PRP is used to treat proliferative diabetic retinopathy and neovascularization due to retinal vein occlusions
Focal laser may used to treat diabetic macular edema
Laser Barricade is used to treat retinal tears and small localized retinal detachments
The purpose of PPR is to treat the formation of abnormal new blood vessels. These abnormal blood vessels initially cause no symptoms. As they grow, they eventually causing bleeding inside the eye, and subsequent vision loss. They may also cause glaucoma, sometimes requiring glacuoma surgery.
PRP has been demonstrated to decrease the risk of severe vision loss as a result of proliferative diabetic retinopathy (new blood vessel growth due to diabetes) by 50%. PRP is typically performed in 1-2 sessions.
The alternative to PRP is to undergo treatment with intravitreal injections.Patients who undergo treatment with intravitreal injections require more frequent treatment and monitoring. The average patient requires 19 injections over a 5 year period of time.
Delaying treatment for weeks to months will often lead to irreversible vision loss.
PRP is performed in the office under topical anesthesia. Occasionally, the treating physician may recommend additional local anesthesia. The procedure may be performed either at a slit lamp or with a laser indirect ophthalmoscope (headset with a laser attached to it). A painless lens will be placed gently on the eye if the procedure is performed at the slit lamp.
The patient will be asked to look in a particular direction. The physician will apply laser spots to the desired areas of the retina.
Patients will notice flashes of light and a mild-moderate burning sensation associated with each laser spot. The procedure may take anywhere from 5-20 minutes, and may need to be repeated 1-2 times.
Many patients find it helpful to take a tylenol prior to the procedure.
The vision will be dark followed by different colors for a few minutes after the procedure, but thereafter, the central vision should return near normal. There may be a slight blurriness, which typically resolves after any remaining gel from the contact lens is rinsed out. The eye is typically sore for approximately 1-2 days. Tylenol may help with any discomfort. Artificial tears may be useful for any irritation of the front of the eye. Sensitivity to light is common, and it may be helpful to use sunglasses when outside.
PRP is known to cause a decrease in the peripheral vision as well as prolong the time needed to adapt to a dark environment. That being said, most patients do not notice any change in vision. This procedure is only recommended in patients who have sight-threatening eye conditions, which if untreated, would lead to blindness and possible loss of the eye.
The purpose of focal laser is to apply laser therapy to the sources of retinal edema (leakage). The laser typically acts over a period of several months to slowly decrease the amount of leakage from these areas. This therapy is useful when the source of edema is far away from the area of central vision. If the source of edema is close to the central vision then intravitreal injections are recommended.
Focal laser is performed in the office under topical anesthesia. The procedure is performed at a slit lamp.. A painless lens is placed gently on the eye.
The patient will be asked to look in a particular direction with the other eye and be very careful not to move the eye. The physician then applies small laser spots to pre-determined areas of the retina.
Patients will notice flashes of light and potentially a mild stinging sensation with each laser spot. The procedure typically takes less than 5 minutes. This procedure may be repeated.
The vision will be dark followed by different colors for a few minutes after the procedure, but thereafter, the central vision should return to near normal. There may be a slight blurriness, which typically resolves after any remaining gel from the contact lens is rinsed out.
Focal laser may cause a mild blurring just outside the central vision, but nearly all patients do not notice any such symptoms. There may be a mild discomfort after the procedure. Tylenol is helpful for pain. Artificial tears are helpful if there is irritation to the front of the eye.
The purpose of a retinal tear is to prevent the formation of a retinal detachment. Retinal detachments are a much more serious condition which are most commonly fixed in the operating room.
A retinal tear refers to a full thickness hole in the retina. This hole allows fluid to traverse underneath it, lifting up the retina like the wallpaper coming off of a wall.
Laser therapy may be applied around the tear. This creates a very tight adhesion between the retina and back wall of the eye, preventing fluid from detaching the retina.
Laser laser is performed in the office under topical anesthesia. The procedure may be performed with either the slit lamp or with a laser indirect ophthalmoscope (see photo on the right).
The patient will be asked to look in a particular direction with the other eye and be very careful not to move the eye. The physician then applies laser spots around the retinal tear.
Patients will notice flashes of light and potentially a mild stinging sensation with the laser spot. The procedure generally takes between 5 and 15 minutes.
The vision will be dark followed by different colors for a few minutes after the procedure, but thereafter, the central vision should return to near normal. There may be a slight blurriness, which typically resolves after any remaining gel from the contact lens is rinsed out.
Laser barricade will not cause any decrease in floaters. Very extensive laser may cause a mild decrease in peripheral vision, but nearly all patients have no symptoms.
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