A laser is an instrument that produces a
pure, high-intensity beam of light energy.
The laser light can be focused onto the
retina, selectively treating the desired
area while leaving the surrounding tissues
untouched. The absorbed energy creates a
microscopic spot to destroy lesions or weld
tissues together. For many patients, laser
can preserve or prevent vision loss if given
in a timely fashion.
Who needs Laser suregery?
Your eye will almost always look and feel
normal with retinal diseases, even when
there is hemorrhaging and leakage in the
back of your eye. Your sight may also be
normal for a while despite the presence of
potentially blinding eye problems.
The only way to tell if you need laser
surgery is to have a careful, dilated
retinal examination, often followed by
special testing including OCT scanning and
fluorescein angiography (a photographic test
that evaluates the eye's circulation).
Lasers are commonly used to treat the
following eye conditions:
1. Diabetic retinopathy
Diabetes causes circulation problems
throughout the body, including the eyes,
nerves, and kidneys. The retinal blood
vessels are usually like pipes, bringing
blood into and out of the back of the eye.
In diabetes, however, the vessels may leak,
causing the retina to swell and not work
properly (diabetic macular edema). Vision is
affected when the swelling involves the
central vision area. Laser surgery can seal
the leaks, thereby preventing further vision
loss.
2. Retinal vein occlusions The small blood vessels that drain blood
from the retina (retinal veins) can
sometimes become blocked as part of the
aging process. This is more common in
patients with diabetes or high blood
pressure. A retinal vein occlusion can cause
the retina to swell with fluid and blood,
blurring central and peripheral vision.
Other times, new blood vessels may grow and
cause pain with very high pressure inside
the eye (neovascular glaucoma). Laser
treatment can help reduce this swelling or
cause the new blood vessels to disappear.
3. Age-related macular degeneration
Some people will develop aging changes in
the macula, the portion of the retina
responsible for our central reading vision.
Most will experience the less harmful dry
type, which usually causes minimal visual
changes. The more severe, or wet type,
causes the macula to swell with fluid and
blood. Symptoms of wet macular degeneration
include painless blurred or distorted
vision. Urgent treatment can often prevent
or delay vision loss in some patients with
this wet type.
4. Ocular histoplasmosis Most people in the Kentuckiana area have
been exposed to histoplasmosis, a tiny
plant-like organism (fungus) that causes an
asymptomatic or viral-type illness early in
life. There are often scars left behind in
the eye and lungs that usually cause no
symptoms. Some patients will develop new
blood vessels adjacent to an old
histoplasmosis scar. These vessels usually
cause painless blurring or distortion.
Urgent treatment can control these leaking
vessels, often preserving central vision.
5. Retinal breaks and detachment.
The retina lines the back of the eye like
wallpaper. Retinal tears or rips can occur
as part of an aging phenomenon, or following
cataract surgery or eye injury. Patients
will often see cobweb-like floaters or light
flashes when a retinal tear develops. Liquid
that normally fills the central portion of
the eye (the vitreous) can leak beneath the
tear, lifting the retina away from the eye
wall. This is called a retinal detachment,
which can cause blindness if left untreated.
Laser surgery around retinal tears is often
able to weld the retina to the underlying
eye wall. This can prevent or limit retinal
detachment.
6. Central serous chorioretinopathy (CSC)
CSC consists of one or more �blisters� of
fluid (serous detachment) beneath the
macula. It can cause central blurriness,
distortion, abnormal color vision, blind
spots, and temporary farsightedness.
Although the vast majority of cases will
resolve spontaneously, laser
photocoagulation is sometimes necessary for
persistent lesions.
7. Ocular tumors
Some patients will have non-cancerous
leaking vascular tumors that can cause the
retina to swell and not function properly.
Laser surgery can destroy these tumors and
allow the swelling to go away.
What happens during my surgery?
There are no special preparations before eye
laser treatment. You should eat normally and
take your regularly prescribed medications
before surgery.
Retinal laser surgery is performed in our
office. Eye drops will be given to dilate
the pupil and numb the eye. The treatment is
performed while you are seated in a chair,
similar to the one used for regular eye
examinations. You will remain awake and
comfortable. Treatment is usually painless,
although some patients may require a numbing
injection for discomfort or sensitivity to
the laser light.
The laser treatment usually takes less than
30 minutes to complete, and you can go home
immediately following surgery. Arrangements
for transportation should be made in advance
since you may not be able to drive right
away.
What are the restrictions and side effects
after laser?
There are virtually no restrictions
following retinal laser surgery, and you
should be able to resume your normal
activities and work schedule the following
day.
Most patients notice no vision changes
following their laser surgery, although
there may be some temporary blurring for
several weeks to months. In addition,
depending on the condition being treated,
some may notice a permanent blind spot or
decrease in peripheral and night vision.
Will I need more than one laser
treatment?
It will take several weeks to months before
we can tell whether the laser surgery has
been successful. Many patients, however,
will need more than one treatment to control
their eye problem and prevent further loss
of vision.
