Peripheral Iridotomy Personal Experience
What is a YAG PI?
YAG is the acronym for Yttrium aluminium garnet used in laser eye surgery at a wavelength of 1064 nm that is infra-red. The PI is shorthand for peripheral iridotomy.
Does it hurt?
No. It feels like a retractable spring pen point released. As if an extended pen was up against the eye and then retracted. The laser has a clicking sound and it feels like a tap.
Why perform the preventive the laser eye surgery to prevent glaucoma closed angle blindness?
Acute angle-closure can cause excruciating pain that will result in total blindness within hours.
How much does it cost?
My copay under Medicare AARP UnitedHealthcare was $150.
What does my eye look like afterwards?
See post operative photos at right.
I freaked out!
I am writing this for others so that people don't freak out like I did when I found out that I could go blind within hours because of high interocular pressure.
My Hispanic Grandmother on my mother's side had glaucoma and I grew up with the knowledge that it skips generations on the female side. I have had free glaucoma screenings sponsored by the Lions Club throughout the years during February because it is glaucoma awareness month.
Don't sleep with your arm over your eyes
I have already partially blinded myself about 10 years ago. At first I thought it was a smudge on my eyeglasses. I went to an eye doctor and he took a picture of my eyeball. He asked me if I sleep with my arm covering my eye. I said yes. He says don't do that anymore.
He explained to me why.
#1 Age-Related Macular Degeneration, (AMD), shows up in the center of vision. Mine was off center, up and to the left in a irregular pattern.
#2 I was 40 years old and the onset of AMD is around 60.
#3 The blood vessels in your eyes are the smallest in your body and therefore any pressure over an extended period of time will kill off your receptors at the back of your eyeball.
Pressure kills the rods or cones that accept light at the back of your eyeball. Ever since then I thought about that whenever I saw a blindfolded prisoner on TV and wondered if somebody blindfolded a person too tight if that would make the victim permanently blinded afterwards.
I was very nervous because I googled online all the things that could go wrong but disregarded the information that complications are extremely rare. I expected the worst.
Pre-check showed that my heartbeat was pounding and my blood pressure was way up. It didn't help that the nurse said, "You do realize that it's going to hurt."
Wh-what? NOW you tell me? 2 minutes before it happens?
The doctor warned me that if was going to feel like a "Poke in the eye."
NOW I"m really nervous!! I was so hyped up that the first click of the laser beam, I jumped back and started crying. I made the doctor nervous. I told him that it didn't hurt and that I cry at sad ATT commercials. I cried because of the emotional release.
It was four clicks on each eye and it was over in 5 minutes. Afterwards they measured my heartbeat and it was 160! I was really 'over the top' nervous!
I told the doctor NOT to use the word 'poke' in describing the feeling. And do not have the nurse say that 'this will hurt' because I was imagining something a LOT WORSE than what actually happened.
I can tell you what it is NOT like:
It is NOT like the eyeball scene in the 1971 movie 'A Clockwork Orange'.
It is NOT like having a hypodermic needle injection at the dentist office.
It is NOT like looking at an arc welding light for 1/3 second without a protective electric welding mask that makes your eyes feel like two cigarettes were put out in your eyeballs and hurts for three days. You should never ever look at an arc welder like I did.
Now that I've gone over the one thing that I think most people fear: pain, I will explain what the doctor told me.
#1 Went in for routine glaucoma exam. Normal intraocular pressure is anywhere from 10 -20. My eye was at 23 as measured by the Goldmann tonometry device with the tiny mirrors and not the 'puffer' machine used 20 years ago.
#2 Doctor said that the intraocular pressure has nothing to do with blood pressure or sinus pressure.
#3 Doctor told me that if I had an acute attack of closed angle glaucoma to NOT to go to the ER but directly to an ophthalmologist. Until have the YAG-PI, do not watch TV without having any room lights on. Flashing lights may bring an acute closed-angle attack because when the iris dilates, it folds like an accordion, the dilation could 'fold wrong' and bring on an acute closed-angle attack. I asked the doctor, "Wouldn't sleeping with my eyes closed make my eyes dilate?" The doctor said that there is no pupillary response during sleep.
#4 I do not have to fear that I would wake up blind because the pressure can shoot up to 90 and that it would be excruciatingly painful and won't sneak up on me unnoticed.
#1 Eye drops were given to make my pupils pinpoint small and to numb out my eyes.
#2 After a few minutes to allow the eye drops to work, doctor inserts a type of contact lens on the eye to keep the eyelid open.
#3 Doctor instructs to look at a point and keep it there. The doctor then says "Here's the first one." A short click as if an retractable pen was released is heard and felt. After the fourth click the doctor asks if I "see a red light', which I responded, "Yes."
#4 Other eye is done and whole process is less than 5 minutes. I was able to drive myself home.
Although it is nice to be able to ask the Internet about complications and watching videos, I suggest to avoid that because there is an inherent visceral fear regarding our eyes.
The loss of eyesight is the scariest fear of all the senses. People do not fear the loss of hearing or smell as much as going blind. The fear of vision loss is greater than having cancer, HIV/AIDS, heart disease or stroke according to the American Foundation for the Blind
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