What is Iridotomy?
Iridotomy is a surgical operation performed on the eye’s iris, the colored ring in the eye with the pupil at its center. Iridotomy uses sophisticated laser technology to perform the surgery. It is used when a person sufferers from angle-closure glaucoma.
Inside the eyeball, fluid flows through a thin strip of hard tissue called the trabecular meshwork. If fluid cannot drain through this tissue, it may build up inside the eye and cause damage to the optic nerve. This can lead to a loss of vision.
The iris may also be pushed forward due to increased pressure on the eye, blocking the eye’s drainage system completely and leading to an angle-closure glaucoma attack. If fluid is completely blocked from draining from the eye, then laser iridotomy is necessary. Iridotomy creates new channels for fluid to flow from behind the iris to the outflow drain of the eye.
When a person suffers an angle-closure glaucoma attack, there may be no obvious symptoms. This is because the attack may develop slowly. Not all people with angle-closure glaucoma experience an attack, but a doctor can recognize the risk before a patient experiences any of the symptoms.
If you do experience symptoms from an attack, they can include eye pain or headache, nausea, and vomiting. You may also suffer from disturbance of vision, red eyes, and haloes appearing around light. If the pressure is not relieved within a few hours, permanent vision loss may occur.
Before an iridotomy surgery, the surgeon applies eyedrops to numb the eye. He then places a contact lens on the eye to precisely focus the laser. The laser iridotomy surgery is performed by making a small opening in the iris to relieve the high pressure from the fluid that has built up inside the eyeball. The surgery will only last a few minutes. You may feel a small pinch-like sensation and see a bright light similar to that of a photographer’s flash.
The opening in the eye should be unnoticeable. It will leave a scar the size of a pinhead. The scar is usually located in the upper section of the iris, and the eyelid usually covers this part. After the surgery, you can go about your daily activities, but it is advisable to have someone drive you home.
As with any laser surgery, there are a few risks to laser iridotomy, including bleeding of a blood vessel in the iris. The iris may be difficult to penetrate and more than one treatment may be necessary. The loss of vision after laser iridotomy is very rare.
There are a few steps you can take to help prevent an angle-closure glaucoma attack. One step is to have regular eye exams; this will help detect any significant risks. Your ophthalmologist will use a mirrored lens to make sure the trabecular meshwork in not in danger of becoming blocked. Check to see if there is a history of angle-closure glaucoma in your family, which can place you at a higher risk. Women are more at risk than men, and people of Asian or Eskimo heritage are also more at risk and should have frequent eye checks.
ANON109349: Sorry to hear. Surgical iridectomy tends to be a bit larger than laser iridotomy but not always. I had one as well for my ICL four years ago. Corneal tattooing helped to reduce the glare, but didn’t eliminate it. It can be sutured when you get a cataract but suturing it beforehand has a high risk of causing a cataract due to the trauma of the surgery and also the risk of the needle touching the lens capsule.
Also, don’t listen to the idiots on here spewing nonsense. There’s no “long lasting inflammation” etc.
Doctors doing iridotomy should inform the patient about the permanent side effects, which are glare, halos, starburst, double vision, ghost images, white lines, etc. They also need to explain the patient that they may have cataract, posterior synechias, macular degeneration, retina detachment, etc. These information should be told to the patient so that they can decide between the possible loss of vision from glaucoma and the vision loss of side effects and complications of iridotomy.
Iridotomy should be conducted only if the medication is not useful, otherwise it is a harm. No prevention of glaucoma using iridotomy. Iridotomy should not be conducted as a prevention.
I am a doctor and I would never suggest healthy individuals to have iridotomy done. That is the worst thing that you can do and harm people. Iridotomy destroys the structure of the eye. It is trauma and there is no help. Please avoid doing it as much as you can.
The doctors themselves should have the iridotomy done to understand what the patients feel, before recommending it.
I had ICL's which had these holes put in my eyes, but the doctor said nothing about side affects. I am going to demand the ICL lenses be removed and these holes sutured closed or I will sue. They are causing halos. This is the worst thing I have ever done.
I had both eyes done a week apart this month (Sept 2013) in Switzerland. Yes, I have the glare and occasional double vision but to me the risk of losing my eyesight if I didn't do it was more frightening than what I am seeing now. I just deal with it. I've also survived cancer twice so maybe this is just not that big of a deal after all that.
@anon334192: You are surely an ophthalmologist who learned at medical school that if you have narrow angles and don't have iridotomies you will be blind. This is exactly what my eye doctor told me. And this is completely wrong.
First of all, you must know that there are lots of varieties of narrow angles, and not all of them require iridotomies. If your angles are narrow grade 3 (Shaffer grade) you don't need surgery. Even with grade 2, it is very unlikely that your angles will close. Grade 1 is more dangerous, and of course grade 0 requires an iridotomy.
The next point to consider is whether the angle is narrow around the whole circumference or only in parts. Besides, it requires great skill to decide how narrow an angle is. Did you know that patients with blue eyes often seem to have narrower angles than they really have?
If you send a patient with narrow angles to eight different doctors, he will be diagnosed with grade 0, 1, 2, 3 or even 4. I am the leader of a glaucoma support group, and we made this experiment. It was an eye-opener for us.
I had an iridotomy on my right eye eight years ago and have had a white line, glare, double vision and an elevated IOP ever since, which has made my vision and my life miserable. My left eye has had no iridotomy, though it was also diagnosed with a narrow angle. I have not become blind in that eye and the IOP is as low as it was in both eyes before.
Did you know that only about 1 percent of all eyes with narrow angles actually have a glaucoma attack? And even those patients need not become completely blind if the attack is broken within an hour or two.
As one doctor of Wills Eye Institute said in an interview: "In this country far too many iridotomies are done."
There are a lot of people posting here who know nothing about laser iridotomy! I'm not sure what their purpose could be in misleading people. Perhaps some are confusing it with surgical iridectomy done with a scalpel? The hole from a laser iridotomy is the size of a head of a pin. It's not even visible. No matter what you read here, not everyone experiences pain during or after LPI. One of my eyes was sore for a day after, but the other didn't hurt at all. A few laser zaps hurt with the first eye but none hurt with the second. My friend felt nothing at all in either eye.
Most people find it is no big deal at all, but then, this probably differs depending on where you live, your doctor's level of training, the quality of the equipment and the particular structure of your eyes. The most common side effect is from light entering the hole causing hair-like lines to appear when you blink. I have this now in one eye and it is the only side effect.
This is surgery. It can have side effects. No surgical procedure is completely safe. I had to sign a consent form that explained all the side effects. However, any side effect is better than the alternative which is blindness. Argh. I can't believe people are asking someone they don't know for advice. If you do have closed angle glaucoma and you don't have an iridotomy, you will go blind. Is the operation perfect? No, but it is better than the alternative.
I'm an international student and I came to the U.S. to complete my Masters degree. I'm 26 years old and I was told that I have a very narrow angle and I need to have an iridotomy. I have read a lot about it, but unfortunately I didn't see these comments.
I went to two doctors and both recommended an iridotomy, then I made the worst decision I have made in my life: I had the iridotomy last week and when I look at a light, I see it double. When I walk down the street, I see the moving cars as double. I had it done at Casey Eye Institute, one of the best places, I heard.
My eye pressure was perfect and they said they needed to do it just to prevent the narrow angle. I hope you find these comments before it is too late.
It's been two years since I had iridotomy in both eyes, a Limbal Relaxing Incision in both eyes and cataract surgery in both eyes. My vision since these surgeries is much worse. I have burning, itching, foreign body sensation, light sensitivity, watery eyes and tired eyes. I have tried many many kinds of eye drops including restasis, which burns terribly, and nothing is working. I cannot watch TV at night because the blurring is much worse. I also have trouble reading, seeing street signs, etc. What is the solution?
I had an iridotomy done about six months ago. My pressures were getting very high with the closure episodes. I have very dark eyes and had to get "hit" with the laser several times - the description of a rubber band snapping your eye was accurate. It sucked, but bearable. One of my eyes closed up again immediately and I had to have it re-done. I guess dark eyes can have the pigment fill up the holes. I have had no negative side effects. Unfortunately, I have had a couple of minor episodes in the past week or so. Makes me so mad. Good news is I have a six month follow up with my surgeon next week. I just wonder if the one eye has closed up again.
I am from India. I am a 43 year old male. I had laser Iridotomy done in both my eyes day before yesterday evening and must admit that my condition is really great and normal thereafter.
