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

  • Chuck

    I had an iridotomy to both eyes several weeks ago and really can’t complain about the procedure. Prior to that I had excellent vision in both eyes and didn’t need glasses for distant vision I do have some side effects. The most discouraging side effect is the light smudges I see at the bottom of my vision in both eyes. It seems to occur in reflected bright light coming up from below. I do not notice them in head-on bright light but they are not predictable and I notice them off and on during the day under varying light conditions. I think that double vision in one eye worsened after the procedure and I think that I need to have my prescription for my glasses changed to correct that. I also do think that my eyes are more watery than before the procedure. I would like to comment to Ari that he might want to pay attention to what people are saying on this blog. Too often medical professionals won’t listen to their patients. An arrogant know-it-all attitude is never a good bed-side manner for a physician.

  • Scott Michaelis

    I had double iridotomy yesterday and all is well with me at this point. I will be getting cataract removed next week. it was not really painful, felt like little pinches about 8 to 10 times each eye.

  • Pat

    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

  • Sherry

    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.

  • Sherry

    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.

  • Joann Klucsarits

    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.

  • ari

    you are 100% correct

  • jo

    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.

  • ari

    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

  • wiscskis

    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.

  • ari

    this is the typical case. thanks.

  • Jeanne

    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.

  • ari

    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.

  • Patty

    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!!!

  • ari

    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.

  • seahappi

    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

  • seahappi

    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

  • ari

    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.

  • Juanita

    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?

  • ari

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