side effects he could do the right too. Because I was able to hold my left eye still without any difficulty he did not need to use the contact lens and was able to make the hole with one shot of the laser. As it seemed to go OK we agreed that the left eye should be done there and then. Again it was completed with one firing of the laser. I hardly felt any sensation and I am now at home some seven hours after the procedures were carried out with seemingly no side effects. Whilst there are some that go bad – as there are with most surgical procedures – it seems that statistically it is a very safe proscedure and that is my experience thus far. I must admit, however, to have the same reservations that others have experienced and spent many hours reading any number of websites looking for comforting reports only to find many worrying reports and then experiencing sleepless nights as a result. I would guess that if all goes well most people would not think to post it on a website such as this – so I think there must be a multitude of happy endings out there which we never hear about. I am so sorry for those who had a bad outcome but do hope my experience is of some comfort to any who are uncertain about whether to proceed or not. :-)

  35. Joe on February 15th, 2013 3:17 pm

    Sorry – I meant………. “the right eye should be done there and then”

  36. ari on February 16th, 2013 9:29 pm

    your experience is typical. side effects are rare.

  37. Rich on February 22nd, 2013 9:11 pm

    I had the iridotomy a year ago and it’s been very negative for me in terms of my vision. I was to have both eyes done but only had the right one done because the side-effects were terrible. Brighter lights or a bright sunny day are awful now and I avoid going outside in the snow (blinding!) or to the beach (sun and sand are brutal) as a result: my right eye is overexposed like a photograph would be at the wrong f-stop. The untreated left is fine. I close my treated eye a lot now-a-days.

    There is a definite slight double image which is, of course, what would happen if the “camera” had 2 holes for light instead of one (the dominant image from the pupil and a ghost from the smaller hole). Night vision is also effected as a result: untreated left eye can see quickly and perfectly in a dark room; the right treated eye takes longer to adjust and in the end is almost the same but not quite as good at giving me contrast in the deepest shadows: I think this is because of the extra light that is coming through the extra hole making what should be “x” amount of light entering the eye now “x + the hole’s light” causing the deepest shadows to look like they are just charcoal black instead of deepest black (meaning I can’t see the difference between the deepest shadows and the charcoal shadows anymore).

    My formerly vertical astigmatism (which I could make better by squinting and was the same in both eyes so it really worked well) is now oblique meaning the angle of the astigmatism (direction of the blurring) in the treated eye changed to be diagonal while the untreated eye is vertical so squinting no longer helps and makes for some pretty bad vision when the glasses are off when the now very different images from the 2 eyes are sent to my brain. Also the -4.75 I was in each eye is now different: -4.75 in the untreated eye and -6.00 or so in the treated. Again, pretty bad vision without the glasses.

    Lastly, the pressures haven’t come down in the treated eye so it was all for nothing in correcting my problem. Overall, big mistake to have this done and I recommend choosing the drops or some other treatment until there is something better. I see Ari’s answers and note that the side effects are seen as acceptable. They are not in my opinion. Avoid this procedure if possible and get a second and third and forth opinion before doing it. I would even go so far as to keep getting the thickness of your retinal tissue checked often and only have something done if there is a noticeable change (beginning of tissue death) showing that you personally cannot take the high pressures. Everyone has a different threshold. I’m hoping that I can wait out the narrow angle problem which my doctor says could happen if my lens thickens enough to stop the pigment from shedding from my iris due to the rubbing. We’ll see how it does but I can’t say enough how sorry I am for having had this procedure. I’m 38 now and thank God for having had 37 years of great vision: the next 37 are going to be much tougher but I have hopes that maybe a contact lens that covers the hole and not the pupil will be made. At least the double vision will go away then and the astigmatism blur will be gone and the -6.00 vision correction can take place – but that overexposure pain can’t be fixed without sunglasses; even then though, the image has no detail in the highlights. It’s darker overall so it’s not painful. That part sucks but I will have to live with it I suppose.

  38. ari on February 27th, 2013 4:44 pm

    i dont think i said the side effects were “acceptable”. they are worth the risk considering the benefit–to avoid angle closure glaucoma. you are under the wrong impression- the iridotomy is not to reduce the pressure. it’s to avoid pupillary block angle closure glaucoma. drops cannot be used for this purpose. of course if drops could protect from this condition, we would use it first. drops are useless in preventing angle closure claucoma. i hope thats clear.

    iridotomy cannot make you go from -4.75 to -6.00. cataract can do that, and in fact, cataract explains much of your symptoms you have described.

    if you have narrow angles at risk for angle closure glaucoma and you refuse an iridotomy, i strongly advise cataract surgery-it is equally effective.