I was diagnosed with Narrow Angle Glaucoma and already had suffered two bouts of severe eye pain due to it a month back. I went to the best doctor in my city who had done some thousands of iridotomies in the past and is a renowned Glaucoma expert. He is proficient in performing YAG Iridotomies.I had YAG Iridotomies done in both my eyes at a time.
I had seven shots of YAG laser in my right and four shots in my left eye. I must admit that at the time of every shot I definitely felt something hitting my eye, but it was not unbearable as such. It took just five minutes. Immediately after in just five minutes I was off towards my home in my car, driven by my driver. Never drive the car yourself because the vision stays partially blurred for 30 to 45 minutes. I didn't have to wear any glasses after the procedure and on my way home my vision started returning back to normal. I put the eye drops suggested by my doctor and then went to sleep.
The following day when I woke up in the morning, my vision was absolutely fine. Just great. No pain at all. I went to my office and did my daily chores. In between only two or three times, I experienced a very mild pain that lasted for some few seconds but it was not an issue at all following the laser surgery that I had undergone. Today is the second day and I am just like before. Nothing abnormal. I am very happy with my condition.
I was told beforehand by my doctor that 90 percent of Iridotomies are always successful and the ones that fail may require a filtering or incisional surgery. But your specialist doctor is the best judge to say whether an Iridotomy is necessary in your case or not.
I also had done my research on the net before undergoing an Iridotomy and ran into many horrific comments made by some people whose iridotomies went haywire, but believe me mine was absolutely perfect. No trouble at all. No white line, no glare, no double images, nothing at all. I cannot see the holes in my eyes. That’s the result of the YAG laser,absolutely perfect.
What I would suggest to people who are suggested Iridotomies by some doctor is:
1)Go to a top notch surgeon who is a Master of Surgery with years of experience in the laser department. It would be more better if he is a Glaucoma specialist too (Mine was a M.S who is proficient in doing laser surgeries as well as a renowned Glaucoma Specialist).
2)Check how many laser surgeries he has performed in the past and his success rate. Discuss everything with him that you want to know about the procedure etc.
3)Ask that specialist if your eye condition can be treated without the iridotomy (whether another alternative is possible).
4)If the specialist tells you to undergo the Iridotomy and if he possesses all the above required criteria then don't hesitate to get this procedure done as the specialist is the best one to judge your condition.
5) If at all you are not satisfied by the response you get to your queries, take a second opinion of another renowned surgeon. (I did take a second opinion and that doctor also told me to get the Iridotomy done).
6)Never defer your Iridotomy just because of reading the negative comments on the Internet on some forums or blogs, etc. I don't mean to say that the ones who had the side effects are fake or wrong, but there are many factors that may have resulted in the Iridotomy going haywire for them. The reasons may be the ones that I have already explained above.
The main reason is the proper choice of the specialist doctor, his experience and skill in performing the iridotomy and his success ratio. All these things count, but remember, deferring your Iridotomy even if suggested by different specialists, just because of reading the negative comments here and there can lead you towards a situation where you can permanently lose your vision.
Remember there is a huge difference in living with some side effects rather than going blind permanently. Just think and then take the right decision. After all it’s your life and you only are solely responsible for the decisions that you take.
The main reason for my posting the comments here is that not many people who have had the iridotomies done to their eyes care to report their success stories, but the ones who were unsuccessful do voice their concerns, but some of them scare people to death and in this way they are doing huge disservice to mankind and causing wrong fear in the minds of people who are suggested this procedure.
If someone's Iridotomy failed due to some reason, it doesn't mean that everyone will suffer. By causing wrong fear such people are pushing others into an abyss of blindness. Iridotomies have never caused serious side effects unless not done properly and in cases where it was not required at all, and that's it.
I am very grateful to my doctor who guided me properly and did a fantastic job. I am also grateful to the almighty.
I hope my comments may help people who have advised to undergo this procedure. My best wishes to all. Regards.
I went to see a eye doctor to get my eyes tested for glasses and that's when i was told i needed to see an eye specialist, because he was concerned about the pressure.
Two weeks later i did see the eye specialist and that's when i was told i had closed angle glaucoma and that i needed laser. My eye pressure was 27 in my right eye and she put nothing down for my left, but did say it was closed. (That was scary to hear).
At that moment it all came to me why i was having headaches and nausea too. My regular MD doctor said it was sinuses (Wow) i thought you're not supposed to use sinus meds if you have glaucoma. Hmm.
My eyes are green and i had laser iridotomy on my eyes four weeks ago. I had my left eye done first and it took three shots. Five days later, they checked the pressure and it was 18. Then I had the right one done that same day and it took seven shots and she said she hit a blood vessel this time. but she acted like it was no big deal, so i didn't say anything because i thought it just happens sometimes. Does this happen sometimes? This eye did hurt more then the other after it was done, and i do have the line glare, but it comes and goes. I think it depends on the light, but i still can see and that is the most important thing.
i think i would rather see a little glare line than not see anything, and i think it is getting better with time. and yes i would have it done again and again. It really doesn't hurt that bad that you would not want it done. i think it hurts worse if you were to get an eyelash in your eye, but the laser just is a little ache that doesn't last but a moment. i hope this helps. i can't wait until friday so they can tell me what the pressure is in my right eye. i hope they take me off the drops.
Is a peripheral laser iridotomy appropriate for a 94 year old who has cataracts as well as glaucoma? The glaucoma resulted from shingles, also known as herpes zoster, of her eye six years ago. She also had what was described as a stroke in one of her eyes years ago.
My mother's ophthalmologist, who is well qualified but is not a glaucoma specialist, recommends that she has a laser iridotomy of her right eye because the angle has been narrow the last two exams. She had an acute glaucoma attack of her left eye five years ago which was treated with laser. She refused to have preventive laser on the right eye at that time because she lost vision in the left eye after having shingles(20/400) but has had no problems with her vision in right eye(20/40). She did not want to risk any complications with her vision in her right eye. Her eye pressures are 14-16 in both eyes.
She has Alzheimer's, a history of falls and lives in an assisted living facility where she gets around with a walker. I am her medical power of attorney and make decisions for her. Should we get a second opinion from a glaucoma specialist?
I had my iridotomy done last year on my left eye. My eyes are almost black, and i had not read about the pain you are supposed to feel if your eyes are darker. I'd say it is a very manageable pain, closer to a discomfort, i might say. I counted near to ten pulses and the procedure itself must have lasted near two minutes?
I was told i have narrow angle configuration (no glaucoma) and the procedure was going to prevent having close angle configuration glaucoma. However, i was warned by my doctor that sometimes this procedure is not effective and they have to actually do surgery (insert some type of micro duct in the eye -- plenty of info online -- to keep the pressure stable). When i scheduled the procedure i was told that i would be able to drive myself to and from the doctor's office, and so i did.
The day of the procedure the nurse first applied some drops (anesthetic) in my eye, then i had to wait some minutes. Later the doctor called me, put some more drops and i sat in front a machine very much like the machines used in regular eye check ups (where one has to put one's chin and forehead against a plastic band and look at the light coming from a little peep hole --sorry about my layman's terms!).
Then the doctor began the procedure. There were 7 to 10 pulses and that was it. He paused maybe after the fourth pulse, and then went on, each pulse less than a second apart. He asked me to look down during the whole procedure. He told me to rest for that day and to wear sun glasses. I was also told that i might have a headache and i could take regular headache pills. My doctor prescribed some drops that i had to apply during the next three days, four times a day.
Right after the procedure, my vision was blurry and stayed that way maybe for four hours. Afterward i had a headache. The the day after the procedure i was fine, no pain, no blurred vision, no headaches, no nothing. But two days after this sort of thin line appeared in the lower half of my eye. This "line" appears only when there are bright artificial lights or on a very sunny day, but it goes away if i wear sunglasses. It took me around a month to get used to it, and now it is just there. It does not bother me and it does not prevent me from driving.
I was supposed to get my right eye done two weeks after the left eye. But i read all the negative comments in this page and i decided to wait to see how the procedure in my left eye evolved. So far, so good. My only problem --not related to the procedure-- is that i had to change insurance and the new one might not cover it since the narrow angle configuration is now a "pre-existing condition." i wonder if they'll say the same thing about my birth control pill? ha.
To sum up, i have not had major health related problems (just insurance ones!) regarding the laser procedure. Am i one of the lucky ones compared to other people that posted here? Well, who knows, but i will post again in a month or so to let you know if anything else happened.
