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Your condition

Fluid in the eye (aqueous) is produced by the ciliary body, and drains out through the trabecular meshwork (drainage pathway) in the drainage angle. When the angle is narrow or closed off by the iris (the coloured part of the eye), aqueous drainage is obstructed, causing pressure to build up in the eye. When the pressure in the eye is too high, it can cause damage to the optic nerve and permanent vision loss – this is called glaucoma.

Diagram of parts of the eye showing the obstruction of the normal aqueous flow

What does the laser do?

The laser makes a full-thickness opening in the iris (iridotomy). This opening allows the aqueous to bypass the iris and opens up the drainage angle, allowing better drainage through the trabecular meshwork.

Even if only one eye is affected, both eyes usually need to have this treatment.

Diagram of the inside of the eye showing where the laser creates an opening in the iris allowing better drainage through the trabecular meshwork.

What does the laser treatment involve?

The laser is performed with the patient seated at the laser machine. The laser is delivered through a special contact lens that is placed on the eye. You will feel some discomfort with the initial laser shot, but this decreases with subsequent laser shots. The laser itself takes only a few minutes to perform.

Your eye pressure will be rechecked between 45 to 60 minutes after laser. You will be given an anti-inflammatory eye drop use for 1 week after laser – this needs to be used in addition to your usual eye drops.

If your eye pressure is high after laser, you may be given additional pressure-lowering medications, either as eye drops or tablets.

Diagram of the outside of the eye showing where the laser (iridotomy) is positioned.

What to expect

  • You will be in the hospital for at least 2 hours.
  • You will have drops put in your eye to prepare the eye for the treatment, so you will be unable to drive home.
  • Local anaesthetic drops will also be put in your eye before the procedure.
  • Treatment is delivered through a lens which rests against the eye.
  • Please take all of your usual medications prior to your appointment, unless otherwise advised by your doctor.
  • Continue all other regular drops (ie glaucoma drops) after laser treatment.
  • As mentioned,Diagram of the outside of the eye showing where the laser (iridotomy) is positioned.cataract surgery may be an option depending on how mature your lens is.
  • Side effects may include discomfort, sensitivity to light (photophobia), headache, or blurry vision for several hours afterwards. Wearing sunglasses (with your prescription, if required) can make the trip home more comfortable.
  • Please arrange for someone to come and pick you up and drive/take you home after the procedure.

More information

The Royal Victorian Eye and Ear Hospital
Phone: (03) 9929 8666
Website: www.eyeandear.org.au

Glaucoma Australia (Victoria)
Phone: (03) 9404 2974
Website: www.glaucoma.org.au

Disclaimer This document describes the generally accepted practice at the time of publication only. It is only a summary of clinical knowledge regarding this area. The Royal Victorian Eye and Ear Hospital makes no warranty, express or implied, that the information contained in this document is comprehensive. They accept no responsibility for any consequence arising from inappropriate application of this information.

  • Laser Peripheral Iridotomy #163
  • Owner: Laser
  • Last Reviewed: February 14, 2020
  • Next Review: February 14, 2023