YAG Laser Iridotomy Complications

Posted by jigglejaws94 @jigglejaws94, Sep 25, 2016

Has anyone had a laser iridotomy with resultant “ghost images” or a crescent of light in field of vision?

Liked by agoldstein

@karen888

when did you do iridotomy?

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October 2015 the month I turned 50 lol
some more about me; have been farsighted since 2.5 years old, had lasik for my farsightedness and astigmatisms in 2002. I am in glasses again, but not a strong prescription as prior to that.

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@quincy9

October 2015 the month I turned 50 lol
some more about me; have been farsighted since 2.5 years old, had lasik for my farsightedness and astigmatisms in 2002. I am in glasses again, but not a strong prescription as prior to that.

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and since then you have side effects?

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@karen888

and since then you have side effects?

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Yes. New side effect being streak/glare. One for each eye done.

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Aren't they less now?

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@aliskahan

Hi @jigglejaws94, welcome to Connect. I found some information on laser iridotomy that says the following:

“Mild light sensitivity and a scratchy feeling on the surface of the eye are also common for 24-72 hours after the procedure. Very rarely, the patient may experience an extra “ghost image” through the tiny opening in the iris. This may be annoying for a while but almost all of the few patients who develop this complication eventually get used to it.” Here is the article in case you’d like to read it in-depth: http://bit.ly/2d3Alam

Since this is a more rare side-effect, you may still want to follow up with your doctor about what you’re experiencing. I’m also tagging @jinngee who has written about laser iridotomy in the past and might be able to weigh in as well. How long ago was your procedure?

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Do the side effects go away over time?

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@jigglejaws94

Hello — I'm glad that my posts helped someone — you! I do still see the crescent of light near the bottom of my field of vision for my right eye which had the iridotomy at about the 12 o'clock position. I don't think I notice it as much anymore. And I only notice it under certain lighting conditions. Bright sunlight is the worst — and especially when driving. I find that wearing sunglasses helps immensely. I was never one to wear sunglasses much but I sure do now. My left eye was the temporal position. I have very little difficulty with any light abberration in that eye. Once in a great while, if the light is very bright and at an odd angle, I will see a little bit on the lateral side of my vision which is vertical. I wish that I had done extensive homework before I had my right eye done — but I didn't anticipate trouble, nor did my ophthalmologist. Had I known that I would get a dysphotopsia — I would definitely have requested the temporal position for both eyes. I hope that with some time — maybe up to even a couple of years — that this light streak in your visual field will lessen.

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Do you still have side effects ?

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@jigglejaws94

Hello — I just had a Yag laser iridotomy done in my right eye about 3.5 weeks ago. The reason is because I have narrow angles and my ophthalmologist said that there was a rapid change in the angles over a four month period — so much so that he has never had a patient progress so rapidly. Anyway — I did not find the laser procedure itself to be painful. It felt like a little pinch in the eye and I believe it took about 5 “hits”. Unfortunately, my physician didn’t really warn me about what the after effects could be. You will likely be given a drug called pilocarpine which causes your pupil to constrict. It apparently also helps with thinning out the iris so that a good spot can be found to place the iridotomy. But it constricts the pupil for about 12-16 hours (or at least that is how long it lasted for me). I experienced very hazy vision for that same length of time also. Felt like I was looking through a brownish wedding veil or through a haze. About an hour after the procedure, I detected a light aberration — which appeared as a horizontal line of light across my field of vision. Over the next few days, that progressed to more of a blob of light or a crescent of light in the mid to lower visual field. It does not bother me all the time but is worse in bright light and I notice it he most when I drive.

The placement of my iridotomy was in the superior position which is somewhere between 11 and 1 o’clock position. I felt good about that position because my eyelid would cover the iridotomy hole. However, that is not a guarantee that you will not experience dysphotopsia (glares, haloes, crescents, etc) following the procedure. In fact, there is some literature that indicates that some patients still experience this phenomenon even when the eyelid fully covers the iridotomy hole. It is especially worsened if your eyelid only partially covers the hole (and I think that may be my situation).

I spoke on the phone with my doctor the following week. I let him know that I had done some online research and found that there was quite a bit of information regarding the horizontal approach — at the 3 or 9 o’clock position — and that the indication was that there was less problems with light aberration at this position. He said that the trend is to do it at the 3 or 9 o’clock position but that he prefers to do it at the superior position based on a study that came out about 10 years ago indicating that 9 percent of people will notice some light aberration in a fully covered iridotomy, 18 percent experience the same with a completely exposed iridotomy site and 27 percent with a partially covered. So he says that the risk of experiencing this doubles with a fully exposed iridotomy. HOWEVER, there is a lot of literature that indicates that the patients who get the 3 or 9’oclock position (referred to as either on the horizontal meridian or temporal position) have far less difficulty with dysphotopsias.

I am scheduled to have my left eye done on October 26th. My physician said he is happy to place the iridotomy in the temporal position, if this is what I prefer. Well, I don’t like the weight of the decision on me — because I’m not a doctor. So I wrote up an email describing my situation and sent it to about a dozen professors specializing in Glaucoma and several of the leading medical school ophthalmology programs. I have received answers back from about 5 physicians. Four of those recommend the horizontal approach. Two of them sent me a reference to a study and if you would like that forwarded to you, you can let me know your email.

It has been frustrating because prior to the procedure — my vision was perfectly fine. Now, I have to deal with this problem. So I want to do everything in my power to understand and be educated on what the best approach for my left eye. I know that though my vision was perfectly fine and now it is messed up — that I am a ticking bomb waiting to go off — and could easily develop acute angle closure glaucoma and be in an eye emergency in short order.

Hope this information is helpful somehow.

Sharon

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in my opinion iridotomy is the worst thing. It changes the structure of the eye and the vision. It should be conducted when there is nothing else that can help. Iridotomy should be conducted in rare cases.

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@jigglejaws94

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.

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I did iridotomy and now I am suffering of side effects. I wish I have never done it. the worst decision I have ever made.

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@jennyone

Thank you this whole procedure is a nightmare to me! just thinking about it!!!!!!!

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Its nightmare to me too

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Has anyone had daily headaches as a side effect?

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@karen888

Aren't they less now?

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no they’re the same.

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@karen888

I did iridotomy and now I am suffering of side effects. I wish I have never done it. the worst decision I have ever made.

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What side effects do you have?

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@karen888

I did iridotomy and now I am suffering of side effects. I wish I have never done it. the worst decision I have ever made.

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I'm sorry to hear that you have had so many problems and feel like it was a terrible decision to have had iridotomy. I was troubled with the dysphotopsias immediately following the procedure but now that I am 3 years post procedure — it is far less of a problem. I hope with time that you have improvement. I'm glad I had mine done as I now have that "relief valve" in place — especially since I am 2 hours from my ophthalmologist.

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Below is an article between Ophthalmologists at a round table discussion. I found it very informative.
https://www.aao.org/Assets/54973b23-da0e-450b-8b5c-c1ebb322cdde/635584956589700000/february-2015-clinical-update-glaucoma-pdf

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@quincy9

no they’re the same.

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how long passed since then?

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