I was really scared by the things i read here. But fortunately none of those happened to me. For this reason, i wanted to share my experience, which has been a positive one.
As for the "line" in my eye, i just got used to it. I knew there could be complications, and yes i did rant about it the first couple of weeks, but you know, we don't stay healthy forever. There is a natural decline as we get older. I am 30 and already have mild arthritis (can't run and can't kneel since i was 20). And I'd rather focus on the things i can do still. I have started taking piano lessons, and if i ever become blind, i know i will get depressed, might cuss and want to be left alone for some time, for a year? But at that point i might have learned enough piano to maybe keep on enjoying and playing music without the need of reading it, or I'll just force myself to find something i can enjoy without needing my eyes.
As for my right eye, I'll see what my insurance decides in the end.
I had the iridotomy done on my right eye, then in two weeks they did the left eye. I have a line in my vision on the right eye and I asked the Doctor about this before he did the left eye.
The Doctor told me that they try to get the hole in the right position every time so you do not see this line, but sometimes they can be off.
Not much pain at all when they did the work.
My vision was normal one day after the surgery and no other complications except the line in my vision.
Nothing was mentioned to me about having the line before I had the surgery done so that is upsetting to me.
I am not happy with the line and I do intend on speaking to an attorney about this.
Due for an iridectomy this morning – some of the negative comments I read prior to the procedure pretty much scared me witless.
As positive comments rarely get posted I thought it would be worth saying the following. I have green eyes, and it took three pulses per hole from the YAG. I do pity those with brown eyes as it can require many more pulses.
Sorry to say that each pulse hurts (cross between getting hit with a stretched rubber band and touching a high voltage electrode). The constriction drug gives you an eye ache and a very red eye and its just starting to wear off now after seven hours.
However, on the plus side, the YAG has a 4 micron spot and the final holes are 100-200 micron. My ophthalmologist said it’s rare that they close. They are invisible (I cannot see them – what’s with the online photos showing two large holes?).
There are no horizontal white lines, no ghosting, no flare, nothing. Now that the pain is subsiding its as it nothing was done to the eye. Even if I raise the eyelid and try to see an odd optical effect in bright light, I see no such thing.
Mine is not for glaucoma, but a prep for collamer lens implant. If your surgeon knows what he’s doing, don’t be frightened. I was driving within a half-hour. Not looking forward to the second eye being done (due to the pain), but much relieved that the outcome for the first eye was perfect.
Things can go wrong, but my ophthalmologist (who has done a couple of thousand implants to date) has only had three “poor” iridectomy outcomes who see the funny white lines and only one of the three says it's a bit of a bother.
These symptoms are completely normal after laser iridotomy. This surgery carries many risks and has many adverse effects, though doctors tell their patients that there are no side effects. Take your drops regularly, they guard against inflammation.
After the surgery, the eye is very sore. You have now a hole in the iris, and it is a wound which must stay open, and that means it cannot heal. And the eye, of course, tries to heal the wound, but it can't, and so it reacts with inflammation and pain. Most people have pain and sore eyes for only a few weeks or perhaps a few months, but eventually the symptoms vanish.
I hope you won't have to suffer long. You should not drive three days after an iridotomy! Wait at least three or four weeks before you drive again. Working on the computer is also something you should not do three days after surgery! Wait at least two weeks before you start working again. I wish you all the best.
I had a laser iridotomy done three days ago and I'm still taking drops four times a day. I work on the computer and never had any headaches or eye pain, but since the procedure, my eyes feel achy when i concentrate in front of the screen and also when i drive. Is this normal? has anyone had any of these symptoms?
I recently had a surgical iridectomy and Visian ICL implant. I now have terrible blurred vision, white line glare, ghosting and I see every light in triple (due to the two holes). It is a nightmare and I wish I could reverse what has been done but know this is impossible. I am now not going ahead with surgery on my other eye as I think it would be completely debilitating and I wouldn't be able to drive at all. Do not have an iridotomy!
@anon 101740: The side effects you experience after your iridotomies are completely normal. Everybody has glare after this procedure, because the iridotomy hole is a second opening in the iris. It is a second pupil, and extra light gets into the eye, causing the glare. Pain is common, too, especially if the doctor hits the ciliary body with the laser. That causes sharp pain which may vanish after a few months, but it can be persistent. If so, you will need strong pain medication for the rest of your life.
Floaters are also common after the surgery. The Yag laser, with which the iridotomy is done, shakes the eye vigorously. this often leads to vitreous detachment, which causes floaters. Most people don't see these floaters after a certain time and get accustomed to them.
What is your vision like? After iridotomies you often lose two or three lines of visual acuity.
I hope you will get some help from your doctor. Most doctors don't know that there are side effects of iridotomy.
I had an iridotomy done on both eyes about one month and half ago for narrow angles. I get some glare, and get some sharp pain and my eyes get tired and i see black floating dots in front of my eyes. I am going to see my doctor this sunday she was on vacation. Has anyone had any of this? please let me know.
Refer to entries of 48 John Locke and 49anon34359. It has now been five years since I had iridotomy surgery in Tulsa. It seems evident by now I will suffer from it the rest of my life since I am now 80 years old. I have used GenTeal, Optive, Systane, Vigamox, Cosopt, Voltaren, Azopt, Lotemax, Econopred Plus, Dry Eye Zone and Nevanac drops which give me 15 to 30 minutes of relief. Not even my own doctor or any other doctor has offered me any help; they don't seem to want to talk about it.
I went to an optician and told her about my problem, and for $135.00 she sold me Carrera by Safilo Polarized dark glasses which gives me my first relief when I wear them. When I take them off for a few minutes, the pain comes back.
Within the past few months I had iridotomies done. Right eye first then second one a week later on the left eye. The surgery was so painless that I asked the doctor as he was doing it if I was supposed to feel something. He asked if I did and I said no.
It only took about 7-10 shots, with a Yag laser, and I have brown eyes. It took less than a minute. Afterward my eye was a blurry for about three or four hours then I had perfect vision. I used drops to take care of any inflammation for about four days. I had no inflammation, very little pain, just a sensation like I had a little something in my eye. The next day that was even gone.
I have a little bit of glare at the bottom of my vision, if I am looking directly in the sun outside only, but I am glad that I do so you know the hole is open and doing its job. Indoors I never have that glare.
As time goes by I notice it less and less and look for it to know it is working. So please don't be scared. Get a good Ophthalmologist, but from what I understand it is a pretty standard procedure. The one I got came from a group that is considered the best in my town, and I live in a smaller community. Don't forget most of these specialists do their glaucoma fellowships at some of the best schools all over the country and have done procedures on all ethnic groups not just those you are familiar in your communities. It's not something they normally discuss with you.
My optometrist who found the narrow angles to begin with mentioned that to me when he recommended this surgeon. I'm thankful that Doctors go into such a complex field, especially taking on surgeries, and I believe they are sharing their skill to help people, not hurt you.
Anon 91404: Of course it may be that the procedure has to be done again! The iridotomy hole will close in about 15 percent of all cases (some studies even say that it is successful in only 44 percent of all cases), and then it has to be done again.
If your doctor says it hasn't, leave his office, because he is not competent. Before having an iridotomy done you should at least consult two glaucoma specialists, because you need at least two specialists to find out whether your angles are so narrow that they need iridotomies. Finding out whether an angle is very narrow or in danger of closing is very difficult and only very experienced ophthalmologists are able to find our whether you really need iridotomies.
after angle closure laser surgery, does anyone knows if you can get angle closure again and have to get the procedure again? my physician says i don't have to do this again.
In reply to Brian, no I'm not an ophthalmologist and I speak only of my experience. As I stated on my comment below, I believe that we only hear of the negative side of an iridotomy and the people with a positive outcome don't bother to report it.
I didn't have the 20 to 40 shots you mentioned but only seven in each eye and that was not at all painful, only the loud clicking noise was a little unnerving.
I wanted to share my experience as I think there's too many negative comments on this procedure which can save your eyesight. I would be interested to hear from more people who have had this done and not suffered any side effects. Karmic
Anon 5902: Glad your surgery went well. But it is really hard to believe that you had no side effects and no pain. The eye can only be numbed from the outside, so everybody feels pain when the iris inside the eye is hit by the extremely hot laser. The 20 to 40 shots you get are really very painful, so I don't know why you had no pain, it sees so incredible.
As for side effects, sometimes they are minor, and that means that the patient can adjust to the new vision he has after the procedure. More than 95 percent have at least the white line, which is the most frequent side effect.