  39. ari on February 27th, 2013 4:54 pm

    i meant to add that i sympathize with your complaints. but you have to understand that angle closure glaucoma is a difficllt, blinding condition, and the risks associated with iridotomy surely are far outweighed by the benefit of avoiding this dreaded disease. but since i have been reading so many complaints, and the literature now suggests that cataract surgery may be a better long-term option, i think i am going to offer cataract surgery more to my patients.

  40. Ann on February 28th, 2013 3:42 pm

    I had a bilateral laser iridotomy done in November to prevent closed angle glaucoma. I had no problems following it but for two days now I’ve had headaches feel sick and have a very painfull right eye. It also feels like someone has scratched my eye or I have grit in it. I feel like there’s pressure behind my eye. The headache and nausea is not as bad today but my eye is very painful any ideas? To complicate matters I’ve ms so don’t know what is what

  41. ari on March 3rd, 2013 7:00 pm

    the iridotomy cannot give you these symptoms now. the pain and pressure sounds like sinus disease. the grittiness sounds like dry eye.

  42. Juanita on March 17th, 2013 6:36 pm

    I questioned my doctor about the glare I had read about on the internet and he said it was impossible and I should stay away from reading things on the internet. (Lots of information is available and I totally disagree with him.) I had the iridotomies done on both eyes 2 weeks apart in January 2013. The day after my first eye was done, I asked the doctor what was causing the lines and glare in the bottom of my vision. He told me that the iridotomy could not cause the vision problems and was probably floaters in my eye. I told him I knew what floaters looked like and it was not floaters. He said it absolutely could not be caused by the iridotomy but gave me no explanatiion.

    Stupidly, I had the second eye done two weeks later and now the vision problems exist in both eyes. During my appointment the day after the second eye was done, the doctor was not pleasant and said he had done thousands of these and if there was a side effect from the iridotomy I would be the first person who has had a problem. He said the hole is placed up under the eye lid and cannot possibly cause my problems.

    The glare it extremely irritating. Sunglasses help a little. I have to wear them even when the sun is not out. I find myself looking at the floor instead of looking someone in the eye when talking to them because of the glare. I am a flight attendant and during the flight the lights are turned down so passengers can clearly see their movie screens. The outside light coming in through the windows causing such glare that I am miserable.

    Can it be reversed and if so, how major and dangerous would the surgery be?

  43. ari on March 17th, 2013 10:56 pm

    it can be reversed pretty easily with special sutures to close the iridotomy. but first try a cosmetic contact lens that is opaque peripherally and covers the iridotomy and see if it works to eliminate the problem.
    you then have to decide how to address the narrow angles–whether to do cataract surgery and replace your lens with an implant, or, place the iridotomy somewhere else on your iris.

  44. seahappi on June 9th, 2013 12:15 am

    I find it comical that someone would actually post a comment on here saying “laser iridotomy procedures only rarely cause problems.”” AND.. “i cannot possibly explain blurred or damaged vision after iridotomy.” ESPECIALLY THIS COMMENT: ” it makes no medical sense to me- sorry. your symptoms cannot possibly be permanent.” ..Exactly who are these ppl w/their FOOLISH comments?? I have not seen ONE single comment on here or ANYWHERE else where someone has commented on the procedure in a positive light after having it done…MYSELF INCLUDED! First, you shouldn’t be saying something COULDN’T be permanent…how do u know that??? SO many ppl on here are saying it’s been a lengthy amount of time and still seeing blurred vision, white hairline lines, which is exactly what I am experiencing and it’s driving me nuts!!! I thought it WAS a hair in my eye at first until I noticed it was in both my eyes and only when looking into the light or going outside. It’s TERRIBLE! I had my surgery done a month ago and it’s not gone away and do not believe it will. How any eye surgeon or optometrist could say they have never heard of this is in denial

  45. seahappi on June 9th, 2013 12:25 am

    oh, and one more thing I’d like to share. this reply posted stating: ari on September 2nd, 2011 8:46 am “very very strange and unusual inflammatory reaction to a laser iridotomy. dont make any decision until the doctor has evaluated you. perhaps a second opinion would be helpful here if things dont resolve soon”.
    ..how is it strange when that IS one of the risk that is clearly stated?? Here is possible risk factors I found from another site…and it’s NOT unheard of apparantley! The greatest risk of laser iridotomy is an increase in intraocular pressure. The second greatest risk of this procedure is anterior uvetis, or inflammation within the eye. Usually the inflammation subsides within several days, but can persist for up to 30 days. Thus, the follow-up care for laser iridotomy includes the application of topical corticosteroids. A posterior synechia, in which the iris may again adhere to the lens, may occur if intraocular inflammation is not properly managed.

