Retinal laser: an expert's guide

Written by: Mrs Samantha Mann
Published:
Edited by: Conor Dunworth

Several different types of retinal lasers are used to treat various retinal conditions. In her latest article, renowned ophthalmologist Mrs Samantha Mann explains the most common reasons people undergo this procedure as well as what the procedure entails.

 

When is retinal laser indicated? What conditions can it treat?

Several different lasers are used in ophthalmology. One of these types is the retinal laser, which is used to treat conditions such as diabetes, vein occlusions or macroaneurysms. They are also used to treat retinal tears.

If someone with diabetes starts to suffer from leaking blood vessels at the back of the eye or some swelling, focal laser treatment can be very effective.

If the blood supply in the periphery part of the retina starts to fail, which results in the growth of abnormal blood vessels on the retina or iris, we often perform a more extensive laser treatment called pan-retinal photocoagulation.

 

How is the laser treatment performed? What effect does it have on the retina?

Most laser treatments are relatively straightforward. After you’ve had your vision checked, and your eyes have been dilated with drops, your doctor will put in some numbing drops and a special lens to stop you from blinking. A bright light will then be shone into the eye, and you will hear a beeping noise. This is the laser being delivered.

If you are having a focal laser treatment for diabetes or a retinal tear, it is usually quick and simple and not painful at all. The laser helps to seal off the leaking blood vessels and has a very long-term effect. It is important to stay very still so that the doctor doesn’t laser the wrong part of the eye.

If you need to have the more extensive pan-retinal laser photocoagulation, it can be a little bit more uncomfortable, especially if we’re lasering around the periphery of the retina.

 

This laser can help to prevent the further growth of abnormal blood vessels, which can bleed into the eye.

 

How many sessions or treatments are usually needed?

This depends on the type of laser you are having. It can usually be done in one session. However, if you need a more extensive pan-retinal photocoagulation laser, it will usually need to be delivered in two or three sessions, about two or three weeks apart.

 

What are the side effects and possible risks involved?

The risks are very low with laser treatment. There is no risk of infection. You may feel dazzled, but this goes away in a few minutes. You will need to keep very still, to allow the doctor to treat the correct part of the eye. If you need to get the pan-retinal laser, this can be slightly uncomfortable at the time of the laser. We usually ask the patient to take a few simple painkillers in the morning and just before the start of the treatment, but most people can tolerate the pain really well.

However, it can affect your night vision and peripheral vision if you need to have extensive laser treatment. However, this laser treatment is very effective at protecting your vision in the long term, and can reduce the risk of bleeding from abnormal blood vessels in the back of the eye. This can lead to blindness if left untreated.

 

How long is recovery?

The recovery depends on the type of laser you have. Focal laser treatment or lasering a retinal tear only takes a few minutes to recover from. The dazzling usually fades after a few minutes. However, the PRP laser can take a bit longer. For 24 hours, you may have a few visual disturbances or flashing lights, and sometime you may suffer from a headache., However, you should be back to normal after a couple of days. If you have any side effects that last longer, you must contact your doctor.

The effect of the laser can last for several months, and it can take quite a long time for it to have its maximum effect. You may need to undergo a second laser treatment after this time, especially if the retinal problem recurs. It is safe to undergo the treatment again after about 4 months and can be repeated several times.

 

Mrs Samantha Mann is a highly-renowned consultant ophthalmologist based in London. If you would like to book a consultation with Mrs Mann you can do so today via her Top Doctors profile

By Mrs Samantha Mann
Ophthalmology

Mrs Samantha Mann is a leading consultant ophthalmologist specialising in medical retina who treats patients from in and around London. With over 25 years of experience, she is highly specialised in the treatment of conditions affecting the retina such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and central serous retinopathy. Additionally, Mrs Mann is an expert in intravitreal injections of both anti-VEGF agents and steroid implants and retinal laser treatments.   
  
In 1996, Mrs Mann qualified as a doctor from St Bartholomew’s hospital in London with distinction and first-class honours in her intercalated BSc. She then gained general medical experience as she trained in various London hospitals before pursuing a career in ophthalmology. Part of her ophthalmic rotation was spent at St Thomas’ hospital after which she spent five years as a specialist registrar and fellow at Moorfield’s Eye Hospital, during which she completed and was awarded an MD for her research into age-related macular degeneration. She was also awarded the Harcourt Medal by the Royal College of Ophthalmologists in 2001 for her performance in her final examinations. 
  
Mrs Mann is currently a consultant ophthalmologist at her NHS base, Guy’s and St Thomas’ Hospital, where she has practised since 2009. Here, she is one of three medical retinal consultants. Privately, she sees patients at the renowned London Medical Clinic. Furthermore, she is the clinical lead for South East London’s Diabetic Eye Screening Programme, which is responsible for over 120,000 patients with diabetes. She also led the production of a video entitled ‘Danny’s Story’ emphasising the importance of eye screening for patients with diabetes. 
  
In addition to her clinical work, Mrs Mann maintains a keen research interest, particularly in age-related macular disease and diabetic eye screening. She has authored numerous peer-reviewed papers. Currently, she is the principal investigator of Thomas’ Hospital’s PINNACLE study, having previously held the role in two vein occlusion treatment trials. Over the last 10 years she has had an active role in teaching and running courses for trainees and other health professionals on diabetic retinopathy, laser for diabetes, and on the progression of retinopathy in pregnancy.  She is also a Fellow of the Royal College of Ophthalmologists.   

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