So you are among the lucky 5 percent who have no adverse effects. Or do you write on behalf of an ophthalmologist or are you an ophthalmologist yourself? Sorry to ask this question, but your description of the procedure sounds very, very unusual indeed.
Just to let all the people who are due to have an iridotomy know that you can have this procedure done and still have the same eyesight as before.
I also researched these sites to find out what I was up against when I was told I had to have an iridotomy on both eyes and to be honest, after reading all the negative reports, I was terrified that I would not be able to see properly ever again.
However, I opted to have this procedure done eight weeks ago on my left eye and the right eye was done four weeks ago. I can honestly say it was pain-free and I have no problems with any visual disturbances.
After my check up at the local hospital I was told my eye pressure is fine and that I will be monitored every four to six months.
So, if you are about to have this done, please remember there are many people who have positive
outcomes but not many comment on it -- only the ones who have negative things to say. --karmic
Anon 60227: I am glad you are having only minor inconveniences after your iridotomy. The white line you are seeing is the most frequent side effect of an iridotomy and it can really become very, very bothersome and make your vision miserable. You will have problems driving, you may even be unable to drive, because that line will always interfere with your vision, so that you will not be able to see anything clearly.
If I were you, I would give up driving now. I am glad you are still able to write on the computer.
If you have a white line it means the doctor did not do everything to avoid it. It can be avoided.
So before having the other eye done go to another eye doctor, a glaucoma specialist. Ask him what he is going to do to avoid the white line. It may only be a small line, but it can also be a broad white fluorescent line which makes it almost impossible for you to see with that eye.
So you should be extremely careful, or you might end up with a white line in each eye, and then you can no longer read or write or work.
Find a glaucoma specialist who is aware of the problem and knows how to prevent it. --Fanny
I had laser Iridotomy to my right eye just four hours ago. I was diagnosed with narrow angle glaucoma after going to an eye doctor for severe pain, and I mean severe pain in my eye.
I started researching glaucoma and this procedure. I was afraid to have the procedure after reading some of the horrible stories on this website. I carefully weighed the options: risk going through a painful glaucoma attack and possibly going completely blind seeing nothing at all or have the procedure and risk the side effects.
So far, after a few hours and after my eye is returning to "normal" I am seeing a slight white line but only under certain light conditions and it disappears if adjust how far I have my eyelids open. If I have to choose between this slight inconvenience and being blind, I still chose the gift of sight, though I do feel I should have been given more info by the dr before hand so I didn't have to research so much on my own.
So ask lots of questions regarding a doctor's experience and how your specific eye conditions may react to the procedure.
Also, to those who have have suffered such serious side effects, my heart goes out to you. I never truly appreciated by vision until I started having trouble with my sight a few months ago. I am scheduled to do the left eye next week and have mixed emotions on it.
Hello Fanny. At the moment the glare doesn't impair my life. It's upsetting. you see it at the movie theater, with sunlight, bright screens, in many situations. The other eye was successfully done and I don't have any bothersome effects with it. I think the solution is a suture on the hole, but as you've said perfectly, I'll look for a second opinion. Thank you very much.
Anon 47762: welcome among the iridotomy victims. I am glad the iridotomy hasn't impaired your life completely. Are you still able to work? I lost my job after the iridotomies. Fortunately you had only one eye done. Don't have the other one done! Yes, the glare and the white line will be with you for the rest of your life, but there are possibilities of suturing the iris. You should go to a different ophthalmologist and get a second opinion, as your doctor, like so many others, doesn't take your problems seriously. Then ask your second doctor to give you the name of a doctor who does iris repair. There are specialists, at least in the USA. I am wearing sunglasses all the time, even when writing on the computer. Perhaps that would be a solution for you.
Hello Brian, thank you very much. I really apreciate any information about doctors who deal with this problem. I was operated on some months ago and my doctor doesn´t seem to recognize the problem. He doesn´t know why I have the glare, apparently. The bad effect doesn´t impair my life totally, of course. But I could see perfectly before with my glasses or contact lenses and now I have this annoying white line up and down, when there's sunlight or watching screens and it affects your mind. Fortunately,it´s only in one eye. Each movement of eyelid or when I wrinkle my forehead and raise my eyelid, I see the glare, and I think it´s the lower edge of my iris. And it´s worse when I´m looking upwards. It´s really depressing to know that that glare will go with you the rest of your life.
Anon 47149: unfortunately there is no real solution for your problem, which is a very frequent side effect of iridotomies. The eyelid never covers the iridotomy hole all the time. When you look up and around the hole is uncovered. And strangely enough, even when the hole is covered patients see this white line. There is an ophthalmologist in Germany, I think it was in Dortmund, who sutures iridotomy holes. I'll try and find his name and address. How did the iridotomy impair your life? Do you still work? Most people lose their jobs when they have had an iridotomy.
Hello to everyone. I´m from Spain and by chance was reading this board. I recently had an intraocular operation for myopia and have a horrible "white line glare" under some light conditions, such as sunlight or inside movie theaters or under dark light conditions and brilliant stages,for example. I think my eyelid raises a little and uncovers the iridotomy hole, creating an uncomfortable blinking glare horizontal line. I only would like to say that I know four cases more here, with the same bad effects or worse. It´s not so strange there are these adverse effects and opthalmologists don´t know well the cause, and they are "top opthalmologists", so the tecnique is not sure or controlled totally. Does anyone know a possible solution? thank you.
anon 43760: Are you an ophthalmologist wanting to tell people how harmless iridotomies are, or are you really a patient that had the surgery done? If so, I am glad you had few side effects. It is good that you are optimistic, but the glare you have will, of course, not go away. It can only disappear if the iridotomy hole closes, but then your doctor will re-open it. So, in any case, the glare won't disappear. This is good to know, because it keeps you from having false hopes. Try and get used to it, that's the only way to handle it. Good luck. --Brian
I am very sorry that some of you have had a bad experience with your iridotomy, but I feel I have to give the other side in this discussion. When I was told I needed it done in both eyes I looked online to find out what an iridotomy was because I had never heard of it before. I found this website which scared me to death - I almost didn't have it done because I was convinced I would lose my eyesight or have chronic pain. The truth is, it is *not* a pleasant procedure, but by the next day you hardly know you've had it done. It is important to have it done by a doctor who is experienced in the procedure (my doctor was one of the pioneers and does between four and 20 of them every week) and someone you can talk to and have confidence in.
I'm glad I have that kind of doctor. I had both eyes done - a week apart - and it has been three weeks since the last surgery. I am experiencing some of the "glare" in my left eye, but it is slowly getting better and I'm hoping will totally disappear with time. It does not affect my vision, it is just annoying - like I think I see something shiny on my nose.
If anyone reading this is about to have the surgery and is scared to death like I was by all the horror stories on this site, just remember that there are bad outcomes with even the simplest of surgeries and chances are the thousands of people who have a good outcome are not going to spend time writing about it. It's important to know the other side of the story, but keep in mind that it's not the *whole* story. And for the people who say that your eyesight never returns to normal after the procedure, you are being downright irresponsible. My eyesight was 20/20 in both eyes beforehand and I've had it checked twice since (once by a doctor not affiliated with my surgeon) and it is still the same. Be informed and ask questions of your doctor, and take what you read here with a grain of salt.
Anon 38245, I am sorry you had such severe side effects of iridotomy, but these effects are not unusual. Iridotomy is very serious surgery with many problems, especially if the doctor is not experienced in doing this procedure. It is quite normal that your visual acuity drops for about 3 or 4 Snellen lines.
Now, when you have mixed glaucoma, open angle and narrow angle, it very often happens that you get a glaucoma attack. With open angle glaucoma, the trabecular meshwork is obstructed, and the debris cut out during the laser iridotomy completely blocks the trabecular meshwork. So after iridotomy you often need glaucoma surgery like trabeculectomy or a shunt implant.
Iridotomy often induces glaucoma, the very disease it is meant to prevent.
You should go and get a second opinion, perhaps an experienced glaucoma specialist might be able to save some of your vision.
I had an iridotomy on my left eye in Jan. 2009, the debris and inflammation completely closed the angle. in Feb. 2009, I had the second eye done before realizing the angle had been closed, the same thing happened to the second eye with complete angle closure. My left eye's vision was 20-20, it is not 20-50 and I had to have a glaucoma implant. the right eye has not been operated on yet, because my blood pressure has never been normal since the iridotomy in Feb. I also have adverse health problems with nausea and swelling since the second iridotomy. I was sent to a retina speciaist who found blood in the right eye.
