Should i have a laser iridotomy before i develop glaucoma? during a recent eye exam, my doctor told me that i have narrow angles and told me about a surgery that i can have now to prevent acute glaucoma when i'm older. do i need to be concerned at age 34,

No : No reason for any treatment and there is no guarantee that it would prevent a problem when you got older. More important is to follow up reguarly with an ophthamologist who can evaluate and treat if necessary in the future.

Laser : Laser peripheral iridotomy (lpi) is recommended for patients with anatomical narrow angles. The procedure create a small opening in the peripheral iris which will decrease the likelyhood of developing an acute angle closure attack. Acute angle closure rarely develops in patients even with narrow angles but... If you should develop one it will cause excruciating pain due to severely elevated eye pressure. And due to the increased eye pressure the patient can become blind unless the pressure is brought under control quickly. For this reason, it is considred a true emergency. If you been diagnosed with narrow angles, chances are that you will never develop acute angle closure but is that a chance you want to take?

Angle closure is Bad: Angle closure glaucoma is far less common than open angle glaucoma. The pathology is based on an anatomical narrowing of the drainage site where fluid made inside the eye drains out. Think plumbing: a clogged drain backs up, and in the eye the pressure increases dramatically. Very painful and vision can be lost entirely in a few hours. High risk patients should be treated, but only if high risk.