Narrow Angle Glaucoma Laser Treatment – LPI

Acute narrow-angle glaucoma occurs suddenly, when the colored portion of your eye (iris) is pushed or pulled forward. This causes blockage of the drainage angle of the eye.

When internal eye structures are blocked in this way, your eye’s internal pressure (intraocular pressure) may spike and possibly damage the optic nerve that transmits images from the eye to the brain.

A sudden glaucoma attack may be associated with severe eye pain and headache, a red inflamed eye, dilated pupils, halos around lights, nausea and vomiting, and blurry vision. These signs may last for hours or until the IOP is reduced. With each narrow-angle glaucoma attack, part of your peripheral vision may be lost.

Acute angle-closure glaucoma is a medical emergency. If the high pressure is not reduced within hours, it can damage vision permanently. Anyone who experiences these symptoms should contact an ophthalmologist immediately or go to a hospital emergency room.

Some chronic forms of narrow-angle glaucoma, however, can progress very slowly to cause eye damage without any obvious symptoms or pain in early stages.

What is LPI?

LPI attempts to “open” a “narrow” angle. Since the angle is the part of the eye that drains fluid FROM the eye, narrowing of the angle can put the eye at risk for an acute attack of angle closure glaucoma. During the LPI, a laser is used to make a small opening in the peripheral iris (the colored part of the eye). This changes the fluid dynamics in the eye and “opens” the angle. If a patient already has acute angle closure glaucoma, the small opening that is made in the peripheral iris allows fluid to drain more normally and also lowers the eye pressure.

What should I expect if I have a laser iridotomy?

The procedure is an outpatient procedure that can usually be performed in the eye doctor’s office. You are seated at a slit lamp with your forehead resting against a headpiece and your chin resting in a chinrest. After some eye drops are put in the eye in order to numb the eye, a lens will be placed on your eye. This will prevent you from blinking and will also minimize your eye movements. The lens also helps to direct the laser light into your eye. The laser, which is attached to the slit lamp equipment, is then directed into the eye. The procedure usually takes a few minutes. Most people experience minimal discomfort during the procedure. After the laser, you may experience some irritation in the eye and some blurry vision, but this commonly resolves by the evening of the procedure. You will usually have your eye pressure checked thirty minutes after the laser procedure. You are then usually seen one week after the laser procedure. The number and frequency of visits after the laser surgery may vary and depend on the condition of your eye. Most people will need to be on an eye drop four times per day for one week to help the eye heal rapidly.