Peripheral Iridotomy (PI)

About Glaucoma

Glaucoma is a degenerative disease that if left untreated can cause permanent damage to the optic nerve, resulting in gradual vision loss and eventual blindness. Damage to the optic nerve due to glaucoma is usually caused by an elevated intraocular pressure (IOP). Clear fluid, called aqueous humor, circulates through the eye to provide nourishment to the tissue and applies pressure to help maintain the shape of the eye.

Narrow-angle glaucoma is a condition in which the iris is bowed forward, which can sometimes partially block the angle where fluid inside the eye usually drains. This can cause the pressure inside the eye to rise and eventually destroy optic nerve fibers, gradually causing peripheral (side) vision loss.

Vision loss from glaucoma is permanent, but can be prevented with early detection and treatment. Glaucoma management is usually a lifelong process that requires frequent monitoring and constant treatment. Since there is no way to determine if glaucoma is under control based on how a person feels, doctor visits should be on a regular basis.

Treatment of Glaucoma

Treatment concentrates on lowering the pressure inside the eye to prevent optic nerve damage. Eye drops are most commonly used to control glaucoma, however, they can be very expensive, have unwanted side effects, and may need to be taken for the rest of your life. If non-surgical methods fail to decrease pressure, surgery may be required. The peripheral iridotomy procedure does not rely on medicines, but uses an advanced laser system to create an alternate route for the draining of the fluid inside your eye. This procedure is reimbursed by Medicare and other insurance providers, which minimizes your out-of-pocket expenses.

How the Procedure Works

A peripheral iridotomy is a laser procedure used to treat narrow-angle glaucoma, which is a disease that can cause permanent vision loss if left untreated. With this procedure, your doctor will use the laser to create a tiny hole in the upper part of the iris so that the acqueous fluid inside the eye can properly circulate and relieve the intraocular pressure (IOP) that has built up.

Before the laser treatment, anesthetic eye drops will be applied to numb the eye and special eye drops will be used to constrict the pupil, allowing the doctor greater access to the iris. A lens lubricated with a gel-like substance will then be placed on the eye to help keep your eyelids from blinking and to allow the doctor to focus the laser onto the iris. The procedure is generally painless, though some patients notice a slight “pinching” sensation from the laser.

Your eye pressure may drop as quickly as a day or more after having the PI performed. Your doctor may treat the eye with an anti-inflammatory eye drop that will be continued after the procedure. Your doctor will need to check your eye’s pressure one hour after the procedure before you will be allowed to return home.