    Other risks of this procedure include the following: swelling of, abrasions to, or opacification of the cornea; and damage to the corneal endothelium (the part of the cornea that pumps oxygen and nutrients into the iris); bleeding of the iris during surgery, which is controlled during surgery by using the iridotomy lens to increase pressure on the eye; and macular edema, which can be avoided by careful aim of the laser during surgery to avoid the macula. The macula is the part of the eye where the highest concentration of photoreceptors is found. Perforations of the retina are rare. Distortion of the pupil and rupture of the lens capsule are other possible complications. Opacification of the anterior part of the lens is common, but this does not increase the risk of cataract formation when compared with the general population.

    When the iridotomy hole is large, or if the eyelid does not completely cover the opening, some patients report such side effects as glare and double vision. The argon laser produces larger holes. Patients may also complain of an intermittent horizontal line in their vision. This may occur when the eyelid is raised just enough such that a small section of the inferior part of the hole is exposed, and disappears when the eyelid is lowered. Blurred vision may occur as well.

    Read more: http://www.surgeryencyclopedia.com/La-Pa/Laser-Iridotomy.html#ixzz2VgpKhNv3

  46. ari on June 14th, 2013 8:58 am

    the possible side effects of driving a car: death, loss of limb, paralysis, blindness, chronic pain. did i mention death?
    possible side effect of cataract surgery: blindness.

    so whats the solution? dont drive a car? stay blind from cataract so you cant read anymore?

    the bottom line remains the same: you want to risk acute angle closure glaucoma? then dont have an iridotomy, and take your chances. good luck.

    i have been in practice 20 years. i have never seen any chronic side effects from an iridotomy. never. they are not common. can they happen? you bet. i HAVE seen people lose vision from acute angle closure.

    i think the risks of an iridotomy are probably lower than that of driving a car. yet we drive cars every day without a second’s thought.

    no one is saying there are no side effects. that is a clasic straw man argument. the issue is whether the side effects are rare and worth the benefits. if i had narrow angles, i would insist on getting an iridotomy, and would sue an ophthalmoogist who did not catch my narrow angles and did not perform it.

    my best advice is to get a second opinion- needless iridotomies are awful. but if you need them, get them.

  47. Patty on July 25th, 2013 1:34 am

    Hi, I had Lpi done on my left eye due to narrow eye angles. I’m very disturbed and debilitated from side effects white lane and ghost images that blind me completely if I enter a room with lots of windows. I experienced terrible headaches for a month. I’m very disappointed with the lack of honesty of the ophtamologists, I got 4 opinions and they all considered this a simple surgery with minimum risk of side effects. My Dr denies my headches are from LPI and says ghost image will get bette my brain will learn to ignore, she has not been honest and does not take responsibility for telling me that not one of her patients experiences side effects. I recommend you find the best ophtamologist even if you have to travel out of town, consider lateral LPI it has less chance of side effects. All the horrible stories I read are true, so dissapointed!!!

  48. ari on August 5th, 2013 11:49 pm

    side effects from lpi is rare, and well worth the risk- i personally would insist on getting them if i had narrow angles.
    yes- temporal lpi’s probably safer, but again- no guarantees.
    driving a car is more risky, but we drive w/o a second thought.

  49. Jeanne on September 6th, 2013 4:12 pm

    I was diagnosed with close angle glaucoma and had my right eye iridotomy done on Wednesday. My vision was clearing nicely by one hour post-procedure. I had an ‘eye ache’ that evening, but a couple of baby aspirin took care of it. The procedure was short and not bad at all. Not fun, but it beats worrying about having an acute attack. If anyone is interested, the ‘hole’ is at 12 o’clock and I have light colored eyes, and was told that they are easier for the laser to penetrate than dark eyes.

    Just as the doctor predicted, I was back to normal the next morning. I have my left eye iridotomy scheduled for this coming Wednesday.

  50. ari on October 9th, 2013 12:10 am

    this is the typical case. thanks.

