The Ophthalmologist that examined Bill yesterday did a full examination and he has decided that Bill has pigment dispersion syndrome even though he is over the age of 40 and has had glaucoma for years. He has put drops in his eyes since he was in his early 30′s and has undergone laser surgery twice to put little holes in his eye to relieve pressure and still the pressure isn’t under control, the drops aren’t working for him. So on June 4th he will have a procedure called laser iridotomy done. The consent form that we have to sign explains the procedure like this:

Consent To Perform Laser Iridotomy

Purpose: A laser iridotomy is a hole created in the iris in the eye by means of a laser light. This procedure replaces a surgical procedure that must be performed in the operating room. When argon laser is used, the energy of the laser is transformed into heat at the point where it’s focused, creating a small burn. By placing multiple burns close to each other, it’s possible, in most cases, to create a small hole in the iris. A neodymium-Yag laser causes a cut at the point where it’s focused. If several of these cuts are superimposed, a small hole is created, in most cases.

Method: Several factors (such as eye color) must be considered by your doctor in determining which laser is most appropriate for your eye. Sometimes one type of laser is not satisfactory and the other type of laser must then be utilized. The eye is anesthetized with an eye drop, a special contact lens is placed onto the eye and a sufficient number of applications is applied. Slight discomfort may be felt as the laser light strikes the iris.

Complications: In almost all cases, the eye will be red and have a foreign body sensation for a few days. The vision is typically a bit blurry for a few days as well. These are not serious problems. In 25-30% of eyes in which the argon laser has been used to create the iridotomy, retreatment is necessary because the body tends to heal over the hole. The retreatment rate is much less with the YAG laser. The YAG laser sometimes causes a small hemorrhage at the iris at the site of focus, but it always clears within a few days.

There may be a transient rise in pressure within the eye following the procedure, but this can usually be controlled with medications if necessary. Burns of the cornea and/ or lens can occur, but these do not usually affect vision and can be left alone. Although it’s not a complication, the laser procedure alone does not always control the glaucoma, and drops, other types of laser treatment, or surgery, are sometimes required in addition to the iridotomy.

The young doctor was very nice and explained everything as he went along and he really put our minds at rest about Bill not losing his sight anytime soon. He explained that he would do this procedure in his office and that it was less evasive than the other procedure that we had done last year at the hospital. He seemed very confident and told us in the past 12 years he hadn’t seen any of the slits close back up so we’re very hopeful that this will help and may even lessen the drops he has to use everyday.

Of course Bill asked him if he knew his daughter Jodi the nurse because she had mentioned to her dad that he performs surgery where she works although she has never assisted him and he does know her and was very concerned because he had already heard about her ectopic pregnancy and voiced his concerns. Bill assured him that she was recuperating, it helped Bill in his mind to establish a bond that they both shared namely his daughter Jodi, now he feels like the doctor will take better care of his eyes.

I liked the young man and am quite sure he would have taken great care regardless of Bill’s daughter. He assured us that if plan A doesn’t work he will have a plan B ready. We did learn something useful yesterday that we didn’t know before. Bill always takes the rest of the day off work when they dilate his eyes because it takes forever to go back to normal. Yesterday we found out they have reverse drops they can put in your eyes to make the process a whole lot quicker.

So now we have to wait for the procedure which is easier now since we know his eyeballs aren’t going to explode any time soon from pressure. Have a great weekend.

Tags: glaucoma, laser iridotomy, pigment dispersion syndrome