Kim 123,I suppose you are an ophthalmologist and you want to tell people that iridotomies are harmless.
Your post contains several points which simply are not true:
1. You write that your surgery was painless. As the iris can't be numbed if the eye is not opened, there is always pain. Some people can tolerate it better than others, but the procedure is not painless.
2. You write that your IOP was lowered by 5.
Iridotomy never lowers IOP and it is not done to lower IOP. On the contrary, IOP rises considerably after an IOP, because the iris debris cut out by the laser can't leave the eye and obstructs the trabecular meshwork. It takes weeks, sometimes months and sometimes years before all the cut out debris has left the eye. A few years ago a study was done on enucleated human eyes that had had iridotomies, and even 12 years after the surgery doctors still found some cut out iris debris in some eyes!
3. You write that your visual fields improved.
Iridotomy never improves visual fields and it is not done to improve visual fields.
That is the horrid fact about glaucoma: what has been lost cannot be regained. If you have lost some fibers of the optic nerve and consequently your visual fields show damage, you will never be able to regain what you have lost and your visual fields won't improve, because iridotomies don't repair the optic nerve.
So, please, Kim123, don't tell people things that are just not true.
I can understand your motives, namely to alleviate people's fear before undergoing this surgery. But patients should never be told lies.
You can say: iridotomy is a minor procedure which in about 70% of all cases opens up narrow angles, which takes about 10 minutes to perform, which gives patients pain that is normally well tolerated, which makes the IOP rise for several days or even weeks, which entails inflammation, which is normally controlled with steroids after about a week. Nobody should be afraid of the procedure itself, but it nevertheless can have serious side effects. These include a white line in the center of your vision, some glare, faint double vision, a slightly blurred vision, high IOP and inflammation. Most of these symptoms vanish after a week or two, but in about 5 to 10% of all cases they are permanent.
Thanks for your comment. It shows that sometimes iridotomies can be done without serious side effects. But this is extremly rare. Even when the immediate results are good, please have your eyes checked regularly.
One long-term effect of iridotomies are quickly developing cataracts and sometimes macular degeneration.
I pray that this may not happen to you.
If I had read these frightening posts prior to my surgery, I probably wouldn't have had it. I had my surgery 4 months ago in both eyes. Everything is perfect. No problems at all. My surgery was quick, painless, and successful. My IOP was lowered by 5, my vision is the same as it was prior, and my visual field improved. I am so sorry for all of your problems and I pray for you. I just wanted to share my story. My Dr has much experience and performed 100+ of these surgeries.
Anon34359 Thanks for responding to me so soon. I think that the Dr. that did my surgery was afraid of a lawsuit by insisting so much that I go to OKC to a specialist who I think was his friend that could testify should I file a lawsuit.
You were very wise not to have the other eye done! Otherwise you would not be able to see with both eyes now.
A foreign body sensation, double vision, glare and blur are completely normal side effects of iridotomy. It is not dry eye, dry eye does not cause double vision.
Doctors don't want to admit that there are severe side effects of iridotomy, because they have been taught at medical school that it is a harmless procedure. But it isn't.
There is not much that can be done against your problems. You might ask your present eye doctor to prescribe you some special tinted contact lenses to cover the iridotomy hole.
Three years ago in Tulsa I had an iriodotmy, was to go back the next week for the other eye, never went back. Since that time my eye has been irritated feels like something in it all the time. At the time dr. said he had never seen this in his practice before. Other problems I have is double vision and blurry eyes but I have not lost any vision. The Dr sent me to a eye specialist in Okla. City, he said that it was just dry eye. This has to be told the Dr. in Okla. City never sent me a bill can anyone understand that?
Dear anon 29135,
I am so glad you had no problems directly after your iridotomy. But how is your vision now? How is the inflammation? What drops are you taking? Do you see the white line? What about glare?
You must be a very tough person to say that everything is normal after an iridotomy. I hope your vision hasn't deteriorated too much. Have you already developed a cataract? This is one of the main side effects of this surgery.
Please, keep us updated.
I pray for you that your vision is OK and that you have no pain and no inflammation.
I had an iridotomy today on my left eye and everything is normal.
Dear anon 16522,
I am so glad that an ophthalmologist reads these comments about iridotomy. As you yourself admitted, hardly any ophthalmologist asks his patients about side effects of iridotomies because every doctor is sure there aren't any. But there are, indeed, many severe adverse effects. It is by no means a harmless procedure. Please ask your patients also about long-term side effects.
If you want to know more about the side effects of this surgery, google for the words 'prevent blindness America, glaucoma'. You will find a forum with 3 threads concerning iridotomies (Iridotomy, Iridotomy2, Iridotomy3) and almost 2000 messages. I suppose that forum will be an eye-opener for you. It is moderated by a well-known ophthalmologist from Miami.
You seem to be a very caring doctor. It is just great that you crawl through forums to see how patients are doing after surgery. I can imagine very few doctors do that! Keep on your good job!
This is some scary list of bad experiences after laser iridotomy... I am an ophthalmologist and sometimes I crawl through forums to see how patients are experiencing different types of treatments. Reading all of this, made me actually call two patients that I lasered the past week. Both of them were fine and without side effects. I have never heard anyone complain after an iridotomy, but then, I have never really asked about side effects, either. It is good to know all of this and I'll be sure to ask after side effects in the future. Apparently, laser iridotomy is not as harmless as we tend to believe. Thank you for sharing your experiences.
Hi, anon 13664,
of course I get the point. But with air crashes as well as iridotomies, any single person concerned (whether dead in an airplane crash or visually impaired by iridotomies) deserves that his case be taken into consideration and fully investigated. Every single person counts, and every single eye counts. And even if iridotomies do more good than bad, remember that most of them are done preventatively on healthy eyes.
You can't just completely disregard people who suffer after any surgery just because the majority don't suffer. Every human being is valuable and his/her fate should be taken seriously!!!
This is anon 13664 responding to Brian: "Bad" iridotomy side effects don't occur in 2% of folks getting iridotomies, it's much less than 2%, according to Dr. Anderson, Patty's expert. Read my last post again Brian --- you misread it.
The FDA may look into iridotomy for the same reason the FAA investigates every plane crash. Not because something is terribly wrong, but because we can always learn something more. The good that iridotomies do far, far outweighs any negative side effects a very few persons have. Of course if you're unfortunate to be one of those few persons, it's everything to you --- just like, if the airliner you're on crashes, you don't really care to hear how safe flying is. Get the point?
even if only 2% have devastating side effects after iridotomies this means that every year about 1700 people are so much visually impaired that they have to give up their job or even become completely blind. I presume there are much more than 2%. Why would the FDA investigate iridotomies? Do you have a source for your 2%?
Comment to Patty, et al. 20% of those who get iridotomies don't "suffer" or have their lives "ruined" from having the iridotomies --- that is a gross exaggeration. It's not even 2%. According to Dr. Anderson it's a lot less than that who may have some lasting negative side effect related to having an iridotomy. To those few persons iridotomies are certainly "bad" but that shouldn't be a reason for anyone not to get an iridotomy if it's recommended. Just like a few persons die in airliner crashes, but that's not a good reason not to fly.
Hi, anon 13073,
you went to 'Prevent Blindness America' and probably only went to 'Iridotomy2'. Just scroll a bit below and you will see 'Iridotomy'. Dr Anderson created a new thread, because the first with more than 1200 posts had become too long.
There are actually more than 60 people writing about the adverse effects of iridotomy, and this is not a handful.
Of course, probably about 80% have only minor problems after this surgery, but for the remaining 20% it is devastating. And when you know that about 85.000 iridotomies are done every year in this country, you can imagine how many suffer.
By the way, Dr. Anderson doesn't only function as a psychologist, but mainly gives medical advice, explains what happens in detail, names ophthalmologists you can go to to fix your problem etc.
Nobody says iridotomies are bad in general. But they shouldn't be done preventatively and for those who don't need them. An ophthalmologist at Will's Eye Institute said too many iridotomies were done. And he is right. Did you know, the FDA is investigating LASIK at the moment. The next surgery they are going to investigate is iridotomy. OK, that's the last post I am writing here.
Be glad that you belong to the 80% who have no problems and don't minimize the suffering of the 20%.
This is anon 13073. Patty, following your suggestion, I went to "Prevent Blindness America" and read the many posts about iridotomy.
