Laser photocoagulation uses the heat from a
laser to seal or destroy abnormal, leaking blood vessels in the
retina. One of two approaches may be used when
treating diabetic retinopathy:
Focal treatment is used to seal specific leaking blood vessels in a small area
of the retina, usually near the
macula. The ophthalmologist identifies individual
blood vessels for treatment and makes a limited number of laser burns to seal
Scatter (pan-retinal) photocoagulation. Scatter treatment is used to slow the growth of new
abnormal blood vessels that have developed over a wider area of the retina. The
ophthalmologist may make hundreds of laser burns on the retina to stop the
blood vessels from growing. The person may need two or more treatment
Laser photocoagulation is usually not painful. The
injection of anesthetic may be uncomfortable. And then you may feel a slight
stinging sensation or see brief flashes of light when the laser is applied to
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Laser photocoagulation is usually
done as an outpatient procedure using a local or topical anesthetic that
affects only the eye. You do not have to stay overnight in a hospital.
You will need someone to drive you home from the doctor's office or
clinic after the procedure. Eyedrops are used to widen (dilate) your pupils
before the procedure. And your eyes will remain dilated for several hours
afterward. Wear sunglasses to keep bright light out of your eyes while they are
Your vision may be blurry and your eye may hurt a
little for a day or two after the treatment.
Be sure to keep all
follow-up appointments with your doctor and report any changes in vision that
you notice. Follow-up treatment can make a big difference in keeping
your vision for the long term.
Why It Is Done
Laser photocoagulation is done to
reduce the risk of vision loss caused by diabetic retinopathy. It is most often
used to stabilize vision and prevent future vision loss rather than to improve
vision loss that has already occurred. (Sometimes focal photocoagulation for
macular edema caused by
nonproliferative retinopathy can help restore lost
Laser photocoagulation may be used to treat and prevent
further progression of:
Macular edema. Focal photocoagulation is usually used
in these cases.
Proliferative retinopathy. Scatter
(pan-retinal) photocoagulation is used to treat proliferative
How Well It Works
Laser treatment may not restore
vision that has already been lost. But when it is done in a timely
manner, laser treatment may reduce the risk of future vision loss.
Laser photocoagulation burns and destroys part of
the retina and often results in some permanent vision loss. This is usually
unavoidable. Treatment may cause mild loss of central vision, reduced night
vision, and decreased ability to focus. Some people may lose some of their side
(peripheral) vision. But the vision loss caused by laser treatment is mild
compared with the vision loss that may be caused by untreated retinopathy.
Rare complications of laser photocoagulation may cause severe
vision loss. These include:
Accidental laser burn of the fovea (a depression
in the central macula that contains no blood vessels). This results in severe
central vision loss.
What To Think About
The biggest drawback to laser
photocoagulation is that the laser damages some of the light-sensitive nerve
cells in the retina and macula. This often results in some vision loss.
But the immediate vision loss caused by laser treatment must be measured
against the more severe vision loss that could result from untreated
retinopathy. For people who have diabetic retinopathy, laser photocoagulation will very likely help prevent more severe vision loss over time.
Diabetes experts agree that early detection and treatment of retinopathy
can prevent many, or even most, cases of severe vision loss and blindness in
people who have diabetes.
Be sure to keep your blood
sugar levels low after laser treatment. Even if your eyes are better, diabetic
retinopathy will keep getting worse over time if your blood sugar levels rise
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If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
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