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What Is a Laser Peripheral Iridotomy (LPI)?

A laser peripheral iridotomy (LPI) is a quick laser procedure that creates a tiny opening in the peripheral iris. The goal is to relieve or prevent pupillary block so fluid can flow more freely from behind the iris to the front of the eye. This helps open the drainage angle and reduce the risk of angle-closure glaucoma. It is typically done in an outpatient clinic using numbing and pressure-lowering eye drops.

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What Is a Laser Peripheral Iridotomy (LPI)?

A laser peripheral iridotomy (LPI) is a quick laser procedure that creates a tiny opening in the peripheral iris. The goal is to relieve or prevent pupillary block so fluid can flow more freely from behind the iris to the front of the eye. This helps open the drainage angle and reduce the risk of angle-closure glaucoma. It is typically done in an outpatient clinic using numbing and pressure-lowering eye drops.

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Why an LPI Is Done

LPI is most commonly used in the primary angle-closure spectrum to reduce angle crowding from pupillary block. It may be recommended when an eye has narrow angles, after an acute angle-closure event, or when angle closure risk is high. In some secondary causes of angle closure with pupillary block, LPI can also be part of treatment. Your eye doctor confirms the mechanism with gonioscopy and other exam findings.

What to Expect During the Procedure

  1. Numbing drops and a special contact lens are placed on the eye to focus the laser.
  2. The surgeon delivers brief laser pulses to create a small opening in the iris, usually under the upper eyelid.
  3. Pressure is often checked shortly after, and anti-inflammatory drops may be prescribed.

You may see bright lights and feel brief pinching or pressure, but the procedure is usually short.

Recovery and Aftercare

It is common to have mild light sensitivity, redness, tearing, or blurry vision for a short time after LPI. Many people return to normal activities the next day, but your doctor may advise avoiding eye rubbing. Follow-up visits confirm the iridotomy is open and the angle is improved, and eye pressure is monitored. Some patients still need glaucoma drops or additional treatment depending on the underlying anatomy.

Risks and Side Effects

Most side effects are temporary, but complications are possible. A short-term eye pressure spike and inflammation can occur, which is why pressure checks and drops may be used. Some people notice glare or halos, especially if the opening is more exposed, and the iridotomy can rarely close and need repeat treatment. Seek urgent care for severe pain, worsening redness, sudden vision loss, or new flashes and floaters.

FAQs on Laser Peripheral Iridotomy

Does an LPI hurt?

Most people feel minimal pain because numbing drops are used. You may feel brief pressure or a quick pinch during laser pulses. If you feel significant pain, tell the clinician so comfort and positioning can be adjusted.

Is LPI the same as an iridectomy?

No. LPI uses a laser to make a small opening without an incision. An iridectomy is a surgical procedure where a piece of iris tissue is removed, usually done in the operating room for specific indications. Both aim to improve fluid flow, but the methods differ.

Will LPI cure glaucoma?

LPI can prevent or treat angle closure related to pupillary block, but it does not cure all glaucoma. Some people still need eye drops, laser trabeculoplasty, or surgery to control eye pressure. Your doctor will tailor follow-up based on your pressure and optic nerve status.

What side effects should I watch for after LPI?

Call promptly for severe or increasing pain, marked light sensitivity, thick discharge, sudden drop in vision, or worsening redness. Mild blur and irritation can be normal early, but symptoms should improve rather than worsen. New flashes or a curtain-like shadow also needs urgent evaluation.

References

Laser Peripheral Iridotomy. EyeWiki. https://eyewiki.org/Laser_Peripheral_Iridotomy. Date Accessed February 9, 2026.

Laser Iridotomy: Frequently Asked Questions. Glaucoma Research Foundation. https://glaucoma.org/articles/laser-iridotomy-frequently-asked-questions. Date Accessed February 9, 2026.

Laser Peripheral Iridotomy: Surgery for Narrow-Angle Glaucoma. BrightFocus Foundation. https://www.brightfocus.org/resource/laser-peripheral-iridotomy-surgery-for-narrow-angle-glaucoma/. Date Accessed February 9, 2026.

Glaucoma. StatPearls (NCBI Bookshelf, National Institutes of Health). https://www.ncbi.nlm.nih.gov/books/NBK538217/. Date Accessed March 16, 2024.

Rethinking Laser Iridotomy in Angle-Closure Disease. PubMed Central (National Library of Medicine). https://pmc.ncbi.nlm.nih.gov/articles/PMC11001235/. Date Accessed February 9, 2026.