Should I have laser treatment for narrow angle eyes?

[TT-tt]

hi

I've recently been diagnosed with narrow angles (20%). The consultant (NHS) has recommended laser iridotomy. It was thought there was a strong history of glaucoma in the family but I've since discovered this is incorrect. Instead there is a history of cataracts. I am now thinking that perhaps I won't need the iridotomy after all. I would prefer monitoring instead but tbh I'm really terrified of having anything done to my eyes as they are otherwise normal. I've been unsuccessful in trying to have a second consultation with the Consultant to explain family history as it has been impossible to speak to anyone at the clinic (have left messages twice etc but no response). I also have dark brown eyes which I believe is more difficult with laser. Ahhh all of it seems so worrying...

[Ritualhazard]

for what it’s worth, I had a history of slightly elevated IOP but wasn’t monitored through Covid. I had acute angle closure one day and probably would have lost my sight if it wasn’t for the advice given to me by a paramedic friend of mine. No warning, just happened one day. I’ve since had iridotomies to open my angles which has been a complete success. However, since then I’ve had all sorts of issues with IOP spikes and am now booked in for the first of two trabeculectomies. I can’t say for sure that one caused the other but there is certainly a correlation. You don’t say what your IOP is but if was me I would go for the treatment. Acute angle closure can cause you to go blind in hours. The treatment really doesn’t hurt (except I had a really bad headache from one of the dilating drops they used, it went after a few hours) and takes just minutes. Hope that helps and happy to answer any other questions related to my experience. Good luck

[TT-tt in reply to Ritualhazard]

thank you both so much for your replies. I looked up my IOP which is 15 in both eyes and the report mentions 20 degrees grade 2. Any insight to these numbers would be very helpful. Again, thank you both.

[Ritualhazard in reply to TT-tt]

I don’t know about the angle but your IOP is normal which is good (normal range is approx 10-21 so youre nicely in the middle). However, if your angles are narrow and your IOP goes up for any reason ( due to the reasons given by lovemy2woofs below) you are at risk of angle closure which is acute and can damage your sight very quickly. Maybe someone else can tell you what the other numbers mean.

[TT-tt in reply to TT-tt]

ok thank you that's really helpful. Wishing you all the best with the trabeculectomies as well.

[Lovemy2woofs]

I have narrow angles diagnosed last year . I was told that they would have just monitored me, but as diabetic and that I need to have my pupils dilated yearly when I have my diabetic retinopathy screen, it was advised for me to have irridotomy .

I had them both done at same time , it didn’t hurt , though a few times it was uncomfortable . I did have a bleed which was quickly stopped by the consultant pressing for a few seconds.

One of my eyes was hard to do ( blue eyes ) but luckily the consultant gave it another go and managed to do it ok , as I didn’t want to be rescheduled .

If I had to have it again, I would , hoping mine lasts ..

With narrow angles if you don’t get anything done , do not use antihistamines and watch some medications and avoid things where cause you pupils to dilate best you can .

Don’t be put off having it done , thinking it will hurt etc…. It’s not painful and it’s a fairly quick procedure .

[Helen_GlaucomaUK Administrator]

The drainage angle is graded to measure how open or narrow it is. Grades 1-2 are narrow with grade 1 being more narrow than grade 2. Grade 3-4 is open drainage angles.

The percentage will probably be that it is 20% of your angle is narrow at grade 2. What the other 80% grade is, I wouldn't know but you could always ask about this and ask them to explain it to you.

Risk factors are also taken into account as you mentioned. Family history, age, short sightedness. It does sound as if you would really benefit from another appointment to see your eye specialist, so you can make a well informed decision to whether you go ahead with the iridotomy.

The lovely people here have explained what could happen if prevention of some sort isn't done, although no one is able to tell you that acute angle closure glaucoma will or will never happen in the future in your case.

[TT-tt]

Thank you that's really helpful. I'm definitely going to have another appointment first. (I hope they will be able to as it is NHS). Btw everyone on this site have been so helpful - honestly - amazing!