Laser Peripheral Iridotomy

Laser peripheral iridotomy, also known as LPI, is a laser procedure used to lower eye pressure in patients with narrow-angle glaucoma. Narrow-angle glaucoma is a condition that occurs when the angle between the iris and the cornea in the eye is too small, resulting in a blockage of fluid in the drainage channel of the eye. Using a laser, a small hole is made in the iris to increase the angle between the iris and cornea allowing fluid to drain from the eye.

Laser peripheral iridotomy is an outpatient procedure. Patients are given eye drops to constrict the pupils. Once these have taken effect, an anesthetic is applied to the eye and the laser treatment can begin. The doctor precisely targets a spot in the periphery of the iris and uses laser pulses to create a tiny hole. The procedure is completed in a few minutes and most patients experience little to no discomfort.

After the laser treatment, the patient’s intraocular pressure will be monitored several times to ensure the LPI was successful. Patients may experience irritation and blurry vision after the procedure which should disappear within a few days. Topical corticosteroids will need to be applied to the eye for approximately one week to prevent swelling and promote healing.

Ocular Hypertension

Ocular hypertension is a condition where the intraocular pressure (IOP) in the eyes is higher than normal. A normal pressure reading falls between 10 mm Hg and 21 mm Hg. Anything greater than 21 mm Hg is considered hypertensive. The increased pressure is caused by a problem in the drainage of fluid produced in the eye.

Symptoms of Ocular Hypertension

Patients with ocular hypertension typically exhibit no changes to their vision or damage within the eyes. No symptoms of glaucoma are present, and the optic nerve is unharmed. It is important to follow up with regular examinations, since those with ocular hypertension are more likely to develop glaucoma.

Risk Factors for Ocular Hypertension

Ocular hypertension may strike at any age, but it is most common in people older than 40. Other individuals at higher risk for this condition include those with the following:

  • Inadequate flow of fluid in the eye
  • Eye injury
  • Complication of medication
  • Family history of hypertension or glaucoma
  • Diabetes
  • African-American
  • Nearsightedness

Diagnosis of Ocular Hypertension

A diagnosis of ocular hypertension is made after the eye pressure is measured using a tonometer. In addition, visual acuity and peripheral vision tests will be performed to rule out glaucoma as the cause of high eye pressure.

Treatment of Ocular Hypertension

Ocular hypertension requires regular monitoring of intraocular pressure during regularly scheduled appointments. Medication and laser treatments have been used as methods to increase outflow.

Optical Coherence Tomography

Optical coherence tomography, also known as OCT, is an imaging system that uses light waves to produce a high-resolution view of the cross-section of the retina and other structures in the interior of the eye.

Conditions Detected With an OCT

The images can help with the detection and treatment of serious eye conditions such as:

  • Macular hole
  • Macular swelling
  • Optic nerve damage
  • Age-related macular degeneration
  • Macular pucker
  • Glaucoma
  • Cataracts
  • Diabetic eye disease
  • Vitreous hemorrhage

OCT uses technology that is similar to that of a CT scan of internal organs. With the scattering of light it can rapidly scan the eye to create an accurate cross-section. Each layer of the retina can be evaluated and measured and compared to normal, healthy images of the retina.

The OCT exam takes about 10 to 20 minutes to perform in your doctor’s office, and usually requires dilation of the pupils for the best results.

Selective Laser Trabeculoplasty

Selective laser trabeculoplasty, or SLT, is an FDA-approved laser procedure for the treatment of open-angle glaucoma. SLT is an advanced treatment option that lowers eye pressure and increases fluid drainage. It is minimally-invasive and uses low levels of energy to selectively pinpoint the areas of the trabecular meshwork, relieving the symptoms of glaucoma. If needed, the procedure can be repeated several times without causing damage to surrounding tissue.

Advantages of SLT for Glaucoma

Performed as an in-office procedure, SLT takes just a few minutes yet provides long-term results. Other advantages of the SLT procedure include:

  • Selective targeting of areas within the trabecular meshwork
  • Minimal damage to surrounding tissue
  • Reduction of intraocular pressure (IOP) by about 30 percent
  • Minimal side effects
  • Procedure can be repeated

SLT controls glaucoma symptoms for up to 5 years with no need for additional medication, and relieves symptoms by promoting the body’s natural healing response. There are no major risks or complications associated with SLT and the procedure is covered by most major insurance companies.