Panretinal Photocoagulation (PRP)

What You Need to Know

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.Β 

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.Β 

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.

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