First of all, the "hundreds" of posts there are mostly by only a handful of persons, repeated over and over, "stuffing the ballot box" so to speak, like all the very negative posts here are written by many of the same persons, such as yourself, over and over again.
Secondly, Dr. Anderson, while he may be a very good ophthalmologist, is functioning on "Prevent Blindness America" more as a psychologist to the few persons who claim iridotomy has "ruined" their lives. Dr. Anderson never writes that iridotomies are "bad" and should be avoided. Rather, he encourages getting them to prevent eye damage, even possible blindness, if one is at high risk for closed-angle glaucoma.
Remember Patty, that you don't normally hear from the countless thousands of people like me who have had very successful iridotomies. The only reason I'm writing now is to help "offset" all the unfounded negativism about iridotomies and hopefully prevent someone from going blind because they did not get a needed iridotomy due to some nonsense they read about it here or on other sites like "Prevent Blindness America."
of course a bad outcome of an iridotomy can be due to an ophthalmologist not being competent. Iridotomy is a very tricky procedure which is not very often performed. If the doctor has little experience he might do it wrong. So it is extremely important to go to someone who does this surgery very often and has great experience.
But as with any surgery, you will never know the outcome. You even won't know why some patients of the same doctor have problems and others don't.
Discuss matters with Dr Anderson at 'Prevent Blindness America.'
Hi, everybody, and anon 13073,
I am truly not the only person with devastating outcome after an iridotomy procedure. Go to the above mentioned website of 'Prevent Blindness America' where hundreds of people complain about iridotomies. They have just opened a second thread, because the first with more than 1200 posts had become too long. Dr. Douglas R. Anderson MD from Bascom Palmer Eye Institute moderates the forum. He is a leading glaucoma specialist, and you can't doubt his expertise.
So if you say, there are no visual problems after iridotomies, why on earth did my ophthalmologist (I live in Kansas City) tell me that he doesn't do any iridotomies on patients who for their job depend on their car???
I agree, there are many people whose vision only changes slightly after an iridotomy, but for others it changes greatly. It is estimated that about 30% of all patients who had an iridotomy can't lead a normal life afterwards. That is an enormous percentage and it doesn't become smaller by denying it. I am so glad you had no problems!
Hello anon 12819, Patty, et al. Patty writes, "The vast majority of patients can't drive after having iridotomies, and more than 30% have to give up their job and can never work again." I don't want to upset Patty, but her statement is absolute nonsense on its face. No one who has any familiarity with iridotomy could possibly believe her above quoted statement to be true. Why do people write/post such blatant falsehoods? I wish I knew. No offense intended Patty. I personally know dozens of iridotomy patients, like myself, who have absolutely no "side effects" whatsoever from our iridotomies and I personally know no one who has had any problem with an iridotomy. We are all still driving our cars and, those of us not retired, doing our jobs just fine. That's not to say you haven't had any problems Patty, but it strongly suggests that you must be a very rare case, where things other than something caused by iridotomies are most likely in play. I'm truly sorry.
This is what Dr.Douglas R. Anderson MD from Bascom Palmer Eye Institute wrote:
'On the issue of blue eyes. The structures in the angle are basically white or transparent, but show up with lightly dusted with pigment. Most eyes have some pigment debris from the iris that does this, even in blue eyes, but in some blue eyed people who are still young ..., there hasn't been enough pigment shed yet to make the structures easy to see. Sometimes when you don't see any angle structures, it is easy to think that probably the angle is closed or very narrow and that's why you don't see any structures. So that's why ... maybe a young person told she has narrow angles might have blue eyes and, in fact, open angles.'
You will find this quotation and an extensive discussion on iridotomies in the glaucoma section of Prevent Blindness America.
You wrote the following:
"If you have blue eyes, as I have, doctors can easily diagnose you with narrow angles when in reality they are wide open."
Do you have a source for this?
Personally, I have found this discussion quite upsetting. I recently saw a glaucoma specialist at Washington Univ Medical School here in St. Louis. My optic nerve is normal and my visual fields are normal, but my eye pressures have been bouncing around a bit which is unusual for me (24/25 in February, 28/29 in April, and down to 24 recently in May.) Typically, my pressures have been stable in 21/23 range. The doctor I saw highly recommended iridotomy in both eyes as a preventative measure against the effects of acute angle closure. Although I was unsure as to what I would decide before I came to this forum, I am now thoroughly confused as to how to proceed after reading this discussion. To those who have had a very outcome after the surgery, are you sure your doctor was competent? Did he/she have extensive experience in performing the surgery? Could it be in your cases the problem was with the doctor and not the procedure itself?
It is very prudent indeed to get a second opinion, but sometimes this is not enough. If you have blue eyes, as I have, doctors can easily diagnose you with narrow angles when in reality they are wide open. So useless iridotomies are done!! Iridotomy may a safe treatment or preventive measure for some patients, but that is not the simple fact of the matter. The second ophthalmologist I went to said to me that nobody has the same vision after iridotomies. For some the changes are minor and they can go on living as before. For many others the changes are major, but can be tolerated, though the impaired vision has negative effects on their life, e.g. they can't drive any longer and have to cut down on their working hours. And for still some others the changes in vision are devastating.
That ophthalmologist also told me that he doesn't do any iridotomies on patients who for their job depend on their car. The vast majority of patients can't drive after having had iridotomies, and more than 30% have to give up their job and can never work again. There are more and more ophthalmologists who take these facts into consideration and do fewer and fewer iridotomies. Besides, there are many different types of narrow angle glaucoma, and iridotomies are only effective for one or two types.
Hi, Anon 12225,
the scientists doing research about iridotomy in Japan conclude that this surgery is one of the leading causes of blindness in the country. They can only come to this conclusion after having taken thousands and thousands of patients who got iridotomies into consideration.
The reason is the speed and power with which the aqueous humor that goes through the iridotomy hole hits the cornea. As the hole is smaller than the pupil, the aqueous humor flows through the iridotomy hole with much power, hitting the cornea rather hard, which, after some months or even years, leads to corneal destruction.
This has been proved by hundreds of research papers.
You say there are thousands upon thousands of eyes which have had iridotomies and are just fine. How do you know this? Are there any statistics on that? Have you yourself done studies to prove it?
Just google for iridotomy (or iridotomie) and a word like 'forum'.You will find hundreds of people complaining in all languages about the adverse effects of this surgery which is wrongly called 'safe'. Dr Douglas R. Anderson MD of the Bascom Palmer Eye Institute in Miami, Florida has often admitted (in the above mentioned forum) that adverse effects of iridotomy like glare, double vision, permanent rise in IOP, corneal damage, uveitis, synechias, loss of vision etc. do occur and that he has seen such patients.
As to cause and effect:
The day before my iridotomies were done I had 20/20 vision in both eyes. I didn't need glasses. The day after my iridotomies were done (they were both done on the same day) my vision was 20/100 in my left eye and 20/200 in my right eye. A month after the iridotomies vision in my left eye was 20/80 and 20/200 in my right eye with glasses! And it has not improved so far. My ophthalmologists, as well as the two others I went to, all admitted these were side effects of the iridotomies. The glare, double vision and posterior synechias I have were also the immediate effect of the iridotomies, as I was told. Besides, there are numerous companies producing special lenses to cover the iridotomy holes so as to avoid glare and double vision. Do you think these companies would be able to exist if there wasn't much demand for these lenses?
Could you cite one single evidence for your assertion that thousands of people have had no problems after iridotomies?
Kind regards, Fanny
Hi folks, this is anon 12225 responding. The Japanese and other studies/reports some of you cite relate to a selected few people who had iridotomies and later developed bullous keratopathy or some other eye malady. The studies completely overlook the thousands upon thousands of eyes which have had iridotomies and are just fine. The studies also overlook the countless thousands of eyes that never had an iridotomy yet suffer from bullous keratopathy or some other problem.
In particular, bullous keratopathy is a very common affliction of elderly eyes. So, of course, some people who have iridotomies will have bullous keratopathy as well, or develop it later due to aging, cataract surgery, or something else, but almost certainly not caused by having had an iridotomy. There is no evidence to suggest otherwise in any studies/reports to date and there has been a concerted effort to find a cause/effect relationship between iridotmy and lots of other eye problems, all to no avail, because there is no causative connection.
It would be like asserting that roosters crowing in the morning make the sun come up. Based upon years of experience and reams of factual data, iridotomy causing rampant bullous keratopathy or any other eye problems is frankly about as ridiculous a causal connection as the rooster/sun example.
