I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
I have been advised by my ophthalmologist to have a YAG Laser Iridotomy, I am having concerns about this procedure, basically the after effects and or the pain during the procedure, If anyone out there have had this procedure done will you kindly share your experience and after affects. Thank you in advance.
One other thing I was going to mention is that -- because my angles are so narrow- - I can no longer have a dilated eye exam until the peripheral iridotomy is complete. Dilation of the eye could push the iris and totally occlude the angle - putting my right into acute angle closure glaucoma. As I await my left eye procedure, I've been careful to avoid any cold medicines (not that I usually take them anyway) or anything that will tend to dilate my eye -- as much as possible.
I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
Oh -- I am sorry that you are feeling very bothered by this. For me, more information helps. Maybe that makes it worse for you. What are you bothered about the most?
I have been advised by my ophthalmologist to have a YAG Laser Iridotomy, I am having concerns about this procedure, basically the after effects and or the pain during the procedure, If anyone out there have had this procedure done will you kindly share your experience and after affects. Thank you in advance.
In my case, I feel like the risk of the procedure is less than the risk of having an eye emergency with acute angle closure glaucoma -- especially in light of the fact that I have had such a rapid change in the closure over a four month period. It isn't an easy decision though because likely right now (like me) your vision is fine. It is disheartening to have "perfect" vision before the procedure and then this problem with the dysphotopsia after. [I live two hours away from my ophthalmologist -- so scary to think of experiencing acute angle closure glaucoma -- with only a short time to save my vision.]
Did your doctor give you a time frame in which you should have the iridotomy done? Mine said within 6 to 9 weeks. He was really surprised in September when he checked me with gonioscopy. He said that in May, he thought to himself that I wouldn't need any intervention for maybe up to two years. So I don't know why my eyes changed suddenly, but they did.
I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
I have been advised by my ophthalmologist to have a YAG Laser Iridotomy, I am having concerns about this procedure, basically the after effects and or the pain during the procedure, If anyone out there have had this procedure done will you kindly share your experience and after affects. Thank you in advance.
Thank you Sharon for sharing your experience, it was very enlighten, Although I am scheduled in less than a week to have the procedure done I still have not fully made up my mind to go forward. Although it was comforting to here that there was minimal pain I am mostly concerned about the complications after the procedure you mentioned as well as further surgeries. I do know if I do not have the procedure I will be facing problems as well. Stuck on not knowing what to do. Thanks again
I have been advised by my ophthalmologist to have a YAG Laser Iridotomy, I am having concerns about this procedure, basically the after effects and or the pain during the procedure, If anyone out there have had this procedure done will you kindly share your experience and after affects. Thank you in advance.
I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
Bah humbug -- I had a beautifully written up reply and it just poofed. My computer has been acting strangely.
So I don't have a link to the article because Dr. Conner cut and pasted it into my email. If you google the title -- most of the sites you have to pay for the article. So here it is pasted.
Am J Ophthalmol. 2014 May;157(5):929-35. doi: 10.1016/j.ajo.2014.02.010. Epub
2014 Feb 14.
Dysphotopsia after temporal versus superior laser peripheral iridotomy: a
prospective randomized paired eye trial.
Vera V(1), Naqi A(1), Belovay GW(1), Varma DK(2), Ahmed II(3).
Author information:
(1)University of Toronto, Department of Ophthalmology and Vision Sciences,
Toronto, Ontario, Canada. (2)University of Toronto, Department of Ophthalmology
and Vision Sciences, Toronto, Ontario, Canada; Trillium Health Partners,
Mississauga, Ontario, Canada; Credit Valley EyeCare, Mississauga, Ontario,
Canada. (3)University of Toronto, Department of Ophthalmology and Vision
Sciences, Toronto, Ontario, Canada; Trillium Health Partners, Mississauga,
Ontario, Canada; Credit Valley EyeCare, Mississauga, Ontario, Canada. Electronic
address: ike.ahmed@utoronto.ca.
Comment in
Am J Ophthalmol. 2014 Oct;158(4):849-50.
Am J Ophthalmol. 2014 Oct;158(4):850.
PURPOSE: To determine if the location of neodymium:yttrium-aluminum-garnet laser
peripheral iridotomy (LPI) is related to the occurrence of postoperative visual
dysphotopsia.
DESIGN: Randomized, prospective, single-masked, paired-eye comparative clinical
trial.