  51. wiscskis on December 28th, 2013 12:39 pm

    I had the same laser iridotomy done to both my eyes. was scheduled for one, but due to extensive travel for work, it was more advantageous for me to have both done together. From a university hospital in a large city, I have been very confident in their doctors/specialists, so there was no reason to question the qualifications of this specialist. In fact, I checked credentials and even patient ratings and it was exemplary. I was told by this doctor that he has done thousands of these procedures and that it is very routine, much like many of these comments note. I WAS NOT told of the possible and debilitating side effects. This was supposed to be completely routine. The day following the procedure I was traveling, driving my car, and had distinct bright white lines across my field of vision in both eyes. I immediately contacted my doctor to be seen. He told me he has never heard of or encountered such a side effect AND he didn’t have a clue what to expect. Ding, ding, ding……what kind of professional was this, from a university hospital, who has no knowledge of these side effects? You put your faith in professionals to be up to date on their field. You’d think that, since there are studies and publications on these potential side effects dating back to 2005, it would be well-known that there are potential results such as mentioned! I now have headaches every day, also. This is not acceptable. I realize this is a critical procedure if you are at risk for a glaucoma attack, but at the very least there should have been discussion of the potential for white lines if the hole is not correctly placed under the eyelid, and I would have had the chance to locate a specialist who is capable and has an excellent success rate for properly placing the hole in your eyes. Folks, these are the only set of eyes you get. Beware.

  52. ari on January 2nd, 2014 3:38 pm

    i think he meant he never saw this complication. of course he was aware of it- its very very basic.
    there is no way to guarantee absence of symptoms- every patient is different, and there are reports of side effects no matter where the iridotomy is placed. i think its better to place them at 3/9 oclock, but thats no guarantee.
    lastly, no normal person would decline iridotomy for the low risk of side effects. its like not flying in an airplane as it may crash. so dont beat yourself up over your decision- it was the right one

  53. jo on February 17th, 2014 11:19 am

    After suffering the painful symptoms of partial closure attacks multiple times over several years – the pain and nausea usually occurred at night, resolving by the time I arrived at the doctor. My new eye doctor identified the narrow angles. I was frightened about the severe side effects many have noted, although my doctor said he had never seen such problems (performed 1000’s of procedures). I got 3 opinions, and had the procedure done on each eye (3 and 9 o’clock) Now, 2 years later, I no longer have those painful partial closure attacks. I have slowly developed a small amount of double vision in each eye, which occurs in the evening (fatigue?) and is corrected when I put my glasses on. Was it worth it? Yes – for peace of mind, & relief from pain. I work in a hospital and witnessed a patient having a full blown attack – the medical management did not prevent him from losing his eye sight.

  54. ari on February 26th, 2014 2:40 pm

    you are 100% correct

  55. Joann Klucsarits on March 4th, 2014 1:56 pm

    My 91 year old father is scheduled for a iridotony on Friday. I am concerned about the side effects and how his age may affect his recovery/side effects. He has had glaucoma since his 50’s but it was controlled with drops. Since I was out of town when he was scheduled for his consultation with the ophthalmologist , my brother took him and I am not sure that he and my dad asked all the important questions. His condition is not acute and right now he is asymptotic. They plan to use the procedure on his “good” eye, but it sounds like they will then schedule a second procedure in the next few weeks. Also, this will be done at a VA facility. Please, any advice, especially from older patients, would be appreciated.

  56. Sherry on March 9th, 2014 9:48 am

    I had a laser iridotomy of my left eye in January and had no side effects afterwards. However, I returned six weeks later to have my right eye iridotomy performed and have been in pain for several days post-procedure. I had to call the on-call doctor on a Sunday morning and he told me to go to an emergency clinic. How would I drive myself to an emergency clinic? I had enough hard time getting someone to take me to the doctor appointment which is only two miles away. The doctor said I could be suffering from a corneal laceration and phoned in some bacitracin ophthalmic ointment. Hopefully, that will help with the pain. It is possible that the cornea could have been scratched during this procedure. I am only 56 years old and too young to lose my vision. I chose to have the procedure done in order to preserve my vision. If I just have to tolerate the pain for a few more days, I guess it was worth it.

  57. Sherry on March 11th, 2014 5:56 pm

    I had an LPI (laser peripheral iridotomy) performed on my left eye in January with no ill effects afterward. I then had the same procedure done on my right eye and experienced a stronger “jolt” from the laser than I did the last time. I have had severe headaches and had to be seen four (4) days post-surgery. I can’t sleep because the pain in my temples wakes me up. A different doctor (from the same practice) checked my right eye after my complaint and stated I had a corneal abrasion, which can be quite painful. Hopefully, the pain will subside in the next few days. I will see my doctor for follow-up in ten more days.

  58. Pat on July 22nd, 2014 2:40 pm

    I just had iridotomy performed on both eyes for high pressure & closed angles ….2 weeks ago & 1 week ago. Minor pain after the surgery that night with slight headache . I have mild light sensitivity in the sun & slight blurred vision in one eye. Considering the long term effects of having a glaucoma attack, this is a great outcome. I would have it done again if needed . I went to Cincinnati Eye Institute (CEI) Ohio in Blue Ash & Dr Cohen performed the surgery. I highly recommend the facility & surgeons.
    I hope this helps with some positive feedback . Good luck to all. Pat

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