retinal laser treatment

Video showing laser being applied to the retina

If you are found to have any problems in your retina like a retinal tear or diabetic retinopahthy, your doctor may recommend you have retinal laser treatment.

how is retinal laser treatment performed?

There are 2 ways in which retinal laser treatment can be done. The first is where you sit at a machine similar to how your eye doctor examines you (at the slit-lamp). Anaesthetic eye drops will be administered to numb your eye so that you do not feel pain and a special contact lens will be positioned on your eye to focus the laser beam. (Figure 1)

 

 

 

 

The second way in which it can be done is to get you to lie down and your doctor uses a head-set to focus the beam via a lens held in front of your eye. (Figure 2) This lens does not come into direct contact with your eye but we may need to depress your sclera (white part of your eye) with a blunt instrument in order to focus the laser into the very periphery of your eye to complete the treatment.

 

 

 

Laser treatment usually involves the laser beam (usually bright green) being absorbed by the retina and heating up. The surgeon modulates the power of the laser to create an adhesion, ablate unhealthy retina or stop leakage depending on the underlying problem being treated (Figure 3). If you feel pain at any time during the laser just let your surgeon know. 

Figure 1. Having laser retinal treatment.

(Image courtesy of NIH National Eye Institute)

Figure 2. Headset used for Laser indirect ophthalmoscopy

(Image courtesy of NIH National Eye Institute)

Figure 3. After laser Pan-retinal photocoagulation - the laser scars appear as round white dots. 

(Image courtesy of NIH National Eye Institute)

how do i prepare for laser treatment?

As this is an outpatient treatment, you can eat and drink as normal. You must take your medication as normal on the morning of the laser treatment (unless instructed not to). If your blood pressure or blood sugar levels are too high then your we may not be able to proceed with your laser treatment.

what are the possible after effects?

You will notice your vision will be all pink and darker in this eye compared to your untreated eye. This is because the laser is a bright green and your eye will take around 20 minutes to recover from this. This is normal, and your vision should return to how it was before the laser by the end of the day. 

 

It is also normal to have gritty, sticky eyelids and mild discomfort for a couple of hours after laser treatment as we use an eye gel to apply the contact lens. The eye drops can also take some time to wear off, and you should not be alarmed if your pupils are still dilated for several hours after treatment. Do not rub your eye for an hour after the laser as your eye will be numb due to the anaesthetic and you may not know if you're hurting your eye in the process. 

 

If any of these symptoms last longer than advised, or if you are worried about your eyes, call your eye doctor for advice. You can also visit your nearest Accident and Emergency (A&E) if necessary.

what do i need to do after i go home?

We may prescribe anti-inflammatory drops after your laser treatment. These help to minimise inflammation (but not infection) within the eye. People normally only have to take these for a week at most – the doctor will tell you how long you need to take them for. You do not usually need any antibiotics because your eye will not have an open wound as no incisions (cuts) are made in your eye for this type of laser. 

 

You will be seen in the outpatient department a week or two later to make sure your eye has responded well to treatment. You will have another check-up to see if the treatment was successful - sometimes it can take 3 to 4 months before we know if the laser has been effective. Also, depending on the type of laser, you may require 2 to 3 sessions per eye to complete the laser as it may be too much to do all in 1 sitting. 

 

You should be given a follow-up appointment before you leave the hospital after your treatment. If you have discomfort once you get home, we suggest that you take your usual pain reliever following the instructions on the package.

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