How Are Attacks of Glaucoma Treated?

Laser iridotomy is a procedure that makes a small opening in the iris (the colored part of the eye) to relieve increased eye pressure due to a type of glaucoma called angle-closure glaucoma. When the fluid that normally flows in and out of the eye cannot drain through its sponge-like drainage system, called the trabecular meshwork, the pressure in the eye (intraocular pressure) may rise. This rise in pressure could damage the optic nerve and lead to vision loss. The increased pressure may also push the iris forward, which blocks the drainage system completely, much like a stopper in a sink. This may trigger an angle-closure glaucoma attack, which is a medical emergency. A laser iridotomy is necessary when the fluid that drains from the eye is completely blocked. Laser iridotomy creates a new route for fluid to flow from behind the iris to the outflow drain of the eye. Laser iridotomy is also performed as a preventative treatment in eyes at risk for angle-closure glaucoma.

What can I expect if I have a laser iridotomy?

A laser iridotomy is performed right in our office. A staff member will give you some drops prior to the procedure that will decrease risks of inflammation associated pressure changes and a drop that will make your pupil smaller and thus your iris thinner. This will take about 15 to 20 minutes to work and in some people causes an aching sensation over the brow that goes away shortly. The physician will then give you a numbing drop once you are seated behind the laser. A contact lens is placed on the eye to help more precisely focus the laser. A laser iridotomy takes only a few minutes. You may see a bright light like a photographer’s flash. You may also feel a pinch-like sensation. In general, there are no activity restrictions following the laser treatment, although you should have someone drive you home after the procedure. Medications that can partially dilate the pupil, such as over-the-counter cold medications and antihistamines, should be avoided until after the laser procedure is performed. The opening made by an iridotomy is about the size of a pinhead. Typically, neither you nor your friends will notice it. It is usually located in the upper part of the iris, which is covered by your upper eyelid.

Loss of vision can be prevented

Laser iridotomy is a safe and effective procedure with very few risks. Although an eye that has suffered an angle-closure glaucoma attack can be treated, the drainage mechanism never again functions as well and usually medications are required for pressure control. The best treatment is to prevent the attack in the first place. While glaucoma treatments cannot restore vision already lost from glaucoma, early detection and treatment of glaucoma offers the best chance of preserving your vision. Our glaucoma fellowship trained ophthalmologist, Dr Andrew Bainnson, is available in our Smithtown, Deer Park and Riverhead offices to examine and determine if you are at risk. While glaucoma cannot be cured it can be controlled especially if caught early. North Shore Eye Care with its now 10 and growing convenient offices has the most sophisticated equipment to examine and treat glaucoma. Call today for an appointment.

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