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Treatments

Iridotomy

iridotomia
This consists of making a small hole in the iris by laser.
It allows for the treatment of ocular hypertension in eyes due to the narrowness of the angle.
An effective procedure to prevent a severe attack of glaucoma.

What is an iridotomy?

An iridotomy is a procedure performed by YAG laser or argon laser to make a small opening in the iris in order to open an alternative passageway for the aqueous humour (colourless fluid) between the rear and front of the eyeball. This ensures the drainage of the fluid through the normal anatomic ducts if fluid evacuation is insufficient or it has become blocked.

The narrowness or blockage of the drainage area means that the aqueous humour accumulates inside the eyeball, causing ocular hypertension. This problem might end up damaging the optic nerve and causing glaucoma if not detected and treated in time.

Eye diseases treated by iridotomy

An iridotomy is recommended to prevent or treat closed-angle glaucoma, avoiding a sudden peak in hypertension due to the complete blockage of aqueous humour. If the angle formed by the iris and the cornea –the area through which this fluid is drained– is narrower than usual in your eye, there is a greater risk of a blockage that could have devastating consequences for your vision.

Whereas glaucoma does not often have any symptoms and progresses silently, a severe attack of glaucoma causes sudden vision loss, red eye, eye pain, halos around lights, and even nausea and vomiting. The damage caused to the optic nerve in very little time is irreversible and, therefore, the early detection of a narrow ocular angle is important.

An iridotomy is a very simple procedure that takes barely 10 minutes (around 5 minutes per eye), and can be performed in the ophthalmologist’s office. We first apply eye drops to dilate the pupil and to facilitate the action of the laser, and anaesthetic eye drops so that you do not have any discomfort, followed by anti-inflammatory eye drops for a few days after the session.

The treatment has no convalescence period and you can return to your everyday life in barely 24 hours. During this time, you might notice some discomfort, such as a slight loss of visual acuity or blurred vision, but this is completely normal and will disappear in a couple of days.

An iridotomy requires no incision in the eye nor access to its inside, making is extremely non-invasive and, because it is performed by laser, it is a very precise and safe technique. Only on few occasions does it lead to a slight inflammation of the eye or a sudden increase in intraocular pressure during the hours following the procedure, due to the accumulation of pigment from the iris in the angle area. These effects often disappear after a few hours, but we must make sure this occurs at a check up that is generally arranged for the following week to make sure everything is OK.

Sometimes you might need to repeat the treatment to increase the size of the hole of the iris. If, despite the repeat intervention, the aqueous humour does still not drain properly, we might suggest a surgical approach.