What are the Side Effects of an Iridotomy?

A. Pasbjerg

Patients with angle closure glaucoma who have an iridotomy, a procedure which uses a laser to create a hole in the iris to allow ocular fluid to drain, may experience a number of side effects from the procedure. The most common complaint patients have is blurred vision. Some people may have a spike in the pressure levels in the eye that has had surgery; others sometimes have swelling, inflammation, or bleeding in the eye. Sometimes the opening that was created will close up. In certain cases, patients may have visual disturbances like glare, clouding, or lines in their vision after having surgery.

Blurred vision is a common complaint of iridotomy patients.
Blurred vision is a common complaint of iridotomy patients.

The problem most patients notice after an iridotomy is blurring of their vision. This is not typically cause for concern and clears up quickly. Most patients can expect it to go away within 30 minutes of surgery.

Any kind of eye surgery comes with a certain amount of risk for complications.
Any kind of eye surgery comes with a certain amount of risk for complications.

Another side effect of iridotomy that affects some people is a spike in intraocular pressure, or IOP. This issue is less common and typically occurs within a day after surgery. If it persists, further medical intervention may be necessary to decrease the pressure.

Iridotomy creates a hole in the iris to allow the draining of ocular fluid.
Iridotomy creates a hole in the iris to allow the draining of ocular fluid.

Patients can also develop a variety of uncomfortable issues after an iridotomy. There may be inflammation in the eye, which typically subsides after several days but may last up to a month. Topical corticosteroids may need to be used to reduce the inflammation. The eye may also become swollen and sore, and some patients may also have bleeding. In rare cases, scratching, burning, or abrasions to the cornea, pupil, or inner lining of the eye can occur during surgery, which may lead to further complications.

The purpose of a laser iridotomy is to create an opening for blocked fluid to drain out of the eye. In certain patients, that hole may spontaneously close itself some time after the surgery. This may lead to the patient needing a second surgery to re-create an opening for drainage.

Though fairly rare, long-term visual disturbances may be a problem after iridotomy. Some people notice that they have clouding in the lens of the eye. Others complain of glare from lights or may experience double vision. Horizontal lines may appear intermittently in their line of vision. Occasionally, patients complain of a loss of vision, though this side effect is very rare and may be related to irritation of the eye or cataract development; anyone who experiences this problem should be checked by their doctor.

An iridotomy is accomplished with a cutting laser.
An iridotomy is accomplished with a cutting laser.

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Discussion Comments


How long should your pupils stay constricted after surgery?


Overall, I think that I have had no side effects. Within a month I did have a lower incidence of headaches. It’s only been one year.


Iridotomy is sometimes done in conjunction with glaucoma surgery. They usually do this when the patient also has cataracts, so it's mostly done on older patients, I think.

My grandfather has to have it done. Luckily he went for a regular checkup at the optometrists and they managed to catch the glaucoma. He knew about the cataract, but he was only covered by the state to get one eye fixed and did that a while ago.

Now that he's got the glaucoma as well, ironically they are going to take off the other cataract while their at it.


I had a friend who managed to get a melanoma on her iris. Apparently, one of the things they don't really emphasize when talking about sun safety is that the eye can get "skin" cancer as well.

She had to have an iridotomy in order to remove it, and she's fine now. But she could have easily ended up much sicker, or even died.

The best way to prevent melanoma of the eye is to wear sunglasses when you're in the sun, as much as possible.

And make absolutely sure they are rated to protect the eyes from UV rays. There are quite a few fancy looking, expensive sunglasses that do nothing except let your pupil open up wider, thinking it's in the dark, but don't block the rays. Wearing those is worse than wearing nothing, apparently.


Even though it seems like a very delicate area, generally surgery of the eye is quite successful. I researched it while I was thinking about having laser eye surgery.

From what I could see, most eye surgeries, like an iridotomy, end up with very few long term problems. The eye is delicate, but it's also got a really good ability to heal itself.

In fact, generally the only problems occur when people cause them by not keeping the area clean or keeping their eye covered. Infection is one of the worst scenarios, and it's often quite within the patient's control to prevent it from happening.

So, if you are having eye surgery of any kind, don't get impatient. Just let it heal the way the doctor ordered.

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