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Patient PortalLaser Peripheral Iridotomy (LPI)
A quick laser procedure to prevent angle-closure glaucoma and o protect your eye's natural drainage pathway.
What is Laser Peripheral Iridotomy?
A laser peripheral iridotomy (LPI) is a preventive laser procedure that creates a small opening in the iris (the colored part of your eye). This opening allows fluid to flow more freely from the back of the eye where it is produced to the front where it passes out of the eye through the trabecular meshwork. . Usually this is passes through the pupil but in narrow angles the pupillary opening is blocked, preventing fluid flow to the front of the eye and as well as from exiting the eye through the trabecular meshwork. If your angle is narrow, LPI lowers the risk of sudden pressure spikes from angle closure.
LPI is quick, performed in the office, and has minimal recovery. It is often recommended for patients with narrow angles, even if they have not yet suffered an acute angle-closure episode. Think of it as a preventive treatment — it removes the risk before it becomes a crisis.
When is LPI recommended? LPI is indicated when your eye angle is narrow (measured by gonioscopy or anterior segment OCT) and you are at risk for angle-closure glaucoma. It may be recommended for both eyes to prevent future problems. The procedure is preventive — it does not treat active glaucoma but rather prevents it from developing.
What to Expect — Before, During, and After
Before the procedure: You will sit at the slit lamp microscope as you would with any eye exam, except the microscope would deliver laser light instead of just illumination A contact lens with a mirror will be placed on your eye after numbing drops are applied. You may feel mild pressure but no pain. The laser will be focused as a spot on your iris and an opening created. This is a small additional opening to provide fluid flow in addition to that permitted by your pupil.
During the procedure: You will see a bright flash of light. A few laser pulses create a small opening in the iris. The opening is tiny — about the size of a pinhead — but allows fluid to flow freely. Total time is about less than 3-5 minutes.
After the procedure: Your eye may feel slightly irritated or scratchy but usually not. Vision may be slightly blurry for a few hours from protective gel drops that will wash away. Use anti-inflammatory drops for 1 week. Most patients notice no long-term effects.
Recovery timeline
- Same day: Mild irritation and possible slight blurriness. You may resume normal activities, including driving, later that day once vision has cleared.
- 1 week: Use anti-inflammatory drops as directed. Any irritation should have been resolved. The opening in the iris is patent allowing the aqueous fluid to flow freely
- 2 weeks: First follow-up visit. We confirm the iridotomy is patent (open) and check your pressure.
- 3 months: Final follow-up to confirm sustained angle widening and stable pressure. Return to routine eye exams.
Possible side effects: Rarely patients experience glare or halos around lights, from this tiny opening but that also means that the opoenkng is patent. This usually resolves within days to weeks. However an angle closure attack is far more disturbing and painful. Rarely, the opening may partially close and need retreatment. Infection is extremely rare when proper care is followed.
Your Follow-up Schedule
LPI requires minimal follow-up because it is a one-time preventive procedure. We check that the opening stays patent and your angle remains open.
What we monitor
- Iridotomy patency (opening remains clear)
- Angle appearance (widening confirmed)
- Intraocular pressure stability
- Absence of inflammation or complications
Our Outcomes — What EPSAZ Patients Experience
LPI is a preventive procedure, so we measure success by prevention of angle-closure events and maintenance of an open angle.
Why this matters: LPI is one of the most effective preventive procedures in ophthalmology. It eliminates the risk of sudden pressure spikes that can damage your optic nerve rapidly. Most patients who receive LPI never develop angle-closure glaucoma.