Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Laser peripheral iridotomy (LPI) is a brief laser procedure that treats and helps prevent angle-closure glaucoma by creating a tiny opening in the outer edge of the iris, the colored part of the eye. This opening gives fluid inside the eye an additional pathway to flow from behind the iris to the front of the eye, relieving the pressure buildup that happens when the iris blocks the eye's natural drainage angle. LPI is used both to treat an acute angle-closure attack and, more commonly, as a preventive measure in eyes found to have a narrow or occludable drainage angle on examination. It is one of the most established laser treatments in ophthalmology.
Who typically needs this
- Recommended for eyes with a narrow or anatomically "occludable" drainage angle found on routine eye examination, even before any symptoms occur.
- Used urgently to treat acute angle-closure glaucoma, a sudden, painful rise in eye pressure that is a medical emergency.
- Considered for patients with a history of intermittent angle-closure symptoms, such as brief episodes of eye pain, headache, or blurred vision with halos.
- Often recommended for the unaffected fellow eye after one eye has had an angle-closure episode, since the risk is usually similar in both eyes.
What to expect
- Performed in the clinic using numbing eye drops; a special contact lens may be used to help focus the laser.
- Drops are often given beforehand to constrict the pupil and reduce eye pressure prior to treatment.
- A laser, typically an Nd:YAG laser and sometimes combined with an argon laser, creates a small, full-thickness opening near the outer edge of the iris, usually positioned under the upper eyelid.
- The procedure is quick, generally taking only a few minutes per eye.
- Eye pressure is checked shortly afterward before the patient is discharged.
Recovery
- Vision may be blurry and the eye mildly red or irritated for the rest of the day.
- Anti-inflammatory eye drops are typically used for several days after treatment.
- Some patients briefly notice a new visual symptom, such as a faint line, glare, or halo, related to the new opening; this often lessens with time.
- A follow-up visit confirms the opening remains functional and checks eye pressure and the drainage angle.
Risks to know about
- Eye pressure can spike temporarily in the hours after the procedure.
- Mild inflammation, bleeding, or blurred vision in the days following treatment is common and usually resolves.
- The iridotomy opening can occasionally close over time and may need to be repeated.
- Some patients experience persistent glare, halos, or a faint line in their vision from the opening, particularly if it is not fully covered by the eyelid.
Frequently asked questions
Is LPI painful?
Most patients feel only brief, mild discomfort. The eye is numbed beforehand, and the laser pulses are very quick.
Will I need this in both eyes?
Often yes. If one eye has a narrow angle or has had an angle-closure episode, the other eye usually carries a similar risk and is often treated preventively.
Does LPI cure angle-closure glaucoma?
LPI relieves the pupil block causing angle closure, but if optic nerve damage has already occurred, ongoing glaucoma monitoring and treatment may still be needed.
Will people be able to see the hole in my iris?
The opening is small and usually positioned under the upper eyelid, so it is rarely noticeable to others.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: AAO — Laser Iridotomy, Moorfields Eye Hospital (NHS) — Laser Peripheral Iridotomy . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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