Iridotomy is a very safe, effective treatment or preventive measure for closed-angle glaucoma. That is the simple fact of the matter. If your ophthalmologist recommends iridotomies, get a second opinion if you like, that's prudent, but when you hear the recommendation twice, get the iridotomies, which may well save your sight.
Hi, Anon 12225,
I suppose you are an ophthalmologist. Could you please help me. After the iridotomies my vision dropped from 20/20 (without glasses) in both eyes to 20/80 in my left eye and 20/200 in my right eye (with glasses). How can I regain my vision?
How can I get rid of double vision and glare? Besides I have posterior synechias. Can anything be done for that? Thanks in advance.
I am so glad some people finally draw attention to the adverse effects of this surgery which has destroyed my vision and consequently my life. I read that iridotomies have far greater risks than e.g. trabeculectomies or even shunt surgery. Some of the side effects are immediate, like blurred vision, glare, diplopia and inflammation and they do NOT subside. Others are long-term effects like corneal decomposition.
I searched the net and only found one single positive testimony (here, by Anon 9383). All other testimonies are negative. I went to the site mentioned above about Iridotomy, and people on that forum try hard to find any positive testimony, but in vain. There isn't.
I asked my doctor whether I could talk to someone who had had the operation beforehand, but he didn't find any. A surgery that is meant to preserve vision kills it. That's the sad reality.
iridotomy is by no means a safe procedure, and the adverse effects of this surgery are of growing concern in Japan, but not only there.
Quotation: 'Bullous keratopathy may arise many years following ALI [ArgonLaser Iridotomy], and is a growing problem in Asian countries. This condition is a major cause of ocular morbidity in Japan, which has seen a worrying increase in the number of cases in recent years.'
Web addresses are not allowed here, but you can easily find the link by googling the quotation.
Here is another quotation: 'In 1984, Pollack2 reported the first case of irreversible corneal edema after ALI, and in 1988, Schwartz et al3 reported more cases of phakic bullous keratopathy and concluded that corneal edema was a serious complication of ALI. The incidence of this devastating disorder is increasing yearly, and, in Japan, ALI-induced bullous keratopathy is now recognized as the second most common corneal disease.'
Complications range from blurred vision, pupillary abnormalities, diplopia, glare, endothelial burns and cell loss, corneal edema, uveitis, synechiae, hemorrhage,elevation of IOP, lens opacities, retinal damage, loss of central VA, and many more.
Bullous keratopathy is a well-known long-term side-effect of iridotomy in Japan.
I quote: 'Bullous keratopathy may arise many years following ALI, and is a growing problem in Asian countries. This condition is a major cause of ocular morbidity in Japan, which has seen a worrying increase in the number of cases in recent years.'
Web addresses are not allowed in posts, but you will easily find the address when googling the above words.
You can also google for another research done in Japan:
'Demonstration of Aqueous Streaming Through a Laser - Iridotomy Window Against the Corneal Endothelium'.
Here the scientific explanations are given why this keratopathy happens after iridotomies. I could give you many more links.
Very little research has been done so far as to the long-term side-effects of iridotomy, though the procedure has been around for more than 50 years. Iridotomies certainly save some people's eyesight, but destroy other people's eyesight. No surgery is without serious side-effects. Anon 11640
Anon 11640, you write, "In Japan iridotomies are the second leading cause of blindness." That is not true. Glaucoma is probably the second leading cause of blindness, cataracts being by far the leading cause of blindness in Japan and around the world. Iridotomy is a very effective treatment and preventive measure for closed-angle glaucoma. Iridotomy prevents blindness, it doesn't even make the list of things that cause it.
Hi, I have carefully read all the comments here and found them very interesting indeed. I created a support group for people who suffer from adverse effects after iridotomies. The complaints put forward by the members of my group vary from disturbances like occasional glare and double vision to severe visual impairment and even complete loss of sight. All ophthalmologists agree that each and every surgery has side effects, and iridotomy is no exception. In Japan iridotomies are the second leading cause of blindness. In the US and in Europe no research has yet been performed concerning the long-term side effects of this surgery. If some scientists do that in the future their findings will surely be an eye opener for all those doctors who don't take complications after iridotomies seriously.
my doctor said I needed iridotomies. I went to get a second opinion, and that doctor told me I had Shaffer grade 3, so iridotomies were not yet necessary.
I have read all the posts here. Of course there are people who have few and people who have many side effects. But my doctor told me that everybody has some side effects after iridotomy.
What to believe?
Well, anon 9383,
I am sorry, but what you wrote makes me decide against iridotomies. Someone who insults others cannot tell the truth!
To anon 9383,
We live in a very litigious society and I suspect many iridotomy "victims" are out for the financial gain of a lawsuit award. Like whiplash "victims" in a car accident. That's terrible.
It should be clear to the dullest observer that iridotomy "victim" support groups are in the same category as UFO support groups...
How do you dare to make such statements?
Even the above article which we are discussing mentions these side effects.
I am a member of an 'iridotomy support group', and I can assure you I have personally met many people who suffer because of iridotomies.
When this surgery is done after a person has had a glaucoma attack, OK. But it is mostly done preventatively on healthy eyes which are very often just slightly narrow. And that is wrong!
Besides, many people still have glaucoma attacks after the iridotomy, because there are at least 5 or 6 different sorts of narrow angle glaucoma, which are very difficult to distinguish, and iridotomies are only effective with one or two sorts of narrow angle glaucoma.
Just be glad that you didn't have any adverse effects and don't insult those who suffer.
Such insults don't make your arguments convincing, on the contrary!
You've done iridotomies a huge disservice!
I just read that the FDA, which at present is investigating the side effects of LASIK, will soon perform an investigation into the adverse effects of iridotomy. During the last year they got hundreds of letters complaining about this surgery.
I can't take your comments any more seriously than UFOs.
You are not a doctor, and yet you qualify all those who write about the side effects of iridotomies as liars. There are so many research papers on the net where all those dire side effects of iridotomies are analyzed. Unfortunately we cannot posts links here. Would you say these doctors who write the research papers are all liars? I would call this attitude presumptuous.
I would like to know the name of that doctor who provides mailing lists with 100 (!) people so that patients can contact them.
My doctor couldn't even name one single person who would be willing to give him his telephone number so that I could contact him.
And your doctor gave you 100 names! Astonishing.
who are you? A doctor who wants to earn money by doing iridotomies?
Who are you to say that all those who have problems after an iridotomy are liars?
Who are you to compare side effects of a surgery to UFOs?
I had iridotomies done 2 years ago. I lost one of my eyes, because the doctor used too much energy and the laser burnt my cornea, my iris and my lens, so that finally the eye had to be taken out.
The other eye has double vision, glare, strange flashes of light and inflammation. I lost most of my vision in that eye too. I am legally blind.
Hi again, this is anon 9492/9712 once more. This is my third and final post on this. The laser iridotomy eye operation has probably saved more people from optic nerve damage and even blindness than any other eye procedure. It is among the safest eye operations.
Several years ago I had iridotomies done on both my eyes to prevent acute closed-angle glaucoma which I was at very high risk of having because of advancing age, being farsighted, having relatively small eyes, IOP of about 20, etc.
Other than having iridotmies myself and therefore being very interested in them, I have no dog in this fight, as the expression goes. I am not a doctor or associated with the medical field in any way, nor is anyone else in my family or any friends. I am a graduate electrical engineer. All my life I've made thoughtful decisions based on data and credible facts, not rumor, fear, or the madness of crowds.
I did due diligence before doing anything to my precious eyes. When I was discussing the pros and cons of having iridotomies with him, my ophthalmologist gave me a list of about 100 of his iridotomy patients to contact, from whom he had gotten permission. Because their response was so positive, I stopped after I had contacted, by phone, 57 of them. None of them had the slightest problem with their iridotomy(s). 29 or them regreted that they were not aware of and had not done the iridotomies sooner because they had an acute closed-angle glaucoma attack which damaged their optic nerve and impaired/diminished their vision in one eye. Those folks did an iridotomy on their remaining "good" eye as well and have not had any problem with it. The other 28 did it, as I did, and none of them have had any problem --- and no acute closed-angle glaucoma attacks. In fact when I called them, many had forgotten that they even had iridotomies! I added my name to my opthomologist's list and have since received a few calls myself. I've even had some call-backs thanking me for encouraging them to get iridotomies.
I don't expect any of these real facts, or the overwhelming weight of medical literature, etc. will change the minds of anon 9534, Fanny, cyril, anon 9610, Pamela3, etc., but hopefully future readers of these posts will read mine, along with theirs, and not be discouraged or needlessly terrorized by largely unfounded tales of doom because of having an iridotomy.
We live in a very litigious society and I suspect many iridotomy "victims" are out for the financial gain of a lawsuit award. Like whiplash "victims" in a car accident. That's terrible.
It should be clear to the dullest observer that iridotomy "victim" support groups are in the same category as UFO support groups, etc. There are undoubtedly millions of persons in the world who have
some sort of "trouble" with their eyes, but it's not due to an iridotomy except perhaps in the rarest of cases. There are valid support groups, such as cancer and heart/stroke support groups and then there are bogus support groups --- the internet is replete with them. They flourish for the same reason that thousands believe there is a vast government conspiracy to keep the "truth" about UFO's and space aliens from all of us. Nonsense. Don't be taken in.
If there were any significant problems with iridotomies doctors certainly couldn't suppress the problems --- trying to hide something is the thing that trial lawyers, our courts, and the media thrive on and love to expose the most. Use your common sense folks!
Bottom line: If your opthomologist recommends iridotomies, do your own research, including reading/considering all the fear-mongering posts, but in the end get iridotomies to easily avoid an acute closed-angle glaucoma attack and the resulting probable damage to your optic nerve, up to and including blindness. Don't be a fool. That's it. Thank you for reading this.
you write: Could it be that the folks posting all the bad stuff are after monetary gain?
This is simply absurd! What money could anyone earn when writing about the side effects of a certain surgery?
if the high "failure" rate and debilitating side effects they mention were true, it would be widely known, there would be exposes written about it, attorneys would be advertising on TV to sue, etc., etc.
This exactly is the crux! Those side effects are widely known by patients, but the doctors don't want to admit them. They have learned that iridotomies are harmless, and they still believe this even if their patients complain about their problems.
There are many companies manufacturing special tinted lenses to help all those who have visual disturbances after iridotomies, and there are many doctors specialized in suturing the iridotomy hole, so that patients will have no more double vision.
Many patients have tried to catch the mass media's attention (e. g. written to Sanjay Gupta), but every criticism concerning iridotomies has been crushed down by doctors.
But more and more groups of 'iridotomy victims' are raising their voices. Patients should be informed about the side effects, and this surgery should only be done to prevent an imminent glaucoma attack.
yesterday I posted the reference to a website on iridotomies along with my message and got an e-mail from the administrator of this site telling me not to post such links.
If you google for iridotomy, Danderson (the doctor moderating that forum) and for some of the participants like anthony or lunabud, you will find that site. It has existed for only 3 months, and there are almost 800 posts only on iridotomies.
That will be an eye opener when you read that forum.
The truth is that the complication rate of iridotomies is much higher than for any other eye surgery.
There are support groups of people suffering from the adverse effects of iridotomies in the USA, in Germany, in France.
Iridotomy is one of the leading causes of blindness in Japan.
But doctors won't admit all this, so patients must speak up.
get a second or third opinion before having an iridotomy done. With most people the side-effects are devastating. You lose so much vision and you will never be able to live a normal life after an iridotomy. Quite a lot of people even become legally blind.
Hi. This is anon 9492 again. Since my original post of only a few days ago, regarding my very satisfactory iridotomies, it is amazing how quickly anon 9534, Fanny, cyril, anon 9610 jumped on it and write that I am very lucky and must be some rare exception to have iridotomies with no disastrous side effects. It's as if they were poised to slam anything good about an iridotomy. The facts are that over many years there have been thousands of iridotomies done to treat or prevent acute angle-closure glaucoma and the vast majority, 99+++ %, are entirely successful and without any side effects whatsoever. Common sense should tell you that in our society today, if the high "failure" rate and debilitating side effects they mention were true, it would be widely known, there would be exposes written about it, attorneys would be advertising on TV to sue, etc., etc. Could it be that the folks posting all the bad stuff are after monetary gain? What kind of eye problem(s) did they have that prompted their iridotomies? How qualified, experienced was the doctor who did them? Of course I don't know the answers to those questions, but the terrible iridotomy assertions made, while they may be true for themselves, are certainly not true for any significant number of persons who have an iridotomy. Any complications or side effects from an iridotomy are extremely rare, and that's the fact of the matter. So stop needlessly scaring folks. That's all I have to say. Thank you.
Of all eye surgeries iridotomy is the one with the most severe adverse-effects. It leads to very poor vision brought about by glare, dipolopia, cataract, corneal troubles, retinal detachment and rise in IOP.
There are very few people who have no adverse effects after iridotomy. Glare, double vision, uveitis and high IOP are very frequent side - effects. Normally visual acuity drops dramatically. Hardly anybody who had an iridotomy can go on driving and many lose their obs.
I'm glad you had no side-effects after your iridotomies.
But most people have devastating side-effects.
Even the head of glaucoma department at Wills Eye Hospital recently said that too many iridotomies are being done!
Iridotomy is major surgery and dramatically impairs vision.
you seem to be one of the lucky few who had no side effects after an iridotomy.
I know 6 people who had to undergo that surgery, and all of them have severe side effects: glare, monocular diplopia, inflammation, high pressure, a white line in the center of their vision, early cataract development, loss of visual acuity.
I myself have double vision and uveitis. My iridotomies were done one year ago.
I've had preventive iridotomies done on both eyes some time ago and my vision has remained perfect, with no side effects whatsoever. Furthermore, before I had the procedure done, I spoke at length with dozens of other persons who had iridotomies and none of them had even the slightest problem. I realize that is only anecdotal evidence, but it was overwhelming for me. And sure enough, just as all the bone fide medical literature suggests, I'm fine as well. So if you are at high risk for acute closed-angle glaucoma, by all means get iridotomies.
I do hope your left eye didn't get an iridotomy!
When you have an iridotomy done to both your eyes, you will never be able to see normally. The side - effects are just horrid: double vision, glare, inflammation which often develops into uveitis, white line in the middle of your vision, strange flashes of light, decrease in visual acuity (normally 3 Snellen lines), decrease in vision, corneal damage, retinal holes, and above all a severe, lifelong rise in IOP.
Studies found out that the cut out debris of the iris obstructs the trabecular meshwork. On enucleated eyes it was found out that even after 12 years there was still debris in the eyes. So after an iridotomy your pressure will rise enormously, so that you will need very invasive surgery (trabeculectomy or implant). An iridotomy always leads to untreatable glaucoma.
I hope you didn't have the surgery done on your second eye!
Vision never returns to normal after an iridotomy.
Iridotomy is very tricky to perform, and many doctors don't really know how to do it, especially if they don't do it often.
About 99% of the patients who have had an iridotomy have visual disturbances. Some adjust to it, most don't. Often the disturbances are so severe that people lose their jobs. Quite a lot of suicide cases due to iridotomies have been reported.
Corneal and retinal damages are frequent as is life-long inflammation.
As a preventive measure this procedure should never be done, because the risks far outweigh the eventual benefits.
Maddy, you are right.
I can only warn people not to have an iridotomy done! If you have a glaucoma attack, it might be wise to have an iridotomy, but this surgery should never be done as a preventive measure.
It severely impairs your vision. You will have long-lasting inflammation and glare and double vision for the rest of your life. Many people who have had an iridotomy try special contact lenses, special glasses even undergo another surgery to have the hole sutured. But it is all in vain. After an iridotomy you will never be able to see normally.
So take care.
by now it may be too late for you to follow my advice, but I can only warn you.
Never do an iridotomy on your second eye! You will always experience strange things in your vision. After the iridotomy you have a second pupil, so you see everything twice, and this double vision is nauseating. You may also have inflammation for the rest of your life (as I am having). Keratopathy is very frequent, too. It may be that your cornea doesn't heal, and this will cause you lifelong pain (that's what I am experiencing).
So discuss matters with your doctor, but be careful. Doctors are reluctant to admit that there are side-effects to their treatment.
I wish you all the best. Make a wise decision.
I recently had an iridotomy on my right eye which was successful EXCEPT that my vision seems to be different now..ie there are blotches and jagged edges (like pixels).
I am having an iridotomy in my left eye next week and am now anxious about the consequences. My left eye has 20/20 vision and NO jagged edges or blotches. What can I expect?
Thank you for a prompt reply. Surgery is on Wednesday, 10/14.
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