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To the Editor.
—Excessive use of laser trabeculoplasty can result in extensive damage to the trabecular meshwork and in excessively high intraocular pressures. Unfortunately, this laser treatment of the trabecular meshwork may be done by the ophthalmologist who is unaware or misinformed about previous laser therapy to the trabecular meshwork. Good medical practice requires that a history be taken, including previous surgical and medical therapy. However, the patient often is unaware or does not understand what laser therapy was given, how many burns were applied, and which part of the eye was treated. Many patients with uncontrolled glaucoma will seek second and third opinions regarding their ocular management. The consulting ophthalmologist may decide that laser trabeculoplasty is needed, and, being given a vague history by a patient who is unaware that previous laser trabeculoplasty has been done, will give a full laser trabeculoplasty treatment.I have seen three patients treated
Freedman J. Laser Trabeculoplasty Alert Mechanism. Arch Ophthalmol. 1986;104(8):1134-1135. doi:10.1001/archopht.1986.01050200040035