Laser Peripheral Iridotomy

The pressure in your eye is maintained by fluid coming into the eye behind the iris, and draining through the ‘angle’ in front of the iris.

In some eyes, this angle is narrower than it should be, which if it is blocked off completely would cause a severe rise in pressure, known as acute angle-closure. This can be very painful, and cause permanent eye damage.

It can also cause a slow, chronic increase in the intraocular pressure and ultimately causing chronic angle closure glaucoma.

A laser peripheral iridotomy is used as a treatment for acute angle- closure, or to prevent angle-closure happening in people who have narrow angles and are at risk of developing it.

It works by creating a small hole in the iris, which helps the drainage angle to open.

Most of the time this procedure is done in both eyes. Some patients who already have glaucoma, may require additional treatments such as drops to reduce intraocular pressures or sometimes surgery.

Your vision will be checked, and pupil-constricting drops will be put in your eyes. You may also be given a tablet to reduce your eye pressure. These take 15-20 minutes to work.

Once enough time has passed, Mr Agarwal will take you through for the treatment. After explaining the procedure, and answering any questions, Mr Agarwal will ask you to sign a consent form.

The laser treatment can then take place.

Mr Agarwal will instil some local anaesthetic eye drops, and use a moistened contact lens to do the treatment. You may feel the lens against your eyelashes and it will help to keep your eyelids open. You will be asked to place your chin on a chin-rest and keep your forehead in place against a bar.

Mr Agarwal will advise you to look in a particular direction. The treatment usually takes a couple of minutes, and you will be aware of flashing lights and clicking sounds, and an odd pressure sensation, but it should not be painful. Most of the time one sitting is enough but some patients with dark eyes might need second sitting to make the hole full thickness.

Laser iridotomy is a very safe procedure.

However, there are small risks of the treatment causing raised pressure inside the eye, bleeding from the iris, inflammation, or damage to the retina, including retinal detachment. Many patients do find their vision is a little misty for a day or two after the treatment, this will improve. The chance of any more serious side-effects is very low - less than 1%.

Some patients may experience glare symptoms longer term, but this is not common and can improve with time.

You may be asked to wait for 30 minutes to have your eye pressure checked again, before you go home. Mr Agarwal will also prescribe you some eye drops to use for a week, to reduce the chance of any inflammation in the eye.

You are then free to go home, though you should not drive yourself. You may find your vision a little misty for a day or two, and some patients feel a mild headache, which settles quickly with simple paracetamol, if this is safe for you, and rest.

You will receive a follow-up appointment at the clinic after this laser treatment.

However, if you have any concerns before then, or feel there is a problem, such as your eye-sight becoming worse, flashing lights, or you feel increasing pain, please contact us for advice.

Alternatively, you can visit your optometrist who can examine you and contact us if there is any concern.


While care has been taken to compile accurate information and to keep it up to date, Mr Agarwal cannot guarantee its correctness and completeness. The information provided in this information sheet is designed to support care and is not a substitute for professional healthcare advice, by a qualified doctor or other healthcare professional, which will be tailored to a patient’s individual circumstances.

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