METHODS: setting: Private subspecialty clinic in Mississauga, Canada. study
population: Patients with primary angle closure or primary angle-closure suspects
were recruited and randomized to receive LPI temporally in one eye and superiorly
in the other. Patients were masked to the location of treatment in each eye.
intervention: Temporal or superior LPI. main outcome measures: Occurrence of
new-onset linear dysphotopsia. Other visual disturbances also were assessed using
a questionnaire before and 1 month after intervention. Secondary outcome measures
included eyelid position, laser parameters, and any intraoperative complications.
RESULTS: A total of 208 patients were recruited to the study, of which 169 (84%)
completed it. New-onset linear dysphotopsia was reported in 18 (10.7%) eyes with
superior LPI versus 4 (2.4%) eyes with temporal LPI (P = .002). Eleven eyes
(6.5%) with superior LPI reported linear dysphotopsia despite complete eyelid
coverage of the iridotomy. No significant differences were found with other
visual disturbances between them. There was more pain experienced by the temporal
LPI (2.8 ± 2.2 vs 2.1 ± 2.0; P = .001), despite no difference in laser energy or
number of shots. Intraoperative rates of hemorrhage were similar (8.9% vs 10.1%;
P = .71).
CONCLUSIONS: Temporal placement of LPI is safe and was found to be less likely to
result in linear dysphotopsia as compared with superior placement. Temporal iris
therefore may be considered a preferred location for LPI.
Brilliant Sharon. Thank you.
How frustrating that you lost your first reply. Thanks for persisting and post this valuable information. Here is the link to the study abstract http://www.ajo.com/article/S0002-9394(14)00073-7/abstract, but as you point out to get the full article you have to pay for it.
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I understand. I am anxious about my second iridotomy next week and am hoping for a good result.
The after effects/complications of the procedure. Other follow up surgeries
One other thing I was going to mention is that -- because my angles are so narrow- - I can no longer have a dilated eye exam until the peripheral iridotomy is complete. Dilation of the eye could push the iris and totally occlude the angle - putting my right into acute angle closure glaucoma. As I await my left eye procedure, I've been careful to avoid any cold medicines (not that I usually take them anyway) or anything that will tend to dilate my eye -- as much as possible.
Oh -- I am sorry that you are feeling very bothered by this. For me, more information helps. Maybe that makes it worse for you. What are you bothered about the most?
In my case, I feel like the risk of the procedure is less than the risk of having an eye emergency with acute angle closure glaucoma -- especially in light of the fact that I have had such a rapid change in the closure over a four month period. It isn't an easy decision though because likely right now (like me) your vision is fine. It is disheartening to have "perfect" vision before the procedure and then this problem with the dysphotopsia after. [I live two hours away from my ophthalmologist -- so scary to think of experiencing acute angle closure glaucoma -- with only a short time to save my vision.]
Did your doctor give you a time frame in which you should have the iridotomy done? Mine said within 6 to 9 weeks. He was really surprised in September when he checked me with gonioscopy. He said that in May, he thought to himself that I wouldn't need any intervention for maybe up to two years. So I don't know why my eyes changed suddenly, but they did.
Thank you this whole procedure is a nightmare to me! just thinking about it!!!!!!!
Thank you Sharon for sharing your experience, it was very enlighten, Although I am scheduled in less than a week to have the procedure done I still have not fully made up my mind to go forward. Although it was comforting to here that there was minimal pain I am mostly concerned about the complications after the procedure you mentioned as well as further surgeries. I do know if I do not have the procedure I will be facing problems as well. Stuck on not knowing what to do. Thanks again
Because I have narrow angles.
I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it -- I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.
There is a photo of this lens in this article: http://emedicine.medscape.com/article/1844179-overview
Also, if you would like to see someone getting an iridotomy, here is a video clip: http://www.rootatlas.com/wordpress/video/645/how-to-perform-a-laser-iridotomy-video/
Also, I didn't mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think -- sometimes they hurt for a few days after getting poked at at the ophthalmologist's office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.
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1 ReactionBrilliant Sharon. Thank you.
How frustrating that you lost your first reply. Thanks for persisting and post this valuable information. Here is the link to the study abstract http://www.ajo.com/article/S0002-9394(14)00073-7/abstract, but as you point out to get the full article you have to pay for it.
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Helpful